How to determine the starting dose and drug concentration when initiating intrathecal therapy

How to determine the starting dose and drug concentration when initiating intrathecal therapy?

The factors to consider when initiating intrathecal therapy in a patient include patient-related factors (e.g., reactions to systemic medications, medical comorbidities) and device-related factors. Conservative dosing regimens should be used for patients with multiple and/or severe comorbidities. All drug delivery systems have a finite volume and delivery rate; some systems have rates that can be adjusted. Drug reservoir volume, drug delivery rate, and drug dose are the device-related factors to consider when formulating intrathecal drugs to be administered to the patient. For example, with a 20-mL pump reservoir volume, a delivery rate of 0.5 mL/day will produce a reservoir refill interval of approximately 40 days compared to a delivery rate of 1 mL that will require a refill of approximately 20 days. Higher delivery rates will negatively impact the life span of intrathecal systems that rely on battery-powered modes of delivery. Ideally, the drug should be delivered at a rate of between 0.25 mL/day and 0.5 mL/day to maximize efficacy, system life-span, and patient convenience. When a desired drug dose is determined (typically measured as dose/day), a delivery rate is chosen, and these two will dictate the drug concentration to be formulated to fill the pump reservoir.

15585

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information

15856
Scroll to Top