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Therapeutic drug monitoring of atypical antipsychotic drugs

dopamine receptor occupancy in patients treated with classical neuroleptics and clozapine. Relation to extrapyramidal side effects, Arch. Gen. Psychiatry 49 (1992) 538-544. 13. S. Nyberg, A. L. Nordström, C. Halldin and L. Farde, Positron emission tomography studies on D2 dopamine receptor occupancy and plasma antipsychotic drug levels in man, Int. Clin. Psychopharmacol. 10 (Suppl. 3) (1995) 81-85. 14. P. J. Perry, Therapeutic drug monitoring of atypical antipsychotics. Is it of potential clinical value? CNS Drugs 13 (2000) 167

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Therapeutic Drug Monitoring in Rheumatic Diseases

fails. There are limitations regarding the use of therapeutic drug monitoring and therefore, it is still not employed routinely in our daily practice. In Hong Kong, tests for monitoring rheumatic drugs are not available. Furthermore, the therapeutic window of each drug has yet to be confirmed by larger clinical trials in order to define a universally accepted window for each rheumatic drug. 6 Conclusion Therapeutic drug monitoring may be helpful in enhancing drug efficacy and in reducing toxicities. It can also allow the detection of drug non

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Rapid liquid chromatography tandem mass spectrometry determination of rivaroxaban levels in human plasma for therapeutic drug monitoring

Abstract

A rapid, sensitive, high-throughput liquid chromatography coupled with tandem mass spectrometry method for the quantification of rivaroxaban from human plasma has been developed and validated. For the analytical separation a Zorbax SB-C18 column with isocratic flow of mobile phase composed of 0.2% formic acid in water and acetonitril (65:35, V/V) with a flow rate of 1 mL/min at a temperature of 45ºC was used. Detection of rivaroxaban was performed using positive electrospray ionization and MS/MS mode (sum of m/z 231.1; 289.2 and 318.2 from m/z 436.3). Plasma samples were prepared using single-step protein precipitation with methanol. Method validation was performed with regards to selectivity, linearity (r >0.9927), within-run and between-run precision (CV< 13.1 %) and accuracy (bias< 9.4 %) over a concentration range of 24.00 - 960.00 ng/mL plasma. Recovery was between 96.5 - 108.5% and the lower limit of quantification of rivaroxaban was 24.00 ng/mL. The developed method is simple, rapid, and selective, requires small plasma sample volumes, and was successfully applied for therapeutic drug monitoring of rivaroxaban in treated patients.

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Simultaneous Determination of Carbamazepine and Carbamazepine-10,11-epoxide in Different Biological Matrices by LC-MS/MS

, Berry DJ, Bourgeois BFD, et al. Antiepileptic drugs - Best practice guidelines for therapeutic drug monitoring: A position paper by the subcommission on therapeutic drug monitoring, ILAE Commission on Therapeutic Strategies. Epilepsia . 2008;49:1239-1276. 6. Johannessen SI, Battino D, Berry DJ, et al. Therapeutic drug monitoring of the newer antiepileptic drugs. Ther Drug Monit . 2003;25:347-363. 7. Neels HM, Sierens AC, Naelaerts K, Scharpé SL, Hatfield GM, Lambert WE. Therapeutic drug monitoring of old and newer anti-epileptic drugs. Vol. 42, Clinical

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The problem of low peak concentration of gentamicin in clinical practice

References BERTINO, J., S., Jr. - RODVOLD, K., A., DESTACHE, C., J.: Cost consideration in therapeutic drug monitoring of aminoglycosides. Clin Pharmacokinet, 26, 1, 1994, p. 71 - 81. ROBERTS, J., A. - PATERSON, D., L.- MARTIN, J., H.: Therapeutic drug monitoring of antimicrobials. Br J Clin Pharmacol, 73, 1, 2012, p. 27 - 36. CONNORS, J., E. - DIPIRO J., T. - SISLEY J., F.: Use of serum concentration in surgical patients. Am J Surg 156, 1, 1988, p. 68 - 76

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Is gentamicin administered to individual patients in optimal doses already at the beginning of therapy?

