Infusion duration

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Alfentanil The curve rises from the origin until reaching a CSHT of 50 min at around 2 h of infusion. Thereafter the curve becomes horizontal. This demonstrates that alfentanil is also context insensitive for infusion durations of 2 h or longer. 

Thiopental The curve begins at the origin but rises more steeply than the others so that the CSHT is 50 min after only 30 min infusion duration. The curve should be drawn like a slightly slurred build-up exponential reaching a CSHT of 150 min after 8h of infusion. As the CSHT continues to rise, thiopental does not become context insensitive. 

Continuous iV infusion For continued reduction of the heart rate (up to 24 hours) in patients with atrial fibrillation or atrial flutter, an IV infusion may be administered. Immediately following bolus administration of 20 mg (0.25 mg/kg) or 25 mg (0.35 mg/kg) and reduction of heart rate, begin an IV infusion. The recommended initial infusion rate is 10 mg/h. Some patients may maintain response to an initial rate of 5 mg/h. The infusion rate may be increased in 5 mg/h increments up to 15 mg/h as needed, if further reduction in heart rate is required. The infusion may be maintained for up to 24 hours. Therefore, infusion duration more than 24 hours and infusion rates more than 15 mg/h are not recommended. 

Temporary control of rapid ventricular rate in atrial flBrillation or flutter, rapid conversion of paroxysmal supraventricular tachycardia to normal sinus rhythm IV push Initially, 0.25 mg/kg actual body weight over 2 min. May repeat in 15 min at dose of 0.35 mg/kg actual body weight. Subsequent doses individualized. IV Infusion / fter initial bolus injection, may begin infusion at 5-10 mg/hr may increase by 5 mg/hr up to a maximum of 15 mg/hr. Infusion duration should not exceed 24 hr. 

Currently, cetuximab (Erbitux ) is indicated for the treatment of patients with EGFR-expressing metastatic colorectal cancer after failure of irinotecan-including cytotoxic therapy. Depending on the country, cetuximab is approved in combination with irinotecan or in addition as monotherapy. The approved dosing regimen consists of an initial dose of 400 mg/m2 body surface area (BSA), followed by weekly doses of 250 mg/m2. The (intravenous IV) infusion durations are 2 h for the initial infusion, and 1 h for the subsequent weekly infusions. 

This expression is obtained by reporting (9.16) and (9.19) into (9.10). Using the numerical inverse Laplace transform and k = 2h-1, A = lh-1, u>e = 0.8, and f.i= 1,4, 6, Figure 9.14 illustrates the p (t) time profiles for a 6-h constant-rate infusion. This figure takes into account the infusion duration, whereas Figure 9.10 considers that all molecules are in compartment 1 at initial times. ... 

Balster RL Schuster CR (1973b) Fixed-interval schedule of cocaine reinforcement effect of dose and infusion duration. Exp Anal Behav 20 119-129. 

In a study of 32 patients, 84% of those who received paclitaxel developed hypersensitivity reactions characterized by hypotension, respiratory distress, and urticaria (35). These symptoms further confirm that histamine is likely to be the cause of the reaction. The majority of reactions (53%) occurred within 2-3.minutes after the administration of paclitaxel and 78% within 10 minutes. There was one fatal reaction, characterized by hypotension and asystole. Most reactions to paclitaxel occurred after the first or second dose, and hypersensitivity reactions were more common with shorter infusion schedules. Since the duration of the infusion affected the incidence of hypersensitivity reactions, an extension of the infusion duration was investigated. Longer infusion schedules were associated with a reduced incidence of hypersensitivity reactions, the frequency of severe reactions being reduced from 12% or more to 5% with longer infusion times (5,15,49). 

In one study of infusion of doses of 175-275 mg/m over 6 hours without premedication, there was only one hypersensitivity reaction in 32 patients (49), while patients who received paclitaxel administered over 1 hour with premedication developed no serious hypersensitivity reactions (37). There were no hypersensitivity reactions in 40 patients who received fractionated doses of paclitaxel administered over 3-5 days, with cumulative doses of 120-250 mg/m (36). In a randomized comparison of two doses of paclitaxel given by 3-hour or 24-hour infusions, premedication alone was sufficient to prevent hypersensitivity reactions with either infusion duration (29). 

T. Kerbusch, R. A. Mathot, H. J. Keizer, G. P. Kaijser, J. H. ScheUens, and J. FI. Beijnen, Influence of dose and infusion duration on pharmacokinetics of ifosfamide and metabolites. Drug Metab Dispos 29 967-975 (2001). 

Similar to that of cytarabine, conversion of gemcitabine to dFdCMP by deoxycytidine kinase is saturated at infusion rates of approximately 10 mg/m per minute, which produce plasma drug concentrations in the range of 15 to 20 pM. In an attempt to increase dFdCTP formation, the duration of infusion at this maximum concentration has been extended to 150 minutes. In contrast to a fixed infusion duration of 30 minutes, the 150-minute infusion produces a higher level of dFdCTP within peripheral blood mononuclear cells and increases the degree of myelosuppression, but has uncertain effects on antitumor activity. 

Intravenous itraconazole has all the adverse effects of capsules but generally is well tolerated. Due to chemical phlebitis, a dedicated catheter port is required, and infusion durations <1 hour are not recommended. The intravenous formulation is contraindicated in patients with a creatinine clearance <30 mUmin. 

The maximum recommended dose for the treatment of hypercalcemia of malignancy is 4 mg. A clinically significant deterioration in renal function occurs when single doses of this agent exceed 4 mg and the infusion duration is less than 15 minutes (52). It is recommended that patients be well hydrated before infusion. If serum calcium levels do not fall to normal levels, retreatment is appropriate, but retreatment is not recommended until 7 days have elapsed from the initial treatment. For the treatment of multiple myeloma and metastatic bone lesions, a 4-mg initial dose is recommended, followed by additional doses every 3 to 4 weeks for 9 to 15 months (prostate cancer, 15 months breast cancer, 12 months other solid tumors, 9 months). 

Zolendronic acid should not be mixed with infusion solutions that contain calcium (e.g., lactated Ringer s) and should be administered via IV infusion in its own line. Because of the possibility of a serious deterioration in renal function, the manufacturer requires strict adherence to the infusion duration being no less than 15 minutes. 

A right atrial catheter has to be placed in the recipient of hematopoietic transplantation. The collected cells are infused freshly, or after rapid thawing in autologous or cord blood transplantation. Infusion duration is variable, from minutes to more than 1 h, depending on the volume to be administered. Vitals have to be monitored every 10-15 min. The main complications of cell infusion are chills, fluid overload and, infrequently, fat emboli in the lungs. 

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