Prednisolone and Prednisone Pharmacokinetics in Adult Renal Transplant Recipients
Conclusions:
The large interindividual variability in both PL exposure and suppression of endogenous CL implies a possible role for therapeutic drug monitoring. An abbreviated profile within the first 4 hours after PL dosing provides a good prediction of PL exposure in renal Tx recipients. The strong negative correlation between PL AUC0–24 and morning CL levels suggests a possible surrogate marker for drug exposure for further evaluation. (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - March 25, 2021 Category: Drugs & Pharmacology Tags: Original Article Source Type: research
Evaluation of Bayesian Forecasting Methods for Prediction of Tacrolimus Exposure Using Samples Taken on Two Occasions in Adult Kidney Transplant Recipients
This study examined the predictive performance of Bayesian forecasting programs/services for the estimation of future tacrolimus area under the curve (AUC) from 0 to 12 hours (AUC0–12) in kidney transplant recipients.
Methods:
Tacrolimus concentrations were measured in 20 adult kidney transplant recipients, 1 month post-transplant, on 2 occasions one week apart. Twelve samples were taken predose and 13 samples were taken postdose at the specified times on the first and second sampling occasions, respectively. The predicted AUC0–12 (AUCpredicted) was estimated using Bayesian forecasting programs/services and data...
Source: Therapeutic Drug Monitoring - March 25, 2021 Category: Drugs & Pharmacology Tags: Original Article Source Type: research
Tacrolimus Exposure in Obese Patients: and A Case–Control Study in Kidney Transplantation
Background:
Tacrolimus pharmacokinetics in obese (Ob) patients has been poorly studied. In this article, the authors explored the impact of obesity on tacrolimus exposure in kidney transplant recipients (KTRs) and estimated a more suitable initial dosage in this population.
Methods:
A retrospective, observational, monocentric case–control study was performed in obese KTRs (BMI> 30 kg/m2) who received tacrolimus between 2013 and 2017 (initial dose: 0.15 mg/kg/d) (actual weight). Nonobese (Nob) controls (BMI (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - March 25, 2021 Category: Drugs & Pharmacology Tags: Original Article Source Type: research
Levamisole—a Toxic Adulterant in Illicit Drug Preparations: a Review
Abstract:
Discovered in the 1960s, the common anthelminthic levamisole has seen widespread use in veterinary applications. Its use rapidly expanded thereafter to include human medical treatments for a variety of acute and chronic disorders. Because of reports of severe adverse effects, the US Food and Drug Administration withdrew levamisole's approval for human use in 2000; however, medical options outside the United States and illicit options worldwide allow continued accessibility to levamisole. The compound is rapidly metabolized in the body, with at least 2 known active metabolites. Levamisole has a broad range of ...
Source: Therapeutic Drug Monitoring - March 25, 2021 Category: Drugs & Pharmacology Tags: Review Article Source Type: research
Evolving Role of Pharmacogenetic Biomarkers to Predict Drug-Induced Hematological Disorders
Abstract:
Drug-induced hematological disorders constitute up to 30% of all blood dyscrasias seen in the clinic. Hematologic toxicity from drugs may range from life-threatening marrow aplasia, agranulocytosis, hemolysis, thrombosis to mild leukopenia, and thrombocytopenia. Pathophysiologic mechanisms underlying these disorders vary from an extension of the pharmacological effect of the drug to idiosyncratic and immune-mediated reactions. Predicting these reactions is often difficult, and this makes clinical decision–making challenging. Evidence supporting the role of pharmacogenomics in the management of these disorde...
Source: Therapeutic Drug Monitoring - March 25, 2021 Category: Drugs & Pharmacology Tags: Review Article Source Type: research
Personalized Therapy for Mycophenolate: Consensus Report by the International Association of Therapeutic Drug Monitoring and Clinical Toxicology
Abstract:
When mycophenolic acid (MPA) was originally marketed for immunosuppressive therapy, fixed doses were recommended by the manufacturer. Awareness of the potential for a more personalized dosing has led to development of methods to estimate MPA area under the curve based on the measurement of drug concentrations in only a few samples. This approach is feasible in the clinical routine and has proven successful in terms of correlation with outcome. However, the search for superior correlates has continued, and numerous studies in search of biomarkers that could better predict the perfect dosage for the individual ...
