Therapeutic drug monitoring. Department of Clinical Pharmacology, Wrocław Medical University

Size: px
Start display at page:

Download "Therapeutic drug monitoring. Department of Clinical Pharmacology, Wrocław Medical University"

Transcription

1 Therapeutic drug monitoring Department of Clinical Pharmacology, Wrocław Medical University

2 Therapeutic index concentration range characterized by a high efficacy of action and low risk of upper toxic symptoms

3 The essence of therapeutic drug monitoring with drug concentration relationship between the pharmacological activity and drug concentration in blood or in other available biological material

4 Therapeutic Drug Monitoring TDM action leading to achieve such a dosage of the drug in a patient that the obtained levels of concentration remain within the therapeutic range

5 Factors conditioning the efficacy of therapeutic drug monitoring the use of pharmacokinetic rules combined analysis of obtained results and clinical status of the patient verification of pharmacological activity of administered drugs by means of other methods

6 Criteria for the selection of drugs for monitoring low therapeutic index dangerous toxic effects of the drug and unnoticeable clinical effect close interrelationship between the drug concentration and its activity administration in a long-term therapy

7 Criteria for the selection of drugs for monitoring continuation the use in life-threatening diseases significant individual differences in the range of pharmacokinetics non linear pharmacokinetics high distribution coefficient

8 Basic clinical indications for the use of therapeutic drug monitoring lack of the expected result of therapy or occurrence of unexpected toxic symptoms in spite of the administered dosage scheme

9 Basic clinical indications for the use of therapeutic drug monitoring - continuation lack of the possibility of adequate clinical or laboratorial control of the efficacy and power of the pharmacological effect of a drug, especially in long lasting therapy and in the prophylactic use

10 Basic clinical indications for the use of therapeutic drug monitoring continuation pathological conditions in which symptoms associated with unsuccessfully treated disease are the same as toxic symptoms of the drug s effect

11 Basic clinical indications for the use of therapeutic drug monitoring continuation individual pharmacokinetic differences depend on the age and genotype of the patient

12 Basic clinical indications for the use of therapeutic drug monitoring continuation coincidence of diseases in organs responsible for the drugs in the organism (renal failure, severe liver diseases, gastrointestinal diseases, pathological states in hypo or dysproteinemia, disturbances in water and electrolyte balance and acid-base balance)

13 Basic clinical indications for the use of therapeutic drug monitoring continuation concomitant administration of other drugs, especially if there is a possibility of interaction between them

14 Basic clinical indications for the use of therapeutic drug monitoring continuation protection against toxic effects of some drugs especially administered at high doses to achieve better therapeutic action of drug (calcium folinate + methotrexate)

15 Basic clinical indications for the use of therapeutic drug monitoring continuation estimation of the therapeutic value of new drugs

16 Rules for rational pharmacotherapy based on measurements of blood serum drug concentration development of such a dosage scheme of the drug that in a study state its concentration remains between the minimal active and the minimal toxic concentrations

17 Factors changing drug kinetics concomitant diseases specially renal and liver diseases, alimentary tract disease, thyroid disease, disturbances in protein binding receptors reactivity concomitant administration of other drugs and interaction of drugs

18 Factors changing drug kinetics - continuation genetic genotype, sex and age determine the individual variability improper dosage administration poor bioavailability of drugs environmental factors, especially tobacco smoking

19 Factors changing drug kinetics continuation tbe use of drugs by patients incompatible with doctor s prescription analytical disturbances, e.g.: the presence of Digoxin Like Immunoreactive Substance DLIS in serum

20 Genetically directed therapeutic monitoring concomitant use of pharmacogenetics and traditional therapeutic monitoring of drugs concentrations in the organism to increase the efficacy and safety of pharmacotherapy

21 Genetically directed therapeutic monitoring - continuation patient s genotype and phenotype estimation before initiation of treatment allows a priori dose modification of such drugs as: mercaptopurine, tioguanine, fluorouracil, azathioprine, trastusumab, irinotecan, tricyclic antidepressants, antiarrhythmic

22 Timing of blood sampling for the estimation of drug concentration after achieving the steady state before administration of another dose of the drug, especially in the morning (minimal drug concentration, C min through concentration)

23 Timing of blood sampling for the estimation of drug concentration continuation in rare cases during administration of toxic drugs, e.g. aminoglycoside antibiotics the estimation of maximal concentration (C max peak concentration) is recommended

24 Recommendations for the estimation of free level of drug concentration diseases of the liver and kidney with associated hypoalbuminemia concomitant use of therapeutic substances with concurrent displacement of the other drugs from serum protein bindings

25 Recommendations for the estimation of free level of drug concentration continuation non linear serum protein binding (salicylates, prednisolon, phenylobutazone, theophylline, disopyrimide) increase of acid α 1 glycoprotein level in some pathological conditions, e.g. myocardial infarction

26 Calculation of changed dose or changed dose interval for drugs undergoing linear pharmacokinetics Changed = Former x indicated drug concentration dose dose estimated drug concentration Changed Former estimated dose interval dose = dose x interval interval indicated dose interval

27 Drugs whose administration is based on therapeutic drug monitoring: cardiac glycosides (digoxin, digitoxin) antiarrhythmic drugs (amiodarone, disopyramide, flecainide, lidocaine, procainamide, propafenone, propranolol) antiepileptic drugs (phenytoine, phenobarbital, carbamazepine, primidone, ethosuximide, valproic acid)

28 Drugs whose administration is based on therapeutic drug monitoring continuation: tricyclic antidepressant drugs (amitriptyline, desipramine, imipramine, norptriptyline) lithium aminoglycosides antibiotics (gentamycin, tobramycin, netilmycin, amikacin, dibecacin, streptomycin, kanamycin)

29 Drugs whose administration is based on therapeutic drug monitoring continuation: theophylline methotrexate cyclosporine tacrolimus

30 Therapeutic concentration range of cardiac glycosides digoxin 0,8 2,0 μg/l digitoxin μg/l

31 Indications for therapeutic monitoring of cardiac glycosides divergence between expected, based on rational premises, and obtained effect of therapy patient s clinical condition restricting correct evaluation of complications after administration of cardiac glycosides pregnancy lactation

32 Indications for therapeutic monitoring of cardiac glycosides continuation diseases of the liver, kidneys, hypo and hyperthyroidaemia, hypoalbuminaemia concomitant administration of drugs increasing the digoxine concentration in plasma by about % (amiodarone, diltiazem, quinidine, verapamil, nifedipine, indomethacin, spironolactone, gentamycin, tetracyclines, cefradine, erythromycin)

