Courses in clinical pharmacology for nurses and young doctors – narrowing the gap of ignorance?

Autor: C.B. Rasmussen, E. Jimenez-Solem, K.M. Harboe, H.R. Christensen, L.Ø. Reuther, M.V. Hansen, A. Bondesen
Rok vydání: 2015
Předmět:
Zdroj: ResearcherID
ISSN: 0149-2918
DOI: 10.1016/j.clinthera.2015.05.464
Popis: e164 Volume 37 Number 8S Personalised pharmacotherapy as a part of personalised medicine is looking for the right drug, right patient, right dose, and right dosage interval. Selection of the right drug given to the right patient can be solved a priori using pharmacogenetics (eg, warfarin, azathioprine, etc). A posteriori therapeutic drug monitoring (TDM) can be used for the selection of the right dose and dosage interval. TDM refers to the individualization of drug dosage by maintaining plasma or blood drug concentrations within a targeted therapeutic range or window for optimal patient benefit. Traditionally, TDM involves measuring drug concentrations in various biological fluids and interpreting these concentrations in terms of relevant clinical parameters. For > 100 drugs (aminoglycosides, vancomycin, antimycotics, digoxin, amiodarone, theophylline, antiepileptic drugs, immunosuppressive drugs, psychopharmaceuticals, cytostatics, etc) with better relationship between plasma or blood concentration-response than doseresponse, the measurement of plasma or blood concentrations has become a valuable surrogate index of drug exposure in the body. Next step, advanced TDM includes the estimation of metabolites and probe drugs (phenotyping), free drug concentrations, and genotyping. The estimation of the phenotype shows actual metabolic status, and genotyping seems to be very useful for the explanation of some differences. Cohort studies and case reports from the routine clinical practice will be demonstrated.
Databáze: OpenAIRE
Externí odkaz: