and gamma), monitored drug and plasma level, pharmacokinetic reports and their degree of acceptance. Results A total of 202 pharmacokinetic reports were performed targeting 191 ambulatory patients. The mean age of the total was 42.33 ± 16.46 years (range: 6-106) and 51% were female. Only 5 patients had established renal insufficiency with renal clearance < 60 ml/min and 3 patients with hepatic insufficiency (liver enzymes greater than 3 times the upper limit of normal).The pharmacokinetic reports produced were valproic (43.56%), lithium (37.62%), carbamazepine (8.91%), digoxin (5.94%), phenytoin (2.47%) and phenobarbital (1.48%). Of the patients, 82.68% had plasma levels in therapeutic range, 14.85% were subtherapeutic and 2.47% were supratherapeutic. We highlight a degree of intervention in 17.32% of the pharmacokinetic reports made, and 10.93% of these reports required a change in the dosing regimen or dosing interval together with a new monitoring. The degree of acceptance by the physician was 67%. Conclusion and RelevanceIt is important to perform an adequate follow-up of patients with active treatment of drugs with a narrow therapeutic margin for a constant optimisation of the treatmentThe data reflect the importance of the hospital pharmacist as part of the multidisciplinary team and the need for direct communication with the primary care physician.The high degree of acceptance of pharmacokinetic reports shows that the circuit is well received.
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