33 Therapeutic concentration range of quinidine 2 5 mg/l

34 Indications for therapeutic monitoring of antiarrhythmic drugs quinidine cirrhosis, hypoproteinemia, circulatory insufficiency, renal insufficiency age (infants) concomitant administration of other drugs increasing quinidine concentration (cimetidine, itraconazole, katoconazole, ciprofloxacin, metronidazole, erythromycin, clarythromycin, fluvoxamine)

35 Therapeutic concentration range of procainamide 4 10 mg/l

36 Indications for therapeutic monitoring of antiarrhythmic drugs procainamide genetically determined acetylation polymorphism to active pharmacological metabolite N acetylo procainamide kidney insufficiency high individual variability of processes: adsorption, distribution, metabolism

37 Therapeutic concentration range of lidocaine 1,5 5 mg/l

38 Indications for therapeutic monitoring of antiarrhythmic drugs lidocaine Pathological conditions, in which liver blood supply decreases (congestive heart failure, cardiac shock) concomitant use of drugs increasing the lidocaine concentration (propanolol, mexiletine, cimetidine) drug infusion lasting longer than 24h

39 Therapeutic concentration range of propafenone μg/l

40 Indications for therapeutic monitoring of antiarrhythmic drugs propafenone genetically determined oxidation polymorphism

41 Therapeutic concentration range of antiepileptic drugs phenytoin mg/l phenobarbital mg/l carbamazepine 4 11 mg/l primidone 5 15 mg/l ethosuximide mg/l valproic acid mg/l

42 Indications for therapeutic drug monitoring of antiepileptic drugs narrow therapeutic index of antiepileptic drugs

43 Indications for therapeutic drug monitoring of antiepileptic drugs continuation failure of monotherapy because of too low concentration of drug as an effect of: non compliance of patient to doctor s recommendations adsorption disturbances pharmacokinetic changes caused by external and internal factors

44 Indications for therapeutic drug monitoring of antiepileptic drugs continuation Occurrence of undesired drug effects during antiepileptic therapy associated with: concomitant liver, renal diseases and other pathological conditions which are associated with the loss of protein, especially albumins

45 Indications for therapeutic drug monitoring of antiepileptic drugs continuation Occurrence of undesired drug effects during antiepileptic therapy associated with: concomitant administration of other drugs decreasing the antiepileptic drugs concentration (erythromycin, klarythromycin + carbamazepine)

46 Indications for therapeutic drug monitoring of antiepileptic drugs continuation Occurrence of undesired drug effects during antiepileptic therapy associated with: concomitant administration of some antiepileptics increasing their concentration (valproic acid + phenytoine)

47 Indications for therapeutic drug monitoring of antiepileptic drugs continuation early age (premature infants, infants) pregnant women with epilepsy (concentration of free fraction of phenytoine, karbamazepine, valproic acid increases in the third trimester ) non linear kinetics (phenytoine)

48 Therapeutic concentration range of tricyclic antidepressants: amitriptyline μg/l desipramine μg/l imipramine μg/l nortriptyline μg/l fluoxetine μg/l

49 Indications for therapeutic drug monitoring of tricyclic antidepressants narrow therapeutic index, lack of satisfactory clinical effect and increase of depression genetically determined oxidation polymorphism occurrence of undesired drugs effects administration of high doses of antidepressants

50 Indications for therapeutic drug monitoring of tricyclic antidepressants continuation suspicion of lack of cooperation between patient and doctor diseases of the heart, liver and kidneys advanced age overdosage or suspicion of drug poisoning

51 Indications for therapeutic drug monitoring of tricyclic antidepressants continuation Possibility of interactions (drugs and other substances increasing the tricyclic antidepressant drugs cimetidine, haloperidol, phenothiazines cosegregates, chloramphenicol, fluconazole, verapamil, diltiazem, propafenone, quinidine, ritonavir, oral contraceptives)

52 Therapeutic concentration range of Lithium 0,3 1,3 mmol/l

53 Indications for therapeutic drug monitoring of lithium high nephro and neurotoxicity concomitant administration of other drugs increasing the cardiotoxicity of lithium preparations (thiazide diuretics, monosteroidal anti-inflammatory drugs, general anaesthetics) coexistence of other diseases pregnancy

54 Therapeutic concentration range of aminoglycosides amikacin mg/l gentamycin 5 12 mg/l dibekacin 5 12 mg/l netylmycin 5 12 mg/l tobramycine 5 12 mg/l streptomycin mg/l vankomycin mg/l

55 Indications for therapeutic drug monitoring of aminoglycosides narrow therapeutic index high oto- and nephrotoxicity administration of other oto- and nephrotoxic drugs age-dependent differences in toxicity

56 Indications for therapeutic drug monitoring of aminoglicosides continuation kidney insufficiency therapy with high doses hypovolemia insufficiency of kidneys and hearing in the history repeated therapy of aminoglycosides the use in peritoneal dialysis, hemodialysis patients and patients with kidney s transplantation

57 Therapeutic concentration range of theophylline 8 20 mg/l

58 Indications for therapeutic drug monitoring of theophylline difficult to anticipate relationship between standard daily dose of the drug and its serum concentration in some patients narrow therapeutic index high individual variations in drug elimination, especially in biotransformation of the drug even in patients with efficient liver

59 Indications for therapeutic drug monitoring of theophylline continuation pathological conditions (diseases of the liver and kidneys) patient s age (infants, elderly people) tobacco smoking diet consumption of high amounts of fat high protein and low carbohydrate diet

60 Indications for therapeutic drug monitoring of theophylline continuation concomitant administration of other drugs and substances increasing the theophylline concentration (macrolides antibiotics, fluoroquinolones, cimetidine, zileuton, oral contraceptives) concomitant administration of other drugs and substances decreasing the theophylline concentration (barbiturates, rifampicin, phenytoin, preparations of Hypericum perforatum

61 Indications for therapeutic drug monitoring of methotrexate administration of methotrexate in high doses with calcium folinate coexistence of kidneys and liver failure, the presence of exudation in body cavities concomitant administration of other drugs increasing the toxicity of methotrexate (salicylates, sulphonamides, probenecid, non steroidal anti inflammatory drugs, cefalothin, penicillin, aminoglycosides antibiotics, cisplatin, cyclosporine)

62 Therapeutic concentration range of cyclosporine inductive therapy: ng/l sustaining therapy: ng/l

63 Therapeutic concentration range of tacrolimus 0,2 2,0 μg/l (serum) 4 40 μg/l (whole blood)

64 Indications for therapeutic drug monitoring of immunosuppressive drugs cyclosporine, tacrolimus low therapeutic index high pharmacokinetic variability in and intra individually frequent administration of drugs in severely ill patients

65 Indications for therapeutic drug monitoring of immunosuppressive drugs cyclosporine, tacrolimus continuation the possibility of determination of the risk of transplant rejection or nephrotoxic action of the drug interaction between concomitantly used drugs verification of cooperation of the patient and the doctor

