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Therapeutic Drug Monitoring

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https://www.readbyqxmd.com/read/28338527/a-slight-smell-of-lemon%C3%A2-a-case-report
#1
Catherine Feliu, Yoann Cazaubon, Aurélie Fouley, Hélène Guillemin, Claire Gozalo, Zoubir Djerada
We present here an example of urine substituted with a yellow cleaning product that leads us to develop the main risks to consider in urine toxicology analysis, i.e., adulteration and analytical interferences, and how to deal with them. This grand round highlights the importance of the dialogue between the clinician and a TDM consultant for optimal care of the patient.
March 23, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28328761/drug-efficacy-monitoring-in-pharmacotherapy-of-multiple-sclerosis-with-biological-agents
#2
M Caldano, W Raoul, T Rispens, A Bertolotto
Multiple Sclerosis (MS) is a heterogeneous disease. Although several EMA approved Disease Modifying Treatments including biopharmaceuticals are available, their efficacy is limited and a certain percentage of patients are always non-responsive. Drug Efficacy Monitoring is an important tool to identify these non-responsive patients early on. Currently, Detection of Anti-Drug Antibodies and quantification of Biological Activity are used as methods of efficacy monitoring for Interferon beta (IFNβ) and Natalizumab (NAT) therapies...
March 22, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28328760/current-practice-for-therapeutic-drug-monitoring-of-biopharmaceuticals-in-inflammatory-bowel-disease
#3
Iris Detrez, Thomas Van Stappen, María Dolores Martín Arranz, Kostas Papamichael, Ann Gils
Since the late nineties, biopharmaceuticals targeting tumor necrosis factor α have revolutionized the treatment of moderately to severely active inflammatory bowel disease. The robust efficacy witnessed in many patients stands in stark contrast with the observation of a proportion of patients who fail to respond or who lose response over time. Therapeutic drug monitoring has been proposed as a means to understand and respond to the variability in clinical response and remission. Various treatment algorithms have been proposed, but optimal use of these measurements in daily practice awaits additional prospective validation trials...
March 22, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28328764/simultaneous-determination-of-protein-unbound-cyclosporine-a-and-mycophenolic-acid-in-kidney-transplant-patients-using-liquid-chromatography-tandem-mass-spectrometry
#4
Heike Bittersohl, Juliane Herbinger, Ming Wen, Lutz Renders, Werner Steimer, Peter B Luppa
BACKGROUND: Therapeutic drug monitoring (TDM) of immunosuppressants is essential to optimize patient care after organ transplantation. In blood, most immunosuppressive drugs are bound to plasma proteins or located inside blood cells. However, it is generally assumed that only protein-unbound (free) drug concentrations are pharmacologically active and could therefore better reflect the clinical outcome. Study data are still limited due to lacking rapid analytical methods. Therefore, a simple multiplex method for direct measurement of free cyclosporine A (CsA) and mycophenolic acid (MPA) has been developed...
March 21, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28328763/induration-at-injection-or-infusion-site-may-reduce-bioavailability-of-parenteral-phenobarbital-administration
#5
Hirokazu Nakayama, Hirotoshi Echizen, Ryuichi Ogawa, Atsuya Akabane, Toshiaki Kato, Takao Orii
BACKGROUND: Phenobarbital is well tolerated and effective for controlling agitation or preventing convulsion at the end of life. No information is available concerning parenteral bioavailability of phenobarbital when induration develops at injection or infusion site. We investigated whether induration at injection or infusion site is related to phenobarbital bioavailability via parenteral routes of continuous subcutaneous infusion and intermittent subcutaneous or intramuscular injection...
