Neal H Shorstein1, Susanne Gardner2. 1. Kaiser Permanente, Walnut Creek, California, USA. Electronic address: neal.shorstein@gmail.com. 2. Alatheia Strategics, LLC, Atlanta, Georgia, USA.
Abstract
PURPOSE: To test the effect of injection volume and concentration on dosing and residence time of moxifloxacin in the anterior chamber (AC). SETTING: Kaiser Permanente, Walnut Creek, California, USA. DESIGN: Experimental study. METHODS: Moxifloxacin 0.5%/0.05 mL, moxifloxacin 0.5%/0.10 mL, and moxifloxacin 0.15%/0.50 mL were drawn into 5 1.0 mL syringes each, injected into tared vials, and weighed. The doses delivered were calculated. The AC concentrations and elimination rates of the drug for two AC volumes were modeled for each dosing method. RESULTS: The 0.05 mL injection volume resulted in the greatest range (35 μg) of delivered dose compared with larger injection volumes (≤25 μg). The mathematical model predicted that variation in dosing in each group would result in differences of 12 minutes or less for the presence of the drug in the AC. Injection of 0.5%/0.1 mL produced AC concentrations above 500 μg/mL for 1.9 to 3.0 hours and above 64 μg/mL for 5.5 to 6.5 hours, depending on the AC volume; however, flushing with a 0.15% concentration sustained AC levels for 1.9 hours and 5.5 hours, respectively, for the two AC volumes. CONCLUSIONS: Smaller injection volumes of a higher concentration moxifloxacin resulted in less accuracy and less precision in the delivered dose (0.05 mL, P = .005; 0.10 mL, P = .03); however, the clinical significance of this might vary. Injection of 0.5%/0.1 mL and flushing with 0.15%/0.5 mL of moxifloxacin would provide similar drug AC residence times according to the model. Flushing provided more consistent AC concentrations with differing AC volumes.
PURPOSE: To test the effect of injection volume and concentration on dosing and residence time of moxifloxacin in the anterior chamber (AC). SETTING: Kaiser Permanente, Walnut Creek, California, USA. DESIGN: Experimental study. METHODS:Moxifloxacin 0.5%/0.05 mL, moxifloxacin 0.5%/0.10 mL, and moxifloxacin 0.15%/0.50 mL were drawn into 5 1.0 mL syringes each, injected into tared vials, and weighed. The doses delivered were calculated. The AC concentrations and elimination rates of the drug for two AC volumes were modeled for each dosing method. RESULTS: The 0.05 mL injection volume resulted in the greatest range (35 μg) of delivered dose compared with larger injection volumes (≤25 μg). The mathematical model predicted that variation in dosing in each group would result in differences of 12 minutes or less for the presence of the drug in the AC. Injection of 0.5%/0.1 mL produced AC concentrations above 500 μg/mL for 1.9 to 3.0 hours and above 64 μg/mL for 5.5 to 6.5 hours, depending on the AC volume; however, flushing with a 0.15% concentration sustained AC levels for 1.9 hours and 5.5 hours, respectively, for the two AC volumes. CONCLUSIONS: Smaller injection volumes of a higher concentration moxifloxacin resulted in less accuracy and less precision in the delivered dose (0.05 mL, P = .005; 0.10 mL, P = .03); however, the clinical significance of this might vary. Injection of 0.5%/0.1 mL and flushing with 0.15%/0.5 mL of moxifloxacin would provide similar drug AC residence times according to the model. Flushing provided more consistent AC concentrations with differing AC volumes.
Authors: Emily W Gower; Lisa J Keay; Dianne E Stare; Pallavi Arora; Sandra D Cassard; Ashley Behrens; James M Tielsch; Oliver D Schein Journal: Ophthalmology Date: 2015-06-02 Impact factor: 12.079
Authors: Mathias V Melega; Monica Alves; Rodrigo Pessoa Cavalcanti Lira; Iuri Cardoso da Silva; Bruna Gil Ferreira; Hermano Lg Assis Filho; Fernando Rodrigo Pedreira Chaves; Alexandre A F Martini; Livia Maria Dias Freire; Roberto Dos Reis; Carlos Eduardo Leite Arieta Journal: J Cataract Refract Surg Date: 2019-01-25 Impact factor: 3.351