Depression in Children: Defining the Therapeutic Range for Imipramine

1989 ◽  
pp. 343-346
Author(s):  
S. H. Preskorn ◽  
E. Weller ◽  
C. Hughes ◽  
R. Weller
Keyword(s):  
Therapeutic Range

Predicting the Dose of Warfarin for Therapeutic Anticoagulation

1982 ◽  
Vol 47 (03) ◽  
pp. 230-231 ◽  
Author(s):  
N K Sharma ◽  
P A Routledge ◽  
M D Rawlins ◽  
D M Davies
Keyword(s):  
Therapeutic Range ◽  
Significant Relationship ◽  
Maintenance Dose ◽  
Warfarin Dose ◽  
Loading Dose ◽  
Intravenous Injections ◽  
Therapeutic Anticoagulation ◽  
Close Relationship ◽  
The Relationship ◽  
Anticoagulant Response

SummaryThe validity of a previously described technique for predicting warfarin requirements based on the anticoagulant response to a fixed loading dose was assessed prospectively in 57 patients. There was a close relationship between the predicted and initially observed daily warfarin dose required to maintain the patient within the therapeutic range for anticoagulation. The significant relationship between predicted and observed maintenance dose persisted at 4 and 12 weeks although it decreased with increasing time.The relationship between observed and predicted maintenance requirement of warfarin was not affected by the concomitant use of intermittent intravenous injections of heparin when 9 hr was allowed to elapse between the previous dose of heparin and the thrombotest estimation on which the prediction was based.It is concluded that the method is valuable in predicting an individual’s warfarin requirement, although it does not obviate the need for regular monitoring of anticoagulant control.

Use of SAMe-TT₂R₂ Score to Predict the Quality of Anticoagulation Control in Patients with Atrial Fibrillation Receiving Warfarin in Thailand

2020 ◽  
Vol 103 (6) ◽  
pp. 548-552
Keyword(s):  
Atrial Fibrillation ◽  
Therapeutic Range ◽  
Statistical Significance ◽  
Discrimination Performance ◽  
Poor Quality ◽  
Chi Square ◽  
Exact Test ◽  
Time In Therapeutic Range ◽  
Anticoagulation Control

Objective: To predict the quality of anticoagulation control in patients with atrial fibrillation (AF) receiving warfarin in Thailand. Materials and Methods: The present study retrospectively recruited Thai AF patients receiving warfarin for three months or longer between June 2012 and December 2017 in Central Chest Institute of Thailand. The patients were classified into those with SAMe-TT₂R₂ of 2 or less, and 3 or more. The Chi-square test or Fisher’s exact test was used to compare the proportion of the patients with poor time in therapeutic range (TTR) between the two groups of SAMe-TT₂R₂ score. The discrimination performance of SAMe-TT₂R₂ score was demonstrated with c-statistics. Results: Ninety AF patients were enrolled. An average age was 69.89±10.04 years. Most patients were persistent AF. An average CHA₂DS₂-VASc, SAMe-TT₂R₂, and HAS-BLED score were 3.68±1.51, 3.26±0.88, and 1.98±0.85, respectively. The present study showed the increased proportion of AF patients with poor TTR with higher SAMe-TT₂R₂ score. The AF patients with SAMe-TT₂R₂ score of 3 or more had a larger proportion of patients with poor TTR than those with SAMe-TT₂R₂ score of 2 or less with statistical significance when TTR was below 70% (p=0.03) and 65% (p=0.04), respectively. The discrimination performance of SAMe-TT₂R₂ score was demonstrated with c-statistics of 0.60, 0.59, and 0.55 when TTR was below 70%, 65% and 60%, respectively. Conclusion: Thai AF patients receiving warfarin had a larger proportion of patients with poor TTR when the SAMe-TT₂R₂ score was higher. The score of 3 or more could predict poor quality of anticoagulation control in those patients. Keywords: Time in therapeutic range, Poor quality of anticoagulation control, Warfarin, SAMe-TT₂R₂, Labile INR

Benefits and Limits of Antiretroviral Drug Monitoring in Routine Practice

2019 ◽  
Vol 17 (3) ◽  
pp. 190-197
Author(s):  
Thomas Maitre ◽  
Patrice Muret ◽  
Mathieu Blot ◽  
Anne Waldner ◽  
Michel Duong ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Therapeutic Range ◽  
Drug Monitoring ◽  
Antiretroviral Treatment ◽  
University Hospital ◽  
Therapeutic Drug ◽  
Routine Practice ◽  
Hiv Viral Load ◽  
Measured Concentration ◽  
The University