March 21, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28328762/a-significant-influence-of-metronidazole-on-busulfan-pharmacokinetics-a-case-report-of-therapeutic-drug-monitoring
#6
Hyewon Chung, Kyung-Sang Yu, Kyung Taek Hong, Jung Yoon Choi, Che Ry Hong, Hyoung Jin Kang, Kyung Duk Park, Hee Young Shin, SeungHwan Lee
Busulfan is a cytotoxic agent used in preconditioning for hematopoietic stem cell transplantation (HSCT). Therapeutic drug monitoring of busulfan is necessary owing to its narrow therapeutic range. Patients undergoing preconditioning are susceptible to infection and might require co-administration of antibiotics. We present a case study of a three-year-old girl with precursor T-cell acute lymphoblastic leukemia who received intravenous busulfan before HSCT. Metronidazole was co-administered before the third dose of busulfan because of Clostridium difficile infection...
March 21, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28230618/biopharmaceuticals-reference-products-and-biosimilars-to-treat-inflammatory-diseases
#7
Ann Gils, Antonio Bertolotto, Denis Mulleman, Theodora Bejan-Angoulvant, Paul J Declerck
Biopharmaceuticals are primarily therapeutic proteins developed to perform specific functions by acting on the disease pathophysiology. Compared to low molecular chemically synthesized drugs, production of biopharmaceuticals is much more complex and routes of administration and pharmacokinetics differ. Biopharmaceuticals are blockbusters in the treatment of inflammatory diseases such as psoriasis, multiple sclerosis, rheumatic diseases, and inflammatory bowel diseases, and the introduction of these drugs has revolutionized treatment...
February 20, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28045781/improved-open-well-stability-of-acmia-reagent-for-determining-blood-tacrolimus
#8
Yoshiharu Suzuki, Keisuke Kohno, Kosuke Doki, Nobuhiro Ohkohchi, Masato Homma
No abstract text is available yet for this article.
December 30, 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28045862/comparing-azole-plasma-trough-levels-in-lung-transplant-recipients-percentage-of-therapeutic-levels-and-intra-patient-variability
#9
Daniela Stelzer, Alexandra Weber, Franziska Ihle, Sandhya Matthes, Felix Ceelen, Gregor Zimmermann, Nikolaus Kneidinger, Rene Schramm, Hauke Winter, Michael Zoller, Michael Vogeser, Juergen Behr, Claus Neurohr
BACKGROUND: This study compared therapeutic azole plasma trough levels (APL) of the azole antimycotics itraconazole (ITR), voriconazole (VOR), and posaconazole (POS) in lung transplant recipients and analyzed the influencing factors. In addition, intra-patient variability for each azole was determined. METHODS: From July 2012 to July 2015, 806 APL of ITR, VOR, POS liquid (POS-Liq), and POS tablets (POS-Tab) were measured in 173 patients of the Munich Lung Transplantation (LTx) Program...
December 29, 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28282367/improved-open-well-stability-of-affinity-column-mediated-immunoassay-reagent-for-determining-blood-tacrolimus
#10
Yoshiharu Suzuki, Keisuke Kohno, Kosuke Doki, Nobuhiro Ohkohchi, Masato Homma
No abstract text is available yet for this article.
April 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28282366/comparing-azole-plasma-trough-levels-in-lung-transplant-recipients-percentage-of-therapeutic-levels-and-intrapatient-variability
#11
Daniela Stelzer, Alexandra Weber, Franziska Ihle, Sandhya Matthes, Felix Ceelen, Gregor Zimmermann, Nikolaus Kneidinger, Rene Schramm, Hauke Winter, Michael Zoller, Michael Vogeser, Juergen Behr, Claus Neurohr
BACKGROUND: This study compared therapeutic azole plasma trough levels (APL) of the azole antimycotics itraconazole (ITR), voriconazole (VOR), and posaconazole (POS) in lung transplant recipients and analyzed the influencing factors. In addition, intrapatient variability for each azole was determined. METHODS: From July 2012 to July 2015, 806 APL of ITR, VOR, posaconazole liquid (POS-Liq), and posaconazole tablets (POS-Tab) were measured in 173 patients of the Munich Lung Transplantation Program...
