scholarly journals Role of Therapeutic Drug Monitoring in Medication Safety, Physicians Perception, and Practice

2021 ◽  
pp. 38-46
Author(s):  
Khaled Alhusayni ◽  
Ibrahim Dighriri ◽  
Abdullah Althomali ◽  
Abdulaziz Alkhammash ◽  
Faisal Alharthi ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Medication Safety ◽  
Therapeutic Process ◽  
Therapeutic Drug ◽  
Cross Sectional ◽  
Physician Practices ◽  
Number Of Patients ◽  
Physician Perception

Introduction: Patients admitted to the hospital will receive various drugs, each carrying the risk of error. Medication errors concern our healthcare system, especially considering the relatively high number of patients admitted to hospitals. Assuming that each patient receives at least two medications twice a day, the likelihood of a medication error is considerable. Therefore, therapeutic drug monitoring (TDM) focuses on measuring blood medication levels and plays a crucial role in medication safety. Aims: This study aimed to determine the effect of TDM in ensuring the safety of medications in many Taif hospitals. Also, to enhance the safety and quality of drug use and reflect physician perception and practice regarding TDM. Methodology: A prospective cross-sectional study consisting of questionnaires was conducted to physicians at many of Taif's governmental hospitals between March and May 2021. Questionnaires evaluated three parts: physician demographics, physician perception about TDM, and physician practices regarding TDM. The collected data were processed using the Excel program. Results: More than 80% of the interviewed physicians agreed that TDM is a tool that can guide the clinician to provide effective and safe drug therapy in the individual patient. Approximately 77% agreed that TDM is a team of decision-making groups. Around 25% of physicians performed TDM weekly, 22% monthly, and 10% daily. The medications that participating physicians ordered TDM were digoxin (30%), carbamazepine (21%), and gentamycin (17%). The participants had a limited understanding of the advantages of TDM in terms of drug safety and welfare. Conclusion: The number of actual drug errors occurs in the healthcare systems. Therefore, must establishment of TDM in hospitals. Medical administration and physicians must cooperate with the clinical pharmacist. Also, establish workshops for health practitioners to educate them about the role of TDM and pharmacokinetic laboratories in controlling the therapeutic process.

scholarly journals The role of therapeutic drug monitoring in treatment of HIV infection

2001 ◽  
Vol 52 (S1) ◽  
pp. 89-96
Author(s):  
David J. Back ◽  
Saye H. Khoo ◽  
Sara E. Gibbons ◽  
Concepta Merry
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Hiv Infection ◽  
Drug Monitoring ◽  
Therapeutic Drug

Patient-led Remote IntraCapillary pharmacoKinetic Sampling (fingerPRICKS) for therapeutic drug monitoring in patients with inflammatory bowel disease

2021 ◽  
Author(s):  
Desmond Chee ◽  
Rachel Nice ◽  
Ben Hamilton ◽  
Edward Jones ◽  
Sarah Hawkins ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Blood Sampling ◽  
Therapeutic Drug ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Immune Mediated ◽  
Low Volume ◽  
Antibody Levels ◽  
At Home

Abstract Background & Aims Because of COVID-19 public health restrictions, telemedicine has replaced conventional outpatient follow up for most patients with chronic immune-mediated inflammatory disorders treated with biologic drugs. Innovative solutions to facilitate remote therapeutic drug monitoring are therefore required. Low-volume intracapillary blood sampling can be undertaken by patients at home and samples returned by post to central laboratories. We sought to report the effect of the COVID-19 pandemic on requests for therapeutic drug monitoring and the equivalence, acceptability and effectiveness of low volume Patient-led Remote IntraCapillary pharmacoKinetic Sampling (fingerPRICKS) compared to conventional venepuncture. Methods We undertook a cross-sectional blood sampling methods comparison study and compared sample types using linear regression models. Drug and antidrug antibody levels were measured using standard ELISAs. Acceptability was assessed using a purpose-designed questionnaire. Results Therapeutic drug monitoring requests for adalimumab (96.5 [70.5 - 106] per week to 52 [33.5 - 57.0], p < 0.001) but not infliximab (184.5 [161.2 - 214.2] to 161 [135 – 197.5], p = 0.34) reduced during the first UK stay-at-home lockdown compared with the preceding six months. Fingerprick sampling was equivalent to conventional venepuncture for adalimumab, infliximab, vedolizumab, and ustekinumab drug, and anti-adalimumab and -infliximab antibody levels. The median (IQR) volume of serum obtained using intracapillary sampling was 195µL (130-210). More than 87% (90/103) patients agreed that intracapillary testing was easy and 69% (71/103) preferred it to conventional venepuncture. In routine care, 75.3% (58/77) patients returned two blood samples within 14 days to permit remote assessment of biologic therapeutic drug monitoring. Conclusions Therapeutic drug monitoring can be undertaken using patient-led remote intracapillary blood sampling and has the potential to be a key adjunct to telemedicine in patients with immune-mediated inflammatory diseases.

scholarly journals Role of Therapeutic Drug Monitoring and Challenges in the Management of Infantile Chronic Myeloid Leukemia

2021 ◽  
Vol 18 (2) ◽  
Author(s):  
Sneha Tandon ◽  
Raviraj Deshpande ◽  
Gaurav Narula ◽  
Maya Prasad ◽  
Amey Paradkar ◽  
...  
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Myeloid Leukemia ◽  
Therapeutic Drug

scholarly journals Can We Rely on AGNP Therapeutic Targets Also For LAI Antipsychotics?

