The relevance of therapeutic drug monitoring in plasma and erythrocytes in anti-cancer drug treatment

2004 ◽  
Vol 42 (11) ◽  
Author(s):  
Herlinde Dumez ◽  
Gunther Guetens ◽  
Gert De Boeck ◽  
Martin S. Highley ◽  
Robert A. A. Maes ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Drug Transport ◽  
Free Fraction ◽  
The Body ◽  
Cancer Drug ◽  
Therapeutic Drug ◽  
Anti Cancer ◽  
Plasma Compartment ◽  
Made In

AbstractTherapeutic drug monitoring generally focuses on the plasma compartment only. Differentiation between the total plasma concentration and the free fraction (plasma water) has been described for a number of limited drugs. Besides the plasma compartment, blood has also a cellular fraction which has by far the largest theoretical surface and volume for drug transport. It is with anti-cancer drugs that major progress has been made in the study of partition between the largest cellular blood compartment, i.e., erythrocytes, and the plasma compartment. The aim of the present review is to detail the progress made in predicting what a drug does in the body, i.e., pharmacodynamics including toxicity and plasma and/or red blood cell concentration monitoring. Furthermore, techniques generally used in anti-cancer drug monitoring are highlighted. Data for complex Bayesian statistical approaches and population kinetics studies are beyond the scope of this review, since this is generally limited to the plasma compartment only.

An update on digoxin.

1989 ◽  
Vol 35 (7) ◽  
pp. 1326-1331 ◽  
Author(s):  
J A Stone ◽  
S J Soldin
Keyword(s):  
High Pressure ◽  
Liquid Chromatography ◽  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
The Body ◽  
Alternative Methods ◽  
Therapeutic Drug ◽  
Recent Developments ◽  
Receptor Assays ◽  
Digoxin Metabolites

Abstract This review deals briefly with recent developments in the therapeutic drug monitoring of digoxin. Strategies for decreasing the interference by digoxin metabolites, digoxin-like factors, and spironolactone metabolites in immunoassays of digoxin are discussed. Other issues addressed include the development of alternative methods of analysis, such as receptor assays and "high-pressure" liquid chromatography; digoxin-like factors in hypertension; drug-drug interactions; redistribution of digoxin stores in the body; and forensic considerations.

scholarly journals Determination of Serum/Plasma Concentrations of Psychotropic Drugs in Therapeutic Drug Monitoring

2021 ◽  
pp. 3-13
Author(s):  
I. I. Miroshnichenko ◽  
N. V. Baymeeva ◽  
A. I. Platova
Keyword(s):  
Mental Health ◽  
Therapeutic Drug Monitoring ◽  
Psychotropic Drugs ◽  
Drug Monitoring ◽  
Antipsychotic Drugs ◽  
Plasma Concentrations ◽  
Mental Health Research ◽  
Therapeutic Drug ◽  
Made In

The article considers the main methodological methods of therapeutic drug monitoring (TDM) of psychotropic drugs. Analytical methods that allow performing these studies have been described. It has been given the interpretation, examples and brief results of two studies of TDM of antipsychotic drugs made in FSBSI “Mental Health Research Center” and Psychiatric hospital No.14 in Moscow.

scholarly journals Are Standard Dosing Regimens of Ceftriaxone Adapted for Critically Ill Patients with Augmented Creatinine Clearance?

2019 ◽  
Vol 63 (3) ◽  
Author(s):  
Julien Ollivier ◽  
Cédric Carrié ◽  
Nicolas d’Houdain ◽  
Sarah Djabarouti ◽  
Laurent Petit ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Creatinine Clearance ◽  
Critically Ill ◽  
Drug Monitoring ◽  
Critically Ill Patients ◽  
Free Fraction ◽  
Compartment Model ◽  
Therapeutic Drug ◽  
Target Attainment ◽  
Dosing Regimens