April 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28230619/population-pharmacokinetics-of-topiramate-in-japanese-pediatric-and-adult-patients-with-epilepsy-using-routinely-monitored-data
#12
Masato Takeuchi, Ikuko Yano, Satoko Ito, Mitsuhiro Sugimoto, Shota Yamamoto, Atsushi Yonezawa, Akio Ikeda, Kazuo Matsubara
BACKGROUND: Topiramate is a second-generation antiepileptic drug used as monotherapy and adjunctive therapy in adults and children with partial seizures. A population pharmacokinetic (PPK) analysis was performed to improve the topiramate dosage adjustment for individualized treatment. METHODS: Patients whose steady-state serum concentration of topiramate was routinely monitored at Kyoto University Hospital from April 2012 to March 2013 were included in the model-building data...
April 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28230617/acute-kidney-injury-after-efavirenz-tenofovir-disoproxil-fumarate-emtricitabine-atripla-overdose
#13
Thomas Havenith, David Burger, Maarten J Visschers, Jolanda Schippers, Astrid O Lashof
We describe a patient with acute renal failure and irreversible kidney damage after an overdose with the fixed dose combination of efavirenz/tenofovir disoproxil fumarate/emtricitabine (Atripla). The acute kidney injury was most probably caused by tenofovir. Efavirenz and emtricitabine seemed relatively safe in overdose. The pharmacokinetics in overdose of all 3 drugs and the effect of hemodialysis on the tenofovir clearance were studied by measuring the plasma concentrations and by the use of clinical pharmacokinetic software...
April 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28207572/cross-reactivity-of-chloroquine-and-hydroxychloroquine-with-dri-amphetamine-immunoassay
#14
Isabel Gomila, Loreto Quesada, Victoria López-Corominas, Julia Fernández, Miguel Á Servera, Laura Sahuquillo, Macarena Dastis, Albert Torrents, Bernardino Barceló
BACKGROUND: Chloroquine and hydroxychloroquine are medical drugs used to treat the chemoprophylaxis of malaria and a second-line anti-inflammatory drug. METHODS: We performed a study of cross-reactivity of chloroquine and hydroxychloroquine in the DRI Amphetamine Assay inspired by a case report of a self-ingestion of chloroquine after a family dispute, that involved the following: (1) an in vitro study with control samples of healthy subjects, (2) an in vivo study with samples of patients with rheumatoid arthritis, and (3) an evaluation of the cross-reactivity of chloroquine and hydroxychloroquine in 3 additional immunoassays...
April 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28196047/a-time-dependent-model-describes-methotrexate-elimination-and-supports-dynamic-modification-of-mrp2-abcc2-activity
#15
Jean-Baptiste Woillard, Jean Debord, Isabelle Benz-de-Bretagne, Franck Saint-Marcoux, Pascal Turlure, Stéphane Girault, Julie Abraham, Sylvain Choquet, Pierre Marquet, Chantal Barin-Le Guellec
BACKGROUND: Multidrug resistance protein-2 encoded by the ABCC2 gene (MRP2/ABCC2), an efflux transporter expressed at the proximal renal tubule, is rate-limiting for urine excretion of coproporphyrin (UCP) isomers I and III, translating in high UCP [I/(I + III)] ratio in MRP2-deficient patients presenting with the Dubin-Johnson Syndrome. MRP2 is also a major contributor to methotrexate (MTX) clearance. As MTX is both a substrate and an inhibitor of MRP2, time course of the concentrations of MTX in blood could induce functional modification of MRP2 over time, which in turn can modify its own elimination rate...
April 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28196046/bioequivalence-of-a-new-oral-levosulpiride-formulation-compared-with-a-standard-one-in-healthy-volunteers
#16
Simona De Gregori, Laura Cipollina, Annalisa De Silvestri, Marianna Ventura, Roberta Michelini, Monica Morosini, Michela Montagna, Carmine Tinelli, Mario Regazzi, Mariadelfina Molinaro, Roberto Imberti
BACKGROUND: A monocentric, single-dose, open-label, 2-way, crossover randomized study was conducted by the San Matteo Phase I Clinical Trial Unit and Experimental Therapy (Pavia, Italy) to assess the bioequivalence and the systemic tolerability of a new oral formulation of levosulpiride (tablet 25 mg: test) versus a commercially available formulation on the Italian market (tablet 25 mg: reference). METHODS: Thirty-five healthy adult volunteers, men (n = 19) and women (n = 16), aged between 18 and 55 years were screened and 32 of them were enrolled in the study...
April 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28169862/quantification-of-acetaminophen-and-its-metabolites-in-plasma-using-uplc-ms-doors-open-to-therapeutic-drug-monitoring-in-special-patient-populations
#17
Robert B Flint, Paola Mian, Bart van der Nagel, Nuria Slijkhuis, Birgit C P Koch
BACKGROUND: Acetaminophen (APAP, paracetamol) is the most commonly used drug for pain and fever in both the United States and Europe and is considered safe when used at registered dosages. Nevertheless, differences between specific populations lead to remarkable changes in exposure to potentially toxic metabolites. Furthermore, extended knowledge is required on metabolite formation after intoxication, to optimize antidote treatment. Therefore, the authors aimed to develop and validate a quick and easy analytical method for simultaneous quantification of APAP, APAP-glucuronide, APAP-sulfate, APAP-cysteine, APAP-glutathione, APAP-mercapturate, and protein-derived APAP-cysteine in human plasma by ultraperformance liquid chromatography-electrospray ionization-tandem mass spectrometry...
April 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28141745/deferasirox-iron-complex-formation-ratio-as-an-indicator-of-long-term-chelation-efficacy-in-%C3%AE-thalassemia-major
#18
Meng-Yao Lu, Ting-Hao Lin, Po-Hung Chiang, Pei-Hsin Kuo, Ning Wang, Wen-Hsin Wu, Kai-Hsin Lin, Tzu-Hua Wu
BACKGROUND: β-Thalassemia major patients with higher total drug levels [deferasirox (DEFR) plus its iron complex] do not yield better serum ferritin (SF) control. This study aimed to determine the concentrations of DEFR and its iron complex (Fe-[DEFR]2) in thalassemia patients to predict the chelation efficacy in terms of SF and cardiac T2* values. METHODS: Patients' steady-state drug levels at trough (Ctrough) and 2 hours postdose (C2h) were determined. Because iron deposition may cause changes in the hepatic metabolism of amino acids, the concentrations of 40 amino acids in plasma were also assayed at 2 hours postdose...
April 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28125504/therapeutic-drug-monitoring-of-everolimus-comparability-of-concentrations-determined-by-2-immunoassays-and-a-liquid-chromatography-tandem-mass-spectrometry-method
#19
Maria Shipkova, Sonja Rapp, Raül Rigo-Bonnin, Eberhard Wieland, Andreas Peter
BACKGROUND: Therapeutic drug monitoring is recommended to guide therapy with the immunosuppressant everolimus (EVL) in solid organ transplantation to prevent rejections and to limit toxicity. For therapeutic drug monitoring, predose EVL concentrations are measured in whole blood mainly by liquid chromatography tandem mass spectrometry (LC-MS/MS). In addition, 2 immunoassays [Quantitative Microsphere System (QMS) EVL and Elecsys EVL] are commercially available. The aim of this study was to evaluate the comparability of EVL results determined with the 2 immunoassays and a validated LC-MS/MS test using samples from kidney, liver, and heart transplant (KT, LT, and HT, respectively) recipients...
April 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28125503/measurement-of-clozapine-norclozapine-and-amisulpride-in-plasma-and-in-oral-fluid-obtained-using-2-different-sampling-systems
#20
Danielle S Fisher, Chad Beyer, Gerrit van Schalkwyk, Soraya Seedat, Robert J Flanagan
BACKGROUND: There is a poor correlation between total concentrations of proton-accepting compounds (most basic drugs) in unstimulated oral fluid and in plasma. The aim of this study was to compare clozapine, norclozapine, and amisulpride concentrations in plasma and in oral fluid collected using commercially available collection devices [Thermo Fisher Scientific Oral-Eze and Greiner Bio-One (GBO)]. METHODS: Oral-Eze and GBO samples and plasma were collected in that order from patients prescribed clozapine...
April 2017: Therapeutic Drug Monitoring
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