2017 ◽  
Vol 51 (06) ◽  
pp. 270-271 ◽  
Author(s):  
Sara Baldelli ◽  
Emilio Clementi ◽  
Dario Cattaneo
Keyword(s):  
Clinical Practice ◽  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Atypical Antipsychotics ◽  
Therapeutic Targets ◽  
Therapeutic Drug ◽  
Consensus Guidelines ◽  
Long Acting

AbstractThe updated AGNP Consensus Guidelines for Therapeutic Drug Monitoring (TDM) in Neuropsychopharmacology recently published in the journal have reinforced the key role of TDM to individualize psychoparmacological therapies in clinical practice. However, we believe, that these guidelines have missed the important opportunity to face with, and to provide useful information on, the emerging issue of long-acting injectable formulations of atypical antipsychotics. Specific therapeutic ranges also for these formulations should be included in the next AGNP guidelines.

Neural and Kernal Methods for Therapeutic Drug Monitoring

2011 ◽  
pp. 238-261 ◽  
Author(s):  
G. Camps-Valls ◽  
J. D. Martin-Guerrero
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Substantial Improvement ◽  
Physical Models ◽  
Therapeutic Drug ◽  
Optimal Dosage ◽  
Blood Concentrations ◽  
Clinical Problems

Recently, important advances in dosage formulations, therapeutic drug monitoring (TDM), and the emerging role of combined therapies have resulted in a substantial improvement in patients’ quality of life. Nevertheless, the increasing amounts of collected data and the non-linear nature of the underlying pharmacokinetic processes justify the development of mathematical models capable of predicting concentrations of a given administered drug and then adjusting the optimal dosage. Physical models of drug absorption and distribution and Bayesian forecasting have been used to predict blood concentrations, but their performance is not optimal and has given rise to the appearance of neural and kernel methods that could improve it. In this chapter, we present a complete review of neural and kernel models for TDM. All presented methods are theoretically motivated, and illustrative examples in real clinical problems are included.

scholarly journals Role of therapeutic drug monitoring in pulmonary infections: use and potential for expanded use of dried blood spot samples

Bioanalysis ◽  
2015 ◽  
Vol 7 (4) ◽  
pp. 481-495 ◽  
Author(s):  
Susan Hofman ◽  
Mathieu S Bolhuis ◽  
Remco A Koster ◽  
Onno W Akkerman ◽  
Sander van Assen ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Dried Blood Spot ◽  
Therapeutic Drug ◽  
Pulmonary Infections ◽  
Blood Spot

scholarly journals Vancomycin prophylaxis in paediatric patients following cardiac surgery: a retrospective evaluation of trough levels and associated variables

2020 ◽  
Vol 31 (5) ◽  
pp. 667-673
Author(s):  
Leonardo Vallesi ◽  
Tiziana Fragasso ◽  
Simona Benegni ◽  
Giulia Insom ◽  
Luca Di Chiara ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Therapeutic Drug ◽  
Clinical Predictors ◽  
Paediatric Patients ◽  
Number Of Patients ◽  
Vancomycin Trough ◽  
Optimal Target ◽  
Independent Association ◽  
Trough Levels

Abstract OBJECTIVES Therapeutic drug monitoring during vancomycin administration is recommended. However, little information is available in case of paediatric vancomycin prophylaxis. The aim of this study was to analyse vancomycin trough levels on postoperative day (POD) 2 and 3 after paediatric cardio-surgery to assess the clinical predictors and outcomes associated with vancomycin concentrations and to evaluate whether adjustments are effective to target optimal levels. METHODS A retrospective study was conducted in paediatric patients receiving vancomycin prophylaxis after elective cardio-surgery. Adjustments were made if levels between 20 and 30 (halving subsequent dose) or ˃30 mg/l (dose withheld) were found. RESULTS Vancomycin doses of the 100 examined children (3.7–6.4 years) were 12.8 (2.5), 9.4 (5.4) and 9.7 (4.5) mg/kg, on POD1, 2 and 3, respectively (P = 0.0001). The 200 vancomycin trough levels decreased from 16.9 (11.4) on POD2 to 14.6 (8.5) on POD3 (P = 0.003). Overall, 66 troughs were sub-target, 68 reached the optimal target and 66 were supra-target. On POD2 and 3, 32 and 27 dose adjustments were required, leading to a reduced number of patients with supra-target troughs. Neonates showed a higher number of supra-target levels with respect to non-neonatal patients on both POD2 (P = 0.003) and 3 (P = 0.0001). At multivariable regression analysis, vancomycin levels showed independent association with weight and creatinine levels on both POD2 and 3. Vancomycin levels correlated with ventilation days (P = 0.31, P = 0.039), but not with methicillin-resistant Staphylococcus aureus positivity (P = 0.69). CONCLUSIONS Vancomycin prophylaxis in paediatric cardio-surgery requires strict therapeutic drug monitoring and several dosage adjustments. Supra-target troughs are frequent and neonatal age, weight and creatinine levels significantly affect vancomycin concentrations.

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