Anonymous
Anonymous asked in HealthDiseases & ConditionsCancer · 1 decade ago

Drug research help??

Anyone know anything about therapeutic drugs with long treatment effect?

any help will be appreciated .

THANX in advance

1 Answer

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  • Anonymous
    1 decade ago
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    Therapeutic drug monitoring of concentrations of drugs in body fluids, usually plasma, can be used during treatment and for diagnostic purposes. The selection of drugs for therapeutic drug monitoring is important as the concentrations of many drugs are not clearly related to their effects. For selected drugs therapeutic drug monitoring aims to enhance drug efficacy, reduce toxicity or assist with diagnosis. Despite its apparent advantages, it has inherent limitations. Some large hospitals have services which provide support with drug monitoring and interpretation of results.

    When an effect, such as changes in blood pressure, pain or serum cholesterol is readily measured, the dose of a drug should be adjusted according to the response. Monitoring drug concentration is more useful when drugs are used to prevent an adverse outcome, for example, graft rejection or to avoid toxicity, as with aminoglycosides. A drug should satisfy certain criteria to be suitable for therapeutic drug monitoring. Examples include:

    narrow target range

    significant pharmacokinetic variability

    a reasonable relationship between plasma concentrations and clinical effects n established target concentration range

    availability of cost-effective drug assay.

    The most commonly monitored drugs are probably carbamazepine, valproate and digoxin. However, there is little evidence that monitoring concentrations of anticonvulsants improves clinical outcomes when the drugs are used to treat mood disorders.

    Table 1 shows some of the drugs that meet these criteria.

    Table 1

    Drugs suitable for therapeutic drug monitoring

    Drug Target range *

    --------------------------------------------------------------------------------

    Drugs regularly monitored in clinical practice

    digoxin 0.8-2 microgram/L and < 0.01 microgram/L in refractory heart failure

    lithium - acute mania

    - maintenance

    0.8-1.2 mmol/L

    0.4-1.0 mmol/L

    perhexiline 0.15-0.6 mg/L

    phenytoin 10-20 mg/L

    cyclosporin 50-125 microgram/L (serum or plasma)

    150-400 microgram/L (whole blood)

    Concentrations differ for various clinical settings

    sirolimus 5-15 microgram/L (whole blood)

    tacrolimus 5-20 microgram/L (whole blood)

    --------------------------------------------------------------------------------

    Drugs for which monitoring may be useful

    amiodarone 1-2.5 mg/L

    carbamazepine 5-12 mg/L

    flecainide 0.2-0.9 mg/L

    lamotrigine 1.5-3 mg/L

    salicylate 150-300 mg/L

    sodium valproate 50-100 mg/L

    vancomycin Trough 10-20 mg/L

    --------------------------------------------------------------------------------

    * Concentrations may vary between laboratories

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