66 Benefits associated with therapeutic concentration drug monitoring increasing the efficacy and safety of administered drugs possibility of tailoring individual patient s dosage possibility of quick doctor s intervention in case of changing clinical condition of the patient

67 Benefits associated with therapeutic concentration drug monitoring continuation decrease in the incidence of undesired drug reactions possibility of drug administration in high doses possibility of detection of imminent risk of undesired reactions before their clinical appearance

68 Benefits associated with therapeutic concentration drug monitoring continuation possibility of checking patient s compliance with the doctor s recommendations shortening of therapy time decrease of the cost of therapy

New drugs necessity for therapeutic drug monitoring

New drugs necessity for therapeutic drug monitoring New drugs necessity for therapeutic drug monitoring Stephan Krähenbühl Clinical Pharmacology & Toxicology University Hospital Basel kraehenbuehl@uhbs.ch Drugs suitable for TDM Narrow therapeutic range

More information

Bassett Healthcare Clinical Laboratory

Bassett Healthcare Clinical Laboratory Therapeutic Drug Level Collection Guidelines Anti-epileptic drugs (carbamazepine, phenobarbital, phenytoin, primidone, valproic acid) Consider collecting after steady state conditions are reached, i.e.

More information

To understand the formulary process from the hospital perspective

To understand the formulary process from the hospital perspective Formulary Process Michael A. Militello, Pharm.D. Cleveland Clinic Cleveland Clinic 2011 Goal and Objectives To understand the formulary process from the hospital perspective p To list the various panels

More information

Therapeutic and Critical Drug Levels

Therapeutic and Critical Drug Levels 6 Results Reporting As a convenience for our clients and their patients, result reports are printed daily at your facility by means of remote printer/fax machine via internet platforms (4Medica, EMR, ecare/mdoffice)

More information

PROGRAM General Information

PROGRAM General Information Association for Quality Assessment in TDM and Clinical Toxicology Section of the Dutch Foundation for Quality Assessment in Medical Laboratories PROGRAM 2016 General Information P.O. Box 43100, 2504 AC

More information

Therapeutic Drug Monitoring (TDM) Guidelines in Blood for Pediatrics and Adults

Therapeutic Drug Monitoring (TDM) Guidelines in Blood for Pediatrics and Adults Acetaminophen 1,5 (Tylenol ) --- 2 hours post 5-20 g/ml >50 g/ml Peak: 1-2 hours Therapeutic Monitoring Acetaminophen 1,5 (Tylenol ) Possible Over Amikacin 7,9 --- 4 hours post --- >50 g/ml Serious toxicity

More information

Appendix 1: Interactions

Appendix 1: Interactions Appendix 1: Interactions Two or more drugs given at the same time may interact with each other. The interaction may be potentiation or antagonism of one drug by another, or occasionally some other. Drug

More information

OMCJH.CHEM.COLL.INF.1001 Therapeutic Drug Monitoring Guidelines

OMCJH.CHEM.COLL.INF.1001 Therapeutic Drug Monitoring Guidelines OMCJH.CHEM.COLL.INF.1001 Copy of version 1.0 (approved and current) Last Approval or Periodic Review Completed 10/5/2017 Next Periodic Review Needed On or Before 10/5/2019 Effective Date 10/5/2017 Controlled

More information

Adjusting phenytoin dosage in complex patients: how to win friends and influence patient outcomes

Adjusting phenytoin dosage in complex patients: how to win friends and influence patient outcomes Adjusting phenytoin dosage in complex patients: how to win friends and influence patient outcomes Brian Hardy, PharmD, FCSHP, FCCP Coordinator Education and Clinical Programs Department of Pharmacy Sunnybrook

More information

LACIPIL QUALITATIVE AND QUANTITATIVE COMPOSITION

LACIPIL QUALITATIVE AND QUANTITATIVE COMPOSITION LACIPIL lacidipine QUALITATIVE AND QUANTITATIVE COMPOSITION Lacidipine, 2 mg - round shaped white engraved on one face. Lacidipine, 4 mg - oval white with break line on both faces. Lacidipine, 6 mg - oval

More information

M O N T H E R A P E D R O R I N G. Dr Tom Hartley UTAS HLS 2014

M O N T H E R A P E D R O R I N G. Dr Tom Hartley UTAS HLS 2014 T H E R A P E U T I C D R U G M O N I T O R I N G Dr Tom Hartley UTAS HLS 2014 TOPICS 1) Why we do TDM 2) What drugs do we monitor 3) How our data assists Clinical Pharmacists & Doctors 4) Bioavailability

More information

TDM. Measurement techniques used to determine cyclosporine level include:

TDM. Measurement techniques used to determine cyclosporine level include: TDM Lecture 15: Cyclosporine. Cyclosporine is a cyclic polypeptide medication with immunosuppressant effect. It has the ability to block the production of interleukin-2 and other cytokines by T-lymphocytes.

More information

Basics of TDM with example drugs

Basics of TDM with example drugs Basics of TDM with example drugs Pharmacokinetic differences in drug handling between patients produce wide variability in serum drug concentrations, but dosage adjustments are generally only required

More information

for therapeutic drug monitoring

for therapeutic drug monitoring Thermo Scientific TDM Assays for Therapeutic Drug Monitoring Complete solutions for therapeutic drug monitoring TDM tests provide quantitative results to ensure beneficial therapeutic effects by determining

More information

PHA 5128 Final Exam Spring 2004 Version A. On my honor, I have neither given nor received unauthorized aid in doing this assignment.

PHA 5128 Final Exam Spring 2004 Version A. On my honor, I have neither given nor received unauthorized aid in doing this assignment. PHA 5128 Final Exam Spring 2004 Version A On my honor, I have neither given nor received unauthorized aid in doing this assignment. Name There are 18 questions. Total /120 pts Final 2004 1 1. T.P., a 66-year-old,

More information

Drug Interactions Year 2 Clinical Pharmacology

Drug Interactions Year 2 Clinical Pharmacology 1 Drug Interactions Year 2 Clinical Pharmacology Prof Mark McKeage Department of Pharmacology & Clinical Pharmacology 2 Objectives Explain the potential for interacting drugs to cause beneficial and harmful

More information

Pharmacokinetics for Physicians. Assoc Prof. Noel E. Cranswick Clinical Pharmacologist Royal Children s Hospital Melbourne

Pharmacokinetics for Physicians. Assoc Prof. Noel E. Cranswick Clinical Pharmacologist Royal Children s Hospital Melbourne Pharmacokinetics for Physicians Assoc Prof. Noel E. Cranswick Clinical Pharmacologist Royal Children s Hospital Melbourne The Important Therapeutic Questions What drug? What dose? How long? Drug Dosage

More information

PACKAGE LEAFLET: Information for the patient FUROSEMID Tablets - 40 mg Solution for injection - 20 mg / 2 ml (Furosemide)

PACKAGE LEAFLET: Information for the patient FUROSEMID Tablets - 40 mg Solution for injection - 20 mg / 2 ml (Furosemide) PACKAGE LEAFLET: Information for the patient FUROSEMID Tablets - 40 mg Solution for injection - 20 mg / 2 ml (Furosemide) Read this leaflet carefully before you start taking this medicine. - Keep this

More information

Valproate Case 3: Formulations Jose de Leon, MD

Valproate Case 3: Formulations Jose de Leon, MD Valproate Case 3: Formulations 2-12-16 Jose de Leon, MD 3.Valproate Case 3 Described in J Clin Psychiatry 2004;65:724-5 http://www.ncbi.nlm.nih.gov/pubmed/15163266 Pharmacological explanation provided

More information

Basic Biopharmaceutics, Pharmacokinetics, and Pharmacodynamics

Basic Biopharmaceutics, Pharmacokinetics, and Pharmacodynamics Basic Biopharmaceutics, Pharmacokinetics, and Pharmacodynamics Learning Outcomes Define biopharmaceutics Describe 4 processes of pharmacokinetics Describe factors that affect medication absorption Describe

More information

Package leaflet: Information for the patient. VEPROL Film coated tablets 40 mg or 80 mg (Verapamil hydrochloride)

Package leaflet: Information for the patient. VEPROL Film coated tablets 40 mg or 80 mg (Verapamil hydrochloride) Package leaflet: Information for the patient VEPROL Film coated tablets 40 mg or 80 mg (Verapamil hydrochloride) Read this leaflet carefully before you start taking this medicine. - Keep this leaflet.

More information

Package leaflet: Information for the user. Uniphyllin Continus 200 mg, 300 mg and 400 mg prolonged-release tablets Theophylline

Package leaflet: Information for the user. Uniphyllin Continus 200 mg, 300 mg and 400 mg prolonged-release tablets Theophylline Package leaflet: Information for the user Uniphyllin Continus 200 mg, 300 mg and 400 mg prolonged-release tablets Theophylline Read all of this leaflet carefully because it contains important information

More information

Drug Interactions Year 2 Clinical Pharmacology

Drug Interactions Year 2 Clinical Pharmacology 1 Drug Interactions Year 2 Clinical Pharmacology Dr Susannah O Sullivan Department of Pharmacology University of Auckland 2 Objectives Explain the potential for interacting drugs to cause beneficial and

More information

Basic Concepts of TDM

Basic Concepts of TDM TDM Lecture 1 5 th stage What is TDM? Basic Concepts of TDM Therapeutic drug monitoring (TDM) is a branch of clinical pharmacology that specializes in the measurement of medication concentrations in blood.

More information

COMMITTEE FOR PROPRIETARY MEDICINAL PRODUCTS (CPMP) NOTE FOR GUIDANCE ON THE INVESTIGATION OF DRUG INTERACTIONS

COMMITTEE FOR PROPRIETARY MEDICINAL PRODUCTS (CPMP) NOTE FOR GUIDANCE ON THE INVESTIGATION OF DRUG INTERACTIONS The European Agency for the Evaluation of Medicinal Products Human Medicines Evaluation Unit London, 17 December, 1997 CPMP/EWP/560/95 COMMITTEE FOR PROPRIETARY MEDICINAL PRODUCTS (CPMP) NOTE FOR GUIDANCE

More information

Dorset Health Technologies Forum SHARED CARE GUIDELINE FOR PRESCRIBING EPLERENONE (INSPRA )

Dorset Health Technologies Forum SHARED CARE GUIDELINE FOR PRESCRIBING EPLERENONE (INSPRA ) INDICATION SHARED CARE GUIDELINE FOR PRESCRIBING EPLERENONE (INSPRA ) Eplerenone is an aldosterone antagonist licensed to be used in addition to standard therapy including beta-blockers, to reduce the

More information

When choosing an antiepileptic ... PRESENTATION... Pharmacokinetics of the New Antiepileptic Drugs. Based on a presentation by Barry E.

When choosing an antiepileptic ... PRESENTATION... Pharmacokinetics of the New Antiepileptic Drugs. Based on a presentation by Barry E. ... PRESENTATION... Pharmacokinetics of the New Antiepileptic Drugs Based on a presentation by Barry E. Gidal, PharmD Presentation Summary A physician s choice of an antiepileptic drug (AED) usually depends

More information

QUALITY CONTROL. Linearity Sets

QUALITY CONTROL. Linearity Sets QUALITY CONTROL Linearity Sets The new Acusera Linearity Sets have been designed with convenience in mind, helping you to easily meet CLIA requirements for calibration verification and assessment of linearity.

More information

Appendix 5: Hepatic impairment

Appendix 5: Hepatic impairment Appendix 5: Hepatic impairment Liver disease may alter the response to drugs. However, the hepatic reserve appears to be large and liver disease has to be severe before important changes in drug metabolism

More information

pharmacy, we need to see how clinical pharmacokinetics fits into the pharmaceutical care process.

pharmacy, we need to see how clinical pharmacokinetics fits into the pharmaceutical care process. Therapeutic drug monitoring (TDM) Is a tool that can guide the clinician to provide effective and safe drug therapy in the individual patient. Monitoring can be used to confirm a plasma drug concentration

More information

Variation in drug responses & Drug-Drug Interactions

Variation in drug responses & Drug-Drug Interactions Variation in drug responses & Drug-Drug Interactions 1 Properties of an Ideal Drug Effective Safety Selective Reversible Action Predictable Freedom from drug interactions Low cost Chemically stable Sources

More information

SUMMARY OF PRODUCT CHARACTERISTICS

SUMMARY OF PRODUCT CHARACTERISTICS SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE MEDICINAL PRODUCT Phenobarbital 30 mg Tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains 30 mg Phenobarbital as the active substance.

More information

Self Assessment Question 1

Self Assessment Question 1 Drug Interactions Bruce G. Pollock, M.D., Ph.D. Professor of Psychiatry, Pharmacology and Nursing Chief, Academic Division of Geriatrics and Neuropsychiatry University of Pittsburgh Medical Center 1 Self

More information

Guideline of Pharmacology for International Student

Guideline of Pharmacology for International Student Guideline of Pharmacology for International Student I Character and Objective of the Course 1. Character of the Course: Basic Medical Course. 2. Preparatory Course: Physiology, biochemistry, and pathophysiology.