ABSTRACT The objective of the present study was to determine whether augmented renal clearance (ARC) impacts negatively on ceftriaxone pharmacokinetic (PK)/pharmacodynamic (PD) target attainment in critically ill patients. Over a 9-month period, all critically ill patients treated with ceftriaxone were eligible. During the first 3 days of antimicrobial therapy, every patient underwent 24-h creatinine clearance (CLCR) measurements and therapeutic drug monitoring of unbound ceftriaxone. ARC was defined by a CLCR of ≥150 ml/min. Empirical underdosing was defined by a trough unbound ceftriaxone concentration under 2 mg/liter (percentage of the time that the concentration of the free fraction of drug remained greater than the MIC [fT>MIC], 100%). Monte Carlo simulation (MCS) was performed to determine the probability of target attainment (PTA) of different dosing regimens for various MICs and three groups of CLCR (<150, 150 to 200, and >200 ml/min). Twenty-one patients were included. The rate of empirical ceftriaxone underdosing was 62% (39/63). A CLCR of ≥150 ml/min was associated with empirical target underdosing with an odds ratio (OR) of 8.8 (95% confidence interval [CI] = 2.5 to 30.7; P < 0.01). Ceftriaxone PK concentrations were best described by a two-compartment model. CLCR was associated with unbound ceftriaxone clearance (P = 0.02). In the MCS, the proportion of patients who would have failed to achieve a 100% fT>MIC was significantly higher in ARC patients for each dosage regimen (OR = 2.96; 95% CI = 2.74 to 3.19; P < 0.01). A dose of 2 g twice a day was best suited to achieve a 100% fT>MIC. When targeting a 100% fT>MIC for the less susceptible pathogens, patients with a CLCR of ≥150 ml/min remained at risk of empirical ceftriaxone underdosing. These data emphasize the need for therapeutic drug monitoring in ARC patients.

scholarly journals Are We Ready for Proactive Therapeutic Drug Monitoring of Anti-TNF to Optimize Care of Patients With Inflammatory Bowel Disease?

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Aline Charabaty
Keyword(s):  
Inflammatory Bowel Disease ◽  
Therapeutic Drug Monitoring ◽  
Bowel Disease ◽  
Drug Monitoring ◽  
Drug Level ◽  
The Body ◽  
Therapeutic Drug ◽  
Inflammatory Bowel

Lay Summary Some patients with inflammatory bowel disease clear anti-TNF drugs out of their blood faster than others, and if there is not enough drug in the body, then the drug cannot control the bowel inflammation properly. Therapeutic drug monitoring is checking the drug level in the blood of patients to help adjust the treatment and make it more effective.

Use of saliva in therapeutic drug monitoring.

1977 ◽  
Vol 23 (2) ◽  
pp. 157-164 ◽  
Author(s):  
M G Horning ◽  
L Brown ◽  
J Nowlin ◽  
K Lertratanangkoon ◽  
P Kellaway ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Enzyme Immunoassay ◽  
Drug Monitoring ◽  
Parent Drug ◽  
Free Fraction ◽  
Therapeutic Drug ◽  
Gas Chromatograph ◽  
Parotid Saliva ◽  
Paired Samples ◽  
Mixed Saliva

Abstract We measured the concentrations of phenobarbital, phenytoin, primidone, ethosuximide, antipyrine, and caffeine in paired samples of saliva and plasma by gas chromatograph-mass spectrometer-computer (GC/MS/COM) and enzyme immunoassay. Mixed saliva was collected for the antipyrine and caffeine studies, parotid saliva for the phenobarbital, primidone, ethosuximide and phenytoin studies. The saliva/plasma (S/P) ratios (by weight) obtained by GC/MS/COM were: phenobarbital, 0.31-0.37; phenytoin, 0.11; ethosuximide, 1.04; antipyrine, 0.83-0.95; caffeine, 0.55. The S/P ratio obtained by enzyme immunoassay were: phenobarbital, 0.32; phenytoin, 0.12; primidone, 0.85. The concentrations of phenytoin, primidone, ethosuximide and antipyrine in saliva correspond to the free fraction of the drug in plasma. When we analyzed samples containing phenobarbital or phenytoin (plasma or saliva) by both techniques, we found that the enzyme immunoassay values were generally higher than GC/MS/COM values, suggesting that the metabolites as well as the parent drug were measured in the immunoassay.

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