The significance of sampling time in therapeutic drug monitoring of clozapine
| Autor: | Kristian Linnet, Camilla K Svensson, Anders Fink-Jensen, Sys Stybe Johansen, Jimmi Nielsen, Julie R. Larsen, Michelle I Jakobsen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty 030226 pharmacology & pharmacy Gastroenterology Drug Administration Schedule Young Adult 03 medical and health sciences 0302 clinical medicine Monocytosis Internal medicine medicine Humans Time point Clozapine Dose-Response Relationship Drug medicine.diagnostic_test business.industry Middle Aged medicine.disease Psychiatry and Mental health Basophilia Therapeutic drug monitoring Anesthesia Schizophrenia Female Sampling time Drug Monitoring business Body mass index 030217 neurology & neurosurgery Antipsychotic Agents medicine.drug Blood drawing |
| Zdroj: | Jakobsen, M I, Larsen, J R, Svensson, C K, Johansen, S S, Linnet, K, Nielsen, J & Fink-Jensen, A 2017, ' The significance of sampling time in therapeutic drug monitoring of clozapine ', Acta Psychiatrica Scandinavica, vol. 135, no. 2, pp. 159-169 . https://doi.org/10.1111/acps.12673 |
| Popis: | OBJECTIVE: Therapeutic drug monitoring (TDM) of clozapine is standardized to 12-h postdose samplings. In clinical settings, sampling time often deviates from this time point, although the importance of the deviation is unknown. To this end, serum concentrations (s-) of clozapine and its metabolite N-desmethyl-clozapine (norclozapine) were measured at 12 ± 1 and 2 h postdose.METHOD: Forty-six patients with a diagnosis of schizophrenia, and on stable clozapine treatment, were enrolled for hourly, venous blood sampling at 10-14 h postdose.RESULTS: Minor changes in median percentage values were observed for both s-clozapine (-8.4%) and s-norclozapine (+1.2%) across the 4-h time span. Maximum individual differences were 42.8% for s-clozapine and 38.4% for s-norclozapine. Compared to 12-h values, maximum median differences were 8.4% for s-clozapine and 7.3% for s-norclozapine at deviations of ±2 h. Maximum individual differences were 52.6% for s-clozapine and 105.0% for s-norclozapine. The magnitude of s-clozapine differences was significantly associated with age, body mass index and the presence of chronic basophilia or monocytosis.CONCLUSION: The impact of deviations in clozapine TDM sampling time, within the time span of 10-14 h postdose, seems of minor importance when looking at median percentage differences. However, substantial individual differences were observed, which implies a need to adhere to a fixed sampling time. |
| Databáze: | OpenAIRE |
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