More information

TACROLIMUS (PROGRAF, Modigraf Adoport, Adagraf ) Prescribing Guidelines for Adult Liver Transplant Patients and autoimmune liver disease

TACROLIMUS (PROGRAF, Modigraf Adoport, Adagraf ) Prescribing Guidelines for Adult Liver Transplant Patients and autoimmune liver disease Oxford Gastroenterology Unit Shared Care Protocol & Information for GPs TACROLIMUS (PROGRAF, Modigraf Adoport, Adagraf ) Prescribing Guidelines for Adult Liver Transplant Patients and autoimmune liver

More information

Clinical Toxicology Toxicity of Digitalis Glycosides 5 th Year (Lab 3)

Clinical Toxicology Toxicity of Digitalis Glycosides 5 th Year (Lab 3) Clinical Toxicology Toxicity of Digitalis Glycosides 5 th Year (Lab 3) Lecturer: Rua Abbas Al-Hamdy Department of Pharmacology & Toxicology University of Al-Mustansiriyah 2017-2018 Introduction: Digitalis

More information

NIMOTOP 30 mg NIMOTOP IV

NIMOTOP 30 mg NIMOTOP IV SCHEDULING STATUS: S3 PROPRIETARY NAMES AND DOSAGE FORMS: NIMOTOP 30 mg NIMOTOP IV Film-coated tablets Solution COMPOSITION: Each NIMOTOP 30 mg film-coated tablet contains 30 mg nimodipine. Other ingredients:

More information

Name: UFID: PHA Exam 2. Spring 2013

Name: UFID: PHA Exam 2. Spring 2013 PHA 5128 Exam 2 Spring 2013 1 Carbamazepine (5 points) 2 Theophylline (10 points) 3 Gentamicin (10 points) 4 Drug-drug interaction (5 points) 5 Lidocaine (5 points) 6 Cyclosporine (5 points) 7 Phenobarbital

More information

Guidelines/Supporting Studies* FDA Label Information Additional Information/Commentsxc` Gene(s)/Level of evidence

Guidelines/Supporting Studies* FDA Label Information Additional Information/Commentsxc` Gene(s)/Level of evidence Drug Gene(s)/Level of evidence Guidelines/Supporting Studies* FDA Label Information Additional Information/Commentsxc` Haloperidol CYP2D6 ( SLC6A5 ( 2D6: DPWG guidelines Reduce dose by 50% in PMs Aripiprazole

More information

Translation from Latvian Approved by SAM on Summary of Product Characteristics

Translation from Latvian Approved by SAM on Summary of Product Characteristics Approved by SAM on 27.10.08 1. NAME OF THE MEDICINAL PRODUCT Eifilīns 150 mg tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Active substance: Aminophylline (Aminophyllinum) Each tablet contains 150

More information

Amiodarone Therapy. Exceptional healthcare, personally delivered

Amiodarone Therapy. Exceptional healthcare, personally delivered Amiodarone Therapy Exceptional healthcare, personally delivered Your information Name: Address: Postcode: Home telephone: Mobile telephone: Hospital number: Name of GP: Address: Postcode: Telephone number:

More information

Section 2: Medication Safety During Transitions of Care: Clinical Implications

Section 2: Medication Safety During Transitions of Care: Clinical Implications Section 2: Medication Safety During Transitions of Care: Clinical Implications A collection of tools for use by pharmacists in any care setting. These tools are intended to assist in identifying and focusing

More information

Common Drug Interactions in Podiatric Medicine

Common Drug Interactions in Podiatric Medicine CHAPTER 32 Common Drug Interactions in Podiatric Medicine Mickey D. Stapp, DPM. INTRODUCTION Any physician licensed to prescribe medication for a patient must be cognizant of potential drug interactions.

More information

Eplerenon Medical Valley + Eplerenon Stada

Eplerenon Medical Valley + Eplerenon Stada VI.2 Elements for a Public Summary VI.2.1 Overview of disease epidemiology Heart failure is a complex syndrome, clinically characterized by signs and symptoms secondary to abnormal cardiac function. It

More information

Drug Interactions: Let me count the ways

Drug Interactions: Let me count the ways : Let me count the ways President: PRN Associates, Ltd. Continuing Education in Pharmacology Tucson, AZ Objectives At the conclusion of this continuing education lesson, the participant will be able to:

More information

Basic Principles of Therapeutic Drug Monitoring

Basic Principles of Therapeutic Drug Monitoring Journal of Applied Biopharmaceutics and Pharmacokinetics, 2013, 1, 87-95 87 Basic Principles of Therapeutic Drug Monitoring Ahmed S. Ali 1,*, Mahran S. Abdel-Rahman 2, Ab Fatah Ab Rahman 3 and Osman H.

More information

Assays for therapeutic drug monitoring

Assays for therapeutic drug monitoring Assays for therapeutic drug monitoring Broad menu of antibiotics, antiepileptics, antiarrythmics, and more - designed for precise, reliable performance Contents Complete Solutions 3 Antibiotics 4 Antiepileptics

More information

P-RMS: FR/H/PSUR/0056/001

P-RMS: FR/H/PSUR/0056/001 Core Safety Profile Active substance: Piretanide Pharmaceutical form(s)/strength: Tablets, 3mg, 6mg Capsules, 6mg Ampoules, 6mg, 12mg, 60mg P-RMS: FR/H/PSUR/0056/001 Date of FAR: 21.12.2009 4.2 Posology

More information

THE CLATTERBRIDGE CANCER CENTRE NHS FOUNDATION TRUST. Systemic Anti-Cancer Treatment Protocol. Abiraterone. PROCTOCOL REF: MPHAABIRA (Version No: 1.

THE CLATTERBRIDGE CANCER CENTRE NHS FOUNDATION TRUST. Systemic Anti-Cancer Treatment Protocol. Abiraterone. PROCTOCOL REF: MPHAABIRA (Version No: 1. Systemic Anti-Cancer Treatment Protocol Abiraterone PROCTOCOL REF: MPHAABIRA (Version No: 1.0) Approved for use in: The treatment of metastatic castration resistant prostate cancer in adult men who are

More information

INSPRA 25 & 50 mg TABLETS

INSPRA 25 & 50 mg TABLETS INSPRA 25 & 50 mg TABLETS SCHEDULING STATUS: Schedule 4 PROPRIETARY NAMES (and dosage forms): INSPRA 25 (Tablets) INSPRA 50 (Tablets) COMPOSITION: INSPRA 25: INSPRA 50: Each tablet contains 25 mg eplerenone

More information

12/19/16. Disclosures

12/19/16. Disclosures @atriumrx Don t Miss a Beat! Practical Tips on Managing Drug-Induced QTc Prolongation Sandeep Devabhakthuni, PharmD, BCPS- AQ Cardiology Assistant Professor University of Maryland School of Pharmacy Disclosures