Source: Therapeutic Drug Monitoring - March 25, 2021 Category: Drugs & Pharmacology Tags: Review Article Source Type: research
Optimization of Aztreonam in Combination With Ceftazidime/Avibactam in a Cystic Fibrosis Patient With Chronic Stenotrophomonas maltophilia Pneumonia Using Therapeutic Drug Monitoring: A Case Study
Abstract:
In this clinician-therapeutic drug monitoring (TDM) consultant interaction, the authors describe the use of TDM in an 11-year-old female patient with cystic fibrosis receiving ceftazidime/avibactam and aztreonam for the treatment of persistent pulmonary exacerbations caused by Stenotrophomonas pneumonia. Serum drug concentrations at a steady state confirmed inadequate antimicrobial exposure, and continuous infusions of both ceftazidime/avibactam and aztreonam were required to optimize the percentage of time when free drug remained above the minimum inhibitory concentration (MIC), known as fT> MIC. After dose ...
Source: Therapeutic Drug Monitoring - March 25, 2021 Category: Drugs & Pharmacology Tags: Grand Rounds Source Type: research
Pharmacobezoar After Venlafaxine and Oxazepam Overdose: How Pharmacokinetics Could Help?—A Grand Round
Abstract:
The authors present here a case of a pharmacobezoar after drug overdose, diagnosed using multiple blood samples for TDM. This grand round highlights the importance of a dialog between a clinician and a TDM consultant for the optimal care of a patient. (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - March 25, 2021 Category: Drugs & Pharmacology Tags: Case Report Source Type: research
Accurate Measurement of Adalimumab Using Competitive Homogeneous Mobility Shift Assay
No abstract available (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - January 21, 2021 Category: Drugs & Pharmacology Tags: Letters to the Editor Source Type: research
Use of Age-Adjusted Serum Creatinine in a Vancomycin Pharmacokinetic Model Decreases Predictive Performance in Elderly Patients
No abstract available (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - January 21, 2021 Category: Drugs & Pharmacology Tags: Letters to the Editor Source Type: research
Toxicology Screening Testing in Patients Undergoing Spine Surgery: A Prospective Observational Pilot Study
Conclusions:
TST in patients presenting for spine surgery is a useful tool to detect substances taken by patients because self-report is often inaccurate. Discrepancies decrease the opportunity for preoperative optimization and adequate perioperative preparation. (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - January 21, 2021 Category: Drugs & Pharmacology Tags: Short Communication Source Type: research
Plasma Concentrations and Safety of Lopinavir/Ritonavir in COVID-19 Patients
Conclusions:
Lopinavir plasma concentrations in patients with moderate-to-severe COVID-19 were higher than expected, and they were associated with the occurrence of hepatic or gastrointestinal adverse drug reactions. However, a high plasma concentration may be required for in vivo antiviral activity against SARS-CoV-2, as suggested by previous studies. Therefore, in the absence of adverse drug reaction, lopinavir dosage should not be reduced. Caution is essential because off-label use can be associated with a new drug safety profile. (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - January 21, 2021 Category: Drugs & Pharmacology Tags: Short Communication Source Type: research
Do Vancomycin Pharmacokinetics Differ Between Obese and Non-obese Patients? Comparison of a General-Purpose and Four Obesity-Specific Pharmacokinetic Models
Conclusions:
The results of the external validation of vancomycin PK in obese patients showed that currently available obesity-specific models do not necessarily outperform a broadly supported general-purpose model. Based on these results, the authors conclude that there is no advantage in using vancomycin PK models specifically tailored to obese patients over the general-purpose model reported by Colin et al. (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - January 21, 2021 Category: Drugs & Pharmacology Tags: Short Communication Source Type: research
Establishing Serum Reference Ranges for Antihypertensive Drugs
Conclusions:
Serum drug concentration measurements, interpreted in light of the established reference ranges, together with blood pressure measurements and other clinical data, may help identify nonadherent patients and tailor individual antihypertensive treatment when deviant drug responses appear in line with the concept of personalized medicine. (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - January 21, 2021 Category: Drugs & Pharmacology Tags: Original Article Source Type: research
Population Pharmacokinetic Models of Antituberculosis Drugs in Patients: A Systematic Critical Review
Conclusions:
More and better models, ideally using nonparametric approaches linked with clear pharmacodynamic goals, are required to optimize anti-TB drug dosing, as recommended in the WHO End TB strategy. (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - January 21, 2021 Category: Drugs & Pharmacology Tags: Review Article Source Type: research