-System Pharmacist. 2011;68(7): 624–632. [7] Fonzo-Christie C, Guignard B, Zaugg C et al.: Impact of clinical Decision Support Guidelines on Therapeutic Drug Monitoring of Gentamicin in Newborns. Ther Drug Monit. 2014;36(5):656–662. [8] Barza M, Ioannidis JP, Cappelleri JC, Lau J et al.: Single and multiple daily doses of aminoglycosides a meta-analysis. BMJ. 1996;10(312):338–345. [9] Nezic L, Derungs A, Bruggisser M, Tschudin-Sutter S, Krähenbühl S, Haschke M: Therapeutic drug monitoring of once daily aminoglycoside dosing: comparison of two methods and

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The Monitoring of Immunosuppressive Therapy with Tacrolimus in Patients with Kidney Transplant, Based on the Pharmacokinetic Criteria

References 1. Venkataraman L, Burakoff SJ, Sen R. FK-506 inhibits antigen receptor-mediated induction of C-rel in B and T lymphoid cells. J Exp Med. 1995;181:1091-1099. 2. Plosker GL, Foster RH. Tacrolimus: a further update of its pharmacology and therapeutic use in the management of organ transplantation. Drugs. 2000;59:323-389. 3. Kang JS, Lee MH. Overview of therapeutic drug monitoring. The Korean Journal of Internal Medicine. 2009;24:1-10. 4. Wong G, Howard K, Chapman JR, Chadban S et al. Comparative survival and economic benefits of

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Exploring sirolimus pharmacokinetic variability using data available from the routine clinical care of renal transplant patients – population pharmacokinetic approach

narrow therapeutic index of sirolimus, therapeutic drug monitoring and dose individualization are necessary ( 1 , 5 ). Therefore, TDM and detailed biochemical and clinical monitoring represent the cornerstone of the transplant patients’care. Finding, explaining and quantifying the potential factors of pharmaco kinetic variability in individual patient would make dose individualization more effective. Population approach could enable this. Numerous sources of pharmacokinetic variability have been recognized in the conventional pharmacokinetic studies of sirolimus ( 8

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An adjustment of vancomycin dosing regimen for a young patient with augmented renal clearance: A case report / Úprava dávkového režimu vankomycínu pre mladého pacienta so zvýšeným renálnym klírensom: Kazuistika

Abstract

Augmented renal clearance (ARC) is a recently reported condition in pathophysiology of critically ill patients in the intensive care unit. ARC refers to the enhanced renal elimination of circulating solutes. These patients are either young or previously healthy people who have undergone surgery or multiple trauma.

This case report describes an adjustment of dosing regime of vancomycin to a young patient, who demonstrated ARC with severe polytrauma, overcome crush syndrome and sepsis. This 16-year old male patient was crushed by a tractor, which caused severe tissue damaged in the right lower limb. He gradually developed a serious crush syndrome. When kidneys resumed their function, creatinine clearance reached the value that indicated ARC (339.81 mL/min/1.73 m2). Vancomycin was included in the patient’s treatment regime by administering conventional dose of 1 g per 12 hours. The residual measured levels were very low. The dose of vancomycin had to be adjusted to double and then to triple the conventional dose. Without the therapeutic drug monitoring (TDM) and subsequent interpretation of the results by the clinical pharmacists, such high doses would not have been considered for administration.

ARC responds strongly to sub-therapeutic serum vancomycin levels. Our case report confirms the significance of TDM and the consecutive interpretation of the results in critically ill patients.

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An LC-MS Assay with Isocratic Separation and On-Line Solid Phase Extraction to Improve the Routine Therapeutic Drug Monitoring of Busulfan in Plasma

References 1. Lucarelli G, Isgro A, Sodani P, Gaziev J. Hematopoietic stem cell transplantation in thalassemia and sickle cell anemia. Cold Spring Harb Perspect Med 2012; 2: a011825. 2. Russell JA, Kangarloo SB. Therapeutic drug monitoring of busulfan in transplantation. Curr Pharm Des 2008; 14: 1936-49. 3. Iwamoto T, Hiraku Y, Oikawa S, Mizutani H, Kojima M, Kawanishi S. DNA intrastrand cross-link at the 5’-GA-3’ sequence formed by busulfan and its role in the cytotoxic effect. Cancer Sci 2004; 95: 454

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