More information

Mr. Eknath Kole M.S. Pharm (NIPER Mohali)

Mr. Eknath Kole M.S. Pharm (NIPER Mohali) M.S. Pharm (NIPER Mohali) Drug Class Actions Therapeutic Uses Pharmacokinetics Adverse Effects Other Quinidine IA -Binds to open and inactivated Na+ -Decreases the slope of Phase 4 spontaneous depolarization

More information

Package leaflet: Information for the patient. Metadon 2care4 10 mg tablets. methadone hydrochloride

Package leaflet: Information for the patient. Metadon 2care4 10 mg tablets. methadone hydrochloride Package leaflet: Information for the patient Metadon 2care4 5 mg tablets Metadon 2care4 10 mg tablets methadone hydrochloride Read all of this leaflet carefully before you start taking this medicine because

More information

MTnL Tablet/ MTnL Kid Tablet Montelukast & Levocetirizine dihydrochloride

MTnL Tablet/ MTnL Kid Tablet Montelukast & Levocetirizine dihydrochloride MTnL Tablet/ MTnL Kid Tablet Montelukast & Levocetirizine dihydrochloride COMPOSITION MTnL Tablets Each film-coated tablet contains: Montelukast sodium equivalent to montelukast Levocetirizine dihydrochloride

More information

Shared Care Guideline for Ranolazine in the Management of Stable Angina Pectoris

Shared Care Guideline for Ranolazine in the Management of Stable Angina Pectoris Shared Care Guideline for Ranolazine in the Management of Stable Angina Pectoris Introduction Indication/Licensing information Ranolazine (Ranexa), as recommended by NICE, is indicated in adults as add-on

More information

The Case of Libby Zion and Dangerous Drug Interactions

The Case of Libby Zion and Dangerous Drug Interactions The Case of Libby Zion and Dangerous Drug Interactions J.R.White, PA, PharmD I. MAOI and Meperidine Libby Zion 18 yo female Rx c phenelzine (Nardil) Meperidine given for shaking chills Outcome Death Libby

More information

2 QUALITATIVE AND QUANTITATIVE COMPOSITION

2 QUALITATIVE AND QUANTITATIVE COMPOSITION SUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT Lacidipine 2 mg Film-Coated Tablets 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains 2 mg lacidipine. Excipient with known

More information

Rhythm Control: Is There a Role for the PCP? Blake Norris, MD, FACC BHHI Primary Care Symposium February 28, 2014

Rhythm Control: Is There a Role for the PCP? Blake Norris, MD, FACC BHHI Primary Care Symposium February 28, 2014 Rhythm Control: Is There a Role for the PCP? Blake Norris, MD, FACC BHHI Primary Care Symposium February 28, 2014 Financial disclosures Consultant Medtronic 3 reasons to evaluate and treat arrhythmias

More information

PATIENT INFORMATION LEAFLET FOR FEDALOC 30 mg / 60 mg SR TABLETS. Please read this leaflet carefully before you start taking FEDALOC tablets.

PATIENT INFORMATION LEAFLET FOR FEDALOC 30 mg / 60 mg SR TABLETS. Please read this leaflet carefully before you start taking FEDALOC tablets. 1 Module 1.5.5.2 Patient information leaflet PATIENT INFORMATION LEAFLET FOR FEDALOC 30 mg / 60 mg SR TABLETS Please read this leaflet carefully before you start taking FEDALOC tablets. Keep this leaflet.

More information

ETHNICITY AND PSYCHOTROPIC RESPONSE

ETHNICITY AND PSYCHOTROPIC RESPONSE Ethnic Differences in Drug Metabolism ETHNICITY AND PSYCHOTROPIC RESPONSE Bridging Cultures: Improving Evaluation & Treatment of Cognitive 8 March 28 Keh-Ming Lin, M.D., M.P.H. Professor Emeritus of Psychiatry,

More information

Clinical Pharmacokinetics and Pharmacodynamics

Clinical Pharmacokinetics and Pharmacodynamics Clinical Pharmacokinetics and Pharmacodynamics Larry A. Bauer e CHAPTER KEY CONCEPTS 2 3 4 6 7 8 9 0 Clinical pharmacokinetics is the discipline that describes the absorption, distribution, metabolism,

More information

Appendix D: Drug Tables

Appendix D: Drug Tables Appendix D: Drug Tables A. Short-acting, Orally Administered Opioids Table D-1: Use of Short-acting, Orally Administered Opioids in Adults [198] Additional Maximum APAP dose: 4000 mg/d (2000 mg/d in chronic

More information

EU Core Safety Profile

EU Core Safety Profile EU Core Safety Profile Active Substance: Triazolam Brand Names: HALCION, SOMESE Pharmaceutical form(s)/strength: Tablets RMS: Finland Date: 9 th Dec 2013 Supersedes: 24 th May 2010 4.3. Contraindications

More information

Valproate Case 1: Pharmacokinetics Jose de Leon, MD

Valproate Case 1: Pharmacokinetics Jose de Leon, MD Valproate Case 1: Pharmacokinetics 2-12-16 Jose de Leon, MD 1. Valproate Case 1 J Clin Psychopharmacology 2009;29:509-11 http://www.ncbi.nlm.nih.gov/pubmed/19745660 Educational Objectives At the conclusion

More information

2/25/2015 PHARMACODYNAMICS OF AGING: NARROWING OF THE THERAPEUTIC INDEX IN THE FACE OF THERAPEUTIC OPPORTUNITY OVERALL PRESCRIBING

2/25/2015 PHARMACODYNAMICS OF AGING: NARROWING OF THE THERAPEUTIC INDEX IN THE FACE OF THERAPEUTIC OPPORTUNITY OVERALL PRESCRIBING Mean # Drugs/Resident 2/25/2015 PHARMACODYNAMICS OF AGING: NARROWING OF THE THERAPEUTIC INDEX IN THE FACE OF THERAPEUTIC OPPORTUNITY Darrell R. Abernethy, M.D., Ph.D. Associate Director for Drug Safety

More information

2/26/2015 PHARMACODYNAMICS OF AGING: NARROWING OF THE THERAPEUTIC INDEX IN THE FACE OF THERAPEUTIC OPPORTUNITY

2/26/2015 PHARMACODYNAMICS OF AGING: NARROWING OF THE THERAPEUTIC INDEX IN THE FACE OF THERAPEUTIC OPPORTUNITY PHARMACODYNAMICS OF AGING: NARROWING OF THE THERAPEUTIC INDEX IN THE FACE OF THERAPEUTIC OPPORTUNITY Darrell R. Abernethy, M.D., Ph.D. Associate Director for Drug Safety Office of Clinical Pharmacology

More information

Basic Pharmacokinetic Principles Stephen P. Roush, Pharm.D. Clinical Coordinator, Department of Pharmacy

