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Kayhan and Akgüneş 2037 Table 1. Comparison of median serum concentration at 2 h after medication administration as estimate of peak serum concentration levels and expected range, therapeutic drug monitoring. Medication Median serum concentration (µg/ml) Expected serum concentration range (µg/ml) Isoniazid (daily 300 mg) 3.83 ± 2.09 3-6 Rifampicin (daily 600 mg) 6.13 ± 4.27 8-24 Ethambutol (weight adjusted) 3.68 ± 2.41 2-6 Pyrazinamide (weight adjusted) 32.20 ± 16.96 20-50 Table 2. Study variables and their correlation with drug serum concentrations (µg/ml). Variable Means± SD or n Test used Age (years) 41.51±16.90 PC Analysis INH result p = 0.160 r = -0.204 Analysis RIF result p = 0.193 r = -0.189 Analysis EMB result p = 0.726 r = 0.051 Analysis PZA result p = 0.106 r = -0.234 Sex (males/females) 31/18 IST p = 0.005 p = 0.000 p = 0.570 p = 0.002 Body mass index (kg/m 2 ) 22.50±4.34 PC p = 0.006 r = 0.390 p = 0.935 r = -0.012 p = 0.317 r = 0.146 p = 0.139 r = -0.214 Smoking status smoker/ nonsmoker IST p = 0.532 p = 0.004 p = 0.551 p = 0.391 'Drug dose(mg/kg) Isoniazid 4.49±1.14 Rifampicin 9.92±2.21 Ethambutol 24.16±5.15 Pyrazinamide 28.98±8.65 Serum Albumin (g/dl) 3.87±0.54 PC Heamoglobin 12.60±1.51 PC PC p = 0.000 r = 0.487 p = 0.303 r = -0.150 p = 0.303 r = -0.150 p = 0.039 r = 0.295 p = 0.734 r = -0.012 p = 0.083 r = -0250 Creatinine clearence* 118.73±37.08 PC - - p = 0.827 r = -0.155 p = 0.889 r = 0.020 p = 0.581 r = 0.081 p = 0.816 r = 0.034 p = 0.005 r = 0.395 p = 0.550 r = -0.087 p = 0.005 r = -0.203 *By Cockcroft-Gault equation: in men= (140-age) × (weight in kg)/ (72 × serum creatinine) and in women = 0.85 × (140-age) × (weight in kg)/(72 × serum creatinine) used for ethambutol; PC = Pearson correlation; IST = Independent samples T-test. significantly associated with drug dose (mg/kg) (p = 0.000) and there was a correlation between these two variables (r = 0.487). 2 h INH concentration was not associated with age, serum albumin, smoking status and heamoglobin levels (Table 2). Serum RIF concentration The mean serum concentration of RIF was 6.13 ± 4.27 µg/ml and the mean RIF dose was 9.92 ± 2.21 mg/kg (Tables 1 and 2; Figure 3). The prevalance of a low 2 h RIF concentration was 75.5% (37/49) in this study (Figure 1) . RIF concentrations did not reach to therapeutic levels at 6 h in these patients. 2 h RIF concentration showed difference according to sex (p = 0.000). The mean RIF concentration of males (4.23 µg/ml) was lower than females (9.41 µg/ml). By Independent samples T-test analysis, 2 h RIF concentration was found to be associated with cigarette smoking (p = 0.004). The mean serum RIF level of smokers (4.50 µg/ml) was lower than non-smokers (7.50 µg/ml). 2 h RIF serum concentration was not associated with the other variables (age, body mass index, serum albumin, drug dose (mg/kg) and -
2038 Afr. J. Pharm. Pharmacol. PYRAZINAMIDE ETHAMBUTOL RIFAMPICIN ISONIAZID 20.4% 18.4% 28.6% 75.5% 61.2% 65.3% 55.1% 18.4% 16.3% 24.5% 16.3% 0 100 Figure 1. Results of serum concentration 2 h after oral drug administration levels of antituberculosis medications . Frequencies(%) are reported for low, within target (therapeutic), and high levels corresponding to levels below, within, or above the expected range for each medication. Figure 2. Isoniazid(INH) serum levels of each patient (low
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African Journal of Pharmacy and Pha
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Editors Sharmilah Pamela Seetulsing
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