Background: HIV infection is a chronic disease for which therapeutic adherence and tolerance require particular attention. Objective: This study aimed to assess whether and when therapeutic drug monitoring (TDM) could be associated with a benefit in routine practice. Methods: All HIV-infected patients who underwent at least one TDM at the University Hospital of Dijon (France) between 1st January 2009 and 31st December 2012 were retrospectively included. Compliance with the recommendations, the results (antiretroviral concentrations), any subsequent therapeutic modifications, and the virological results at 4-8 months were analysed each time TDM was performed. TDM was defined as “practically relevant” when low or high antiretroviral concentrations led to a change in therapy. Results: Of the 571 patients who followed-up, 43.4% underwent TDM. TDM complying with recommendations (120 patients) was associated with a higher proportion of antiretroviral concentrations outside the therapeutic range (p=0.03). Antiretroviral treatment was modified after TDM in 22.6% of patients. Protease inhibitors, non-nucleoside reverse transcriptase inhibitors and raltegravir were more significantly modified when the measured concentration was outside the therapeutic range (p=0.008, p=0.05 and p=0.02, respectively). Overall, 11.7% of TDM was considered “practically relevant”, though there was no significant correlation between subsequent changes in antiretroviral treatment and undetectable final HIV viral load. Conclusions: TDM may be a useful tool in the management of HIV infection in specific situations, but the overall benefit seems moderate in routine practice. TDM cannot be systematic and/or a decision tool per se, but should be included in a comprehensive approach in certain clinical situations.

COMPUTER PREDICTION OF ANTICOAGULATION STATUS AND WARFARIN DOSE FOLLOWING CARDIAC SURGERY

1987 ◽  
Author(s):  
M J Crow ◽  
A B Latif ◽  
A I Critchley ◽  
C Stainton ◽  
P Nealon ◽  
...  
Keyword(s):  
Therapeutic Range ◽  
Maintenance Dose ◽  
Prosthetic Heart Valve ◽  
Warfarin Dose ◽  
Study Data ◽  
Computer Prediction ◽  
Prothrombin Activity ◽  
Upper Limit ◽  
Post Operative Period ◽  
Post Operation

Fluctuations are freguently seen in the anticoagulant status of patients in the immediate post operative period following prosthetic heart valve replacement. These patients are at high risk of haemorrhage or thromboembolism. We have used a pharmokinetic model of warfarin metabolism to develop a computer programme to predict the maintenance dose of warfarin from early prothrombin activity determinations. This will enable controlled anticoagulation to be achieved. The expression for warfarin kinetics employs 4 constants determined by the residual sum of the sguares, which are used immediately to redefine dosage predictions. In a pilot study data obtained from 16 patients post operation 3, 5 and 7 days after commencing treatment, has been used to predict the reguired maintenance dose at 21 days. These predicted doses were then compared with the maintenance dose achieved by clinical practice. The programme was told to optimise its dose to achieve a PT ratio of 3 whereas clinically the ratio was allowed to vary in the therapeutic range of 2 to 4. Predicted doses at 21 days are shown.in the table:Correlation between predicted and clinical maintenance doses after 3 and 5 days treatment was poor but had improved significantly by 7 days, despite similar levels of prothrombin activity. Predicted prothrombin activity never exceeded the upper limit of the therapeutic range, and the predicted dose can be uprated on addition of further data within 2 minutes.After 7 days computer predicted warfarin dose has produced a good correlation with the clinical maintenance dose (the doses of only 3 patients varying by more than 1 mg/day). The significant fluctuations seen in the prothrombin ratio during clinical dosage were not observed with computer dosing and we now feel it is safe to use this programme to anticoagulate patients post operatively.

Tacrolimus time‐in‐therapeutic range is associated with freedom from acute rejection and graft failure following intestinal transplantation

2021 ◽  
Author(s):  
Andrew D. Santeusanio ◽  
Alan Gu ◽  
Alan D. Weinberg ◽  
Jang Moon ◽  
Kishore R. Iyer
Keyword(s):  
Acute Rejection ◽  
Therapeutic Range ◽  
Graft Failure ◽  
Intestinal Transplantation ◽  
Time In Therapeutic Range

scholarly journals Health-related quality of life correlates with time in therapeutic range in children on anticoagulants with International Normalised Ratio self-monitoring

2020 ◽  
Vol 113 (12) ◽  
pp. 811-820
Author(s):  
Hamouda Abassi ◽  
Fanny Bajolle ◽  
Oscar Werner ◽  
Annie Auer ◽  
Amandine Marquina ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Therapeutic Range ◽  
Health Related Quality ◽  
Self Monitoring ◽  
Time In Therapeutic Range ◽  
International Normalised Ratio ◽  
Related Quality ◽  
Health Related

scholarly journals Health-related quality of life correlates with time in therapeutic range in children under anticoagulants with INR self-monitoring

2019 ◽  
Vol 11 (4) ◽  
pp. e394
Author(s):  
Hamouda Abassi ◽  
Fanny Bajolle ◽  
Oscar Werner ◽  
Annie Auer ◽  
Amandine Marquina ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Therapeutic Range ◽  
Health Related Quality ◽  
Self Monitoring ◽  
Time In Therapeutic Range ◽  
Related Quality ◽  
Health Related
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