Basic Pharmacokinetic Principles Stephen P. Roush, Pharm.D. Clinical Coordinator, Department of Pharmacy Basic Pharmacokinetic Principles Stephen P. Roush, Pharm.D. Clinical Coordinator, Department of Pharmacy I. General principles Applied pharmacokinetics - the process of using drug concentrations, pharmaco-kinetic

More information

PHARMACOKINETICS SMALL GROUP I:

PHARMACOKINETICS SMALL GROUP I: PHARMACOKINETICS SMALL GROUP I: Question 1 Absorption of the anti-fungal agent, itraconazole, is dependent on a low gastric ph. Calculate the relative concentrations of a weak acid (with a pka of 5.4)

More information

FREQUENTLY ASKED QUESTIONS

FREQUENTLY ASKED QUESTIONS FREQUENTLY ASKED QUESTIONS Frequently Asked Questions: Table of Contents How should pain be assessed in an unconscious patient? What is the cardiovascular risk associated with the use of nsnsaids/coxibs

More information

Elements for a Public Summary. Overview of disease epidemiology

Elements for a Public Summary. Overview of disease epidemiology VI.2 VI.2.1 Elements for a Public Summary Overview of disease epidemiology Gout i Gout has a worldwide distribution. In the United Kingdom from 2000 to 2007, the estimated occurrence of gout is 5.9% in

More information

M0BCore Safety Profile

M0BCore Safety Profile M0BCore Safety Profile Active substance: Flecainide Acetat Pharmaceutical form(s)/strength: Tablets: 50 mg, 100 mg, 150 mg. Capsules: 50 mg, 100 mg, 150 mg, 200 mg Injection: 15 ml (150 mg), 5 ml (50 mg)

More information

Patient Information leaflet

Patient Information leaflet Patient Information leaflet CARDISEC (90 MG, 120 MG AND 180 MG) DILTIAZEM HYDROCHLORIDE PROLONGED- RELEASE CAPSULES USP) Read all of this leaflet carefully before you start taking this medicine because

More information

TOP APS DRUGS - DIVALPROEX SODIUM BRAND NAME: DEPAKOTE (ER)

TOP APS DRUGS - DIVALPROEX SODIUM BRAND NAME: DEPAKOTE (ER) divalproex sodium TOP APS DRUGS - DIVALPROEX SODIUM BRAND NAME: DEPAKOTE (ER) Pharmacodynamics study of what a drug does to the body Divalproex sodium is chemically compounded from sodium valproate and

More information

M0BCore Safety Profile

M0BCore Safety Profile M0BCore Safety Profile Active substance: Aciclovir Pharmaceutical form(s)/strength: Tablets 200, 400 or 800 mg Dispersible tablets 200, 400 or 800 mg Oral suspensions 200 mg or 400 mg per 5 ml. Freeze

More information

Smoking Cessation Pharmacotherapy Guidelines

Smoking Cessation Pharmacotherapy Guidelines Smoking Cessation Pharmacotherapy Guidelines INTRODUCTION This guideline is based on public health guidance 10 Smoking Cessation Services issued by the National Institute for Health and Clinical Excellence

More information

PACKAGE LEAFLET: INFORMATION FOR THE USER. Pro-Epanutin 75mg/ml Concentrate for Solution for Infusion/ Solution for Injection (fosphenytoin sodium)

PACKAGE LEAFLET: INFORMATION FOR THE USER. Pro-Epanutin 75mg/ml Concentrate for Solution for Infusion/ Solution for Injection (fosphenytoin sodium) PACKAGE LEAFLET: INFORMATION FOR THE USER Pro-Epanutin 75mg/ml Concentrate for Solution for Infusion/ Solution for Injection (fosphenytoin sodium) Read all of this leaflet carefully before you start taking

More information

Package Leaflet: Information for the patient. EPANUTIN 30 mg/ 5ml Oral Suspension (phenytoin)

Package Leaflet: Information for the patient. EPANUTIN 30 mg/ 5ml Oral Suspension (phenytoin) Package Leaflet: Information for the patient EPANUTIN 30 mg/ 5ml Oral Suspension (phenytoin) Read all of this leaflet carefully before you start taking this medicine because it contains important information

More information

Pediatric Pharmacotherapy

Pediatric Pharmacotherapy Pediatric Pharmacotherapy A Monthly Review for Health Care Professionals of the Children's Medical Center Volume 1, Number 7, July 1995 Therapeutic Drug Monitoring in Pediatric Patients Therapeutic Drug

More information

CLINICAL PHARMACOKINETICS INDEPENDENT LEARNING MODULE

CLINICAL PHARMACOKINETICS INDEPENDENT LEARNING MODULE CLINICAL PHARMACOKINETICS INDEPENDENT LEARNING MODULE Joseph K. Ritter, Ph.D. Assoc. Professor, Pharmacology and Toxicology MSB 536, 828-1022, jritter@vcu.edu This self study module will reinforce the

More information

Abbott. doses, as follows: 1 Isoptin 80 mg film-coated tablet

Abbott. doses, as follows: 1 Isoptin 80 mg film-coated tablet 10-14 Isoptin Abbott NAME OF THE MEDICINAL PRODUCT Isoptin 80 mg, film-coated tablets Isoptin SR, 240 mg prolonged-release tablets COMPOSITION OF THE MEDICINAL PRODUCT Active substances: Isoptin 80 mg:

More information

Metabolism. Objectives. Metabolism. 26 July Chapter 28 1

Metabolism. Objectives. Metabolism. 26 July Chapter 28 1 Metabolism bjectives Describe various processes by which drugs are metabolized Describe induction and inhibition of metabolism Use the venous equilibration model to describe hepatic clearance and the effect

More information

2. What you need to know before you take Bisoprolol Tablets

2. What you need to know before you take Bisoprolol Tablets PACKAGE LEAFLET: INFORMATION FOR THE USER Bisoprolol 2.5 mg Film-coated Tablet Bisoprolol 5 mg Film-coated Tablet Bisoprolol 10 mg Film-coated Tablet Bisoprolol fumarate Read all of this leaflet carefully

More information

Pharmacokinetics in the critically ill. Intensive Care Training Program Radboud University Medical Centre Nijmegen

Pharmacokinetics in the critically ill. Intensive Care Training Program Radboud University Medical Centre Nijmegen Pharmacokinetics in the critically ill Intensive Care Training Program Radboud University Medical Centre Nijmegen In general... Critically ill patients are at higher risk for ADE s and more severe ADE

More information

ICU Volume 11 - Issue 3 - Autumn Series

ICU Volume 11 - Issue 3 - Autumn Series ICU Volume 11 - Issue 3 - Autumn 2011 - Series Impact of Pharmacokinetics of Antibiotics in ICU Clinical Practice Introduction The efficacy of a drug is mainly dependent on its ability to achieve an effective

