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This can be accomplished by the use of unbound concentrations obtained from plasma and brain, with subsequent advanced mathematical modeling.
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Use of unbound piperacillin concentrations in the PK model may also have contributed to the higher Vd observed, although use of free concentrations is essential to describe the pharmacologically active fraction of piperacillin.
Intracerebral microdialysis was used to measure unbound concentrations of cefadroxil in rat blood, striatum extracellular fluid (ECF) and lateral ventricle cerebrospinal fluid (CSF).
The extraction fractions (4 mm probe, 13 ± 1.4%; 1 mm probe, 8.4 ± 2.6%) were used to calculate unbound concentrations in ECF and CSF from microdialysate concentrations.
Moreover, its design should allow the determination of the unbound concentrations of other hydrophobic drugs.
Next, we used intracerebral microdialysis to determine unbound concentrations of quinidine in brain extracellular fluid (ECF) and cerebrospinal fluid (CSF) from 0 to 240 min after intravenous quinidine administration at ZT8 (resting period) and ZT20 (active period of the animals).
Data were then linearized as a function of unbound DNA concentration and fitted using the second order rate equation (eq 3), where A0 and At are the initial and final unbound DNA concentrations, respectively.
Clinically-relevant (achievable) unbound concentrations of each antibiotic in blood or tissues were used.
In vivo, the unbound concentrations of lopinavir and ritonavir are only 1 2% of the total amount in plasma.
The unbound fraction of darunavir was calculated as the ratio of the unbound concentration in the filtrate to the total concentration in the plasma before centrifugation.
Furthermore, maximal clinically-achievable unbound concentrations of antibiotics were employed to mimic the in vivo killing effect when maximum antibiotic doses were used, allowing better clinical extrapolation of the results.
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