Therapeutic Drug Monitoring of Pregabalin in a critically ill patient
with Acute Kidney Injury undergoing Continuous, Prolonged Intermittent,
and Intermittent Kidney Replacement Therapy modalities
Abstract
Pregabalin is an anti-epileptic drug which also represents one of the
most frequently prescribed medications for neuropathic pain management
worldwide. Moreover, in recent years its use has widely increased also
in critically ill patients in the setting of multimodal analgesia.
Commonly available as capsules and oral solution, it is characterized by
a predominant kidney elimination. Consequently, in patients with kidney
failure posology adjustments are needed. According to the
pharmacokinetic parameters (low molecular weight and volume of
distribution, negligible protein binding), pregabalin is expected to
undergo a significant extracorporeal clearance, which should be taken
into account when one of the different Kidney Replacement Therapy (KRT)
modalities is required for Acute Kidney Injury (AKI). The case of a
critically ill patient with AKI undergoing Therapeutic Drug Monitoring
of Pregabalin in course of Continuous, Prolonged Intermittent KRT (CKRT
and PIKRT, respectively), and conventional intermittent hemodialysis
(IHD) is presented here for the first time.