An Audit of Therapeutic Drug Monitoring Services of Anticonvulsants at a Tertiary Care Hospital in India

Taur, Santosh; Kulkarni, Namrata; Gogtay, Nithya J; Thatte, Urmila M

doi:10.1097/ftd.0b013e3182803d16

Cited by 12 publications

(10 citation statements)

References 18 publications

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“…Although this sometimes might be related the patients’ clinical status, however, sub-therapeutic concentrations may lead to the failure of therapy and development of resistance to some drugs like antibiotics and might also lead to increased length of hospitalization and health care costs. This trend has also been observed elsewhere (Ratanajamit et al, 2009, Dalaklioglu, 2013, Taur et al, 2013). Sub-therapeutic concentrations should be as clinically alarming as toxic concentrations as failure of therapy and appearance of toxicity should be considered equally.…”

Section: Discussionsupporting

confidence: 88%

Sampling time and indications appropriateness for therapeutically monitored drugs at a teaching university hospital in Oman

Za’abi

Muqbali

Al-Waili

2015

Saudi Pharmaceutical Journal

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Section: Discussionsupporting

confidence: 88%

Sampling time and indications appropriateness for therapeutically monitored drugs at a teaching university hospital in Oman

Za’abi

Muqbali

Al-Waili

2015

Saudi Pharmaceutical Journal

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“…One study showed that although TDM helped in distinguishing nonresponders due to noncompliance, the "reference range" of the drugs did not reliably predict breakthrough seizures or toxicity (Harivenkatesh et al, 2015). The latter finding had been seen previously in a study in which among patients clinically suspected of having phenytoin toxicity, only 59% had plasma concentrations above the reference levels (Taur et al, 2013). Another study emphasized the need for monitoring the serum levels of even newer antiepileptics like levetiracetam as its levels decreased by about 57% when enzyme inducers were used concomitantly (Gupta et al, 2016).…”

Section: Therapeutic Drug Monitoring (Tdm)mentioning

confidence: 88%

Clinical Pharmacology in India-A Systematic Review of Research in the Past 5 Years

Shafiq

Malhotra²

2017

Proceedings of the Indian National Science Academy

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The Indian National Science Academy has published two Status Reports on Pharmacological Research (1984 & 2000). The International Council for Science (ICSU) National Committee for Pharmacology has commissioned the third status report on Pharmacological Research in India covering the last 5 years. This systematic review covers the status of research in Clinical Pharmacology (excluding pharmacogenomics, pharmacovigilance, pharmaco-economics). We searched PubMed, Scopus and Google Scholar to extract published articles in the various sub-categories like drug discovery and development, clinical trial methodology & biostatistics, medical education, ethics, drug utilization research, therapeutic drug monitoring, pharmacodynamics, therapeutics and systematic reviews. This report presents a summary of the published research in the last 5 years, discusses some of the challenges and how some steps can be taken to raise the standards of clinical pharmacological research in India.

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“…Consensus is reached on the rational prescription of TDM, which is – despite recent advancements – a demanding procedure with non-negligible costs for the healthcare systems, both in high- (Schumacher and Barr, 2001; Ghiculescu, 2008; Kang and Lee, 2009; Buclin et al, 2012) and low- (Taur et al, 2013; Nwobodo, 2014) income countries. Guidelines recommend TDM when the following circumstances occur (Gross, 2001; Schumacher and Barr, 2001; Touw et al, 2005; Buclin et al, 2012): (1) when there is a stronger (and ascertainable) relationship between the drug concentration and its therapeutic effect or toxicity, rather than between the administered dose and the effect.…”

Section: Therapeutic Drug Monitoring: a Little Explored Field For Poc?mentioning

confidence: 99%

On the Slow Diffusion of Point-of-Care Systems in Therapeutic Drug Monitoring

Sanavio

Krol

2015

Front. Bioeng. Biotechnol.

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Recent advancements in point-of-care (PoC) technologies show great transformative promises for personalized preventative and predictive medicine. However, fields like therapeutic drug monitoring (TDM), that first allowed for personalized treatment of patients’ disease, still lag behind in the widespread application of PoC devices for monitoring of patients. Surprisingly, very few applications in commonly monitored drugs, such as anti-epileptics, are paving the way for a PoC approach to patient therapy monitoring compared to other fields like intensive care cardiac markers monitoring, glycemic controls in diabetes, or bench-top hematological parameters analysis at the local drug store. Such delay in the development of portable fast clinically effective drug monitoring devices is in our opinion due more to an inertial drag on the pervasiveness of these new devices into the clinical field than a lack of technical capability. At the same time, some very promising technologies failed in the clinical practice for inadequate understanding of the outcome parameters necessary for a relevant technological breakthrough that has superior clinical performance. We hope, by over-viewing both TDM practice and its yet unmet needs and latest advancement in micro- and nanotechnology applications to PoC clinical devices, to help bridging the two communities, the one exploiting analytical technologies and the one mastering the most advanced techniques, into translating existing and forthcoming technologies in effective devices.

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An Audit of Therapeutic Drug Monitoring Services of Anticonvulsants at a Tertiary Care Hospital in India

Abstract: TDM continues to remain an important tool to support dose individualization when the patient is receiving multiple AEDs or other drugs such as antitubercular medicines, to assess compliance, and to monitor and treat toxicity.

Cited by 12 publications

References 18 publications

Sampling time and indications appropriateness for therapeutically monitored drugs at a teaching university hospital in Oman

Sampling time and indications appropriateness for therapeutically monitored drugs at a teaching university hospital in Oman

Clinical Pharmacology in India-A Systematic Review of Research in the Past 5 Years

On the Slow Diffusion of Point-of-Care Systems in Therapeutic Drug Monitoring

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