More information

Interactions. Muscle weakness in myasthenia gravis patients Reduced salicylate blood levels. cyclophosphamide

Interactions. Muscle weakness in myasthenia gravis patients Reduced salicylate blood levels. cyclophosphamide Table 12.3.1 Drug Drug interactions with Interactions Amphotericin B Anticholinesterase drugs Aspirin Cyclophosphamide Cyclosporine Digoxin Furosemide/ thiazides Ephedrine Insulin Ketoconazole Mitotane

More information

Composition: Each tablet contain. Levocetirizine. Each 5ml contains. Montelukast. Pharmacokinetic properties:

Composition: Each tablet contain. Levocetirizine. Each 5ml contains. Montelukast. Pharmacokinetic properties: Composition: Each tablet contain Montelukast Levocetirizine 10mg 5mg Each 5ml contains Montelukast Levocetirizine 4mg 2.5mg Pharmacokinetic properties: Peak plasma concentrations of montelukast are achieved

More information

LD = (Vd x Cp)/F (Vd x Cp)/F MD = (Css x CL x T)/F DR = (Css x (Vm-DR))/Km Css = (F x D)/(CL x T) (Km x DR)/(Vm DR)

LD = (Vd x Cp)/F (Vd x Cp)/F MD = (Css x CL x T)/F DR = (Css x (Vm-DR))/Km Css = (F x D)/(CL x T) (Km x DR)/(Vm DR) PHARMKIN WORKSHOP A PHARMACOKINETICS TEACHING SIMULATION Joseph K. Ritter, Ph.D. Associate Professor, Pharmacology and Toxicology MSB 536, 828-1022, jritter@mail2.vcu.edu Tompkins-McCaw Libray Room 2-006

More information

Nonlinear Pharmacokinetics

Nonlinear Pharmacokinetics Nonlinear Pharmacokinetics Non linear pharmacokinetics: In some cases, the kinetics of a pharmacokinetic process change from predominantly first order to predominantly zero order with increasing dose or

More information

Summary of Product Characteristics

Summary of Product Characteristics Summary of Product Characteristics 1. Name of the Medicinal Product Zemtard 180 XL. Angiozem 180 XL. Uard 180XL. 2. Qualitative and Quantitative Composition Diltiazem hydrochloride EP 180mg. International

More information

ROSOBAC-1GM / ROSOBAC-FORT

ROSOBAC-1GM / ROSOBAC-FORT ROSOBAC-1GM / ROSOBAC-FORT ROSOBAC - 1GM. COMPOSITION : Each vial contains Sterile Cefoperazone Sodium IP Eq. to Anhydrous Cefoperazone - Sterile Sulbactam Sodium USP Eq. to Anhydrous Sulbactam - ROSOBAC

More information

PACKAGE LEAFLET: INFORMATION FOR THE USER. Pro-Epanutin 75mg/ml Concentrate for Solution for Infusion/ Solution for Injection (fosphenytoin sodium)

PACKAGE LEAFLET: INFORMATION FOR THE USER. Pro-Epanutin 75mg/ml Concentrate for Solution for Infusion/ Solution for Injection (fosphenytoin sodium) PACKAGE LEAFLET: INFORMATION FOR THE USER Pro-Epanutin 75mg/ml Concentrate for Solution for Infusion/ Solution for Injection (fosphenytoin sodium) Read all of this leaflet carefully before you start taking

More information

TEACHERS TOPICS Role of Protein Binding in Pharmacokinetics

TEACHERS TOPICS Role of Protein Binding in Pharmacokinetics TEACHERS TOPICS Role of Protein Binding in Pharmacokinetics Reza Mehvar, PhD School of Pharmacy, Texas Tech University Health Sciences Center Submitted January 3, 2005; accepted February 13, 2005; published

More information

B. 14 Antidysrhythmic drugs. a. Classify antidysrhythmics by their electrophysiological actions. Vaughan-Williams classification

B. 14 Antidysrhythmic drugs. a. Classify antidysrhythmics by their electrophysiological actions. Vaughan-Williams classification B. 14 Antidysrhythmic drugs a. Classify antidysrhythmics by their electrophysiological actions. Vaughan-Williams classification I II III IV membrane stabilizers all ERP, ERP/APD, all except c APD classified

More information

PACKAGE LEAFLET: Information for the user. METFORMINE Film-coated tablets 500 mg, 850 mg or 1000 mg (Metformin hydrochloride)

PACKAGE LEAFLET: Information for the user. METFORMINE Film-coated tablets 500 mg, 850 mg or 1000 mg (Metformin hydrochloride) PACKAGE LEAFLET: Information for the user METFORMINE Film-coated tablets 500 mg, 850 mg or 1000 mg (Metformin hydrochloride) Read this leaflet carefully before you start taking this medicine. - Keep this

More information

Metformin Hydrochloride

Metformin Hydrochloride Metformin Hydrochloride 500 mg, 850 mg, 500 mg LA and 750 mg LA Tablet Description Informet is a preparation of metformin hydrochloride that belongs to a biguanide class of oral antidiabetic drugs. Metformin

More information

Early Identification and Prevention of Drug-to-Drug Interactions in a tertiary care hospital. RadhikaSoanker*, SubbalaxmiMVS $.

Early Identification and Prevention of Drug-to-Drug Interactions in a tertiary care hospital. RadhikaSoanker*, SubbalaxmiMVS $. Early Identification and Prevention of Drug-to-Drug Interactions in a tertiary care hospital. RadhikaSoanker*, SubbalaxmiMVS $. * Dept of Clinical Pharmacology & Therapeutics, $ Dept of General Medicine,

More information

Therapeutic Drug Monitoring

Therapeutic Drug Monitoring Therapeutic Drug Monitoring news from the laboratory Pieter Vermeersch, Steven Pauwels, Matthijs Oyaert Laboratory Medicine, UZ Leuven Overview 1. Introduction 2. Analytical methods 3. Testing on dry blood

More information

Document 3 Summary of Data and Guidance for Medical Professionals

Document 3 Summary of Data and Guidance for Medical Professionals Document 3 Summary of Data and Guidance for Medical Professionals Anvirzel Anvirzel is a novel antitumor compound extracted from the plant Nerium oleander, which belongs to the family Apocynaceae. Anvirzel

More information

Composition: Each Tablet contains. Pharmacokinetic properties:

Composition: Each Tablet contains. Pharmacokinetic properties: Composition: Each Tablet contains Torsemide 5/10/20/40/100mg Pharmacokinetic properties: Torsemide is well absorbed from the gastrointestinal tract. Peak serum concentrations are achieved within 1 hour

More information