Pharmacokinetic modeling of the high-dose bolus regimen of tirofiban in patients with severe renal impairment
Bibliographic record
Abstract
For the treatment of patients with acute coronary syndromes in the catheterization laboratory, a high-dose bolus (HDB) regimen of tirofiban (25 µg/kg bolus, followed by an infusion of 0.15 µg/kg/min) leads to a consistent and rapid inhibition of platelet aggregation during the first hour after initiation of therapy. The objective of the present study was to use pharmacokinetic modeling to identify an appropriate dosage of tirofiban that would produce a plasma concentration-time profile in patients with severe renal impairment (creatinine clearance<30 ml/min) as similar as possible to that of the HDB regimen in patients with normal renal function. For patients with severe renal impairment, previous recommendations have been to reduce the dosage by 50%. Pharmacokinetic modeling was performed with the following sets of data: the plasma concentrations of tirofiban from patients with normal renal function who were treated with the HDB regimen of tirofiban and the plasma concentrations of tirofiban from patients with severe renal impairment who were treated with a 0.1 µg/kg/min infusion of tirofiban for 1 h. In conclusion, for patients with severe renal impairment, a 25 µg/kg bolus, followed by a 0.10 µg/kg/min maintenance infusion of tirofiban produced a plasma concentration-time profile similar to that observed with the HDB regimen of tirofiban in patients with normal renal function.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".