Dried blood spots in therapeutic drug monitoring and toxicology

Velghe, Sofie; Troyer, Rani De; Stove, Christophe

doi:10.1080/17425255.2018.1414181

Cited by 30 publications

(34 citation statements)

References 16 publications

(55 reference statements)

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“…Population pharmacokinetics modelling can be a useful tool, not only to predict pharmacokinetics parameters, but also to develop more evidence-based dosing in special populations [ 55 ]. Patient-related (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…After the development of a pharmacokinetics model and model-based dosing, it would be of the utmost importance to prospectively validate the model-based dosing in a clinical study, not only to investigate whether the target concentration is reached, but also to investigate if the safety values are within the reference range. A first step could be to evaluate the already performed pharmacokinetics studies on quality and the amount of data, such as clinical characteristics, drug concentrations in plasma, number of patients and time of sampling, retrieved from these studies in order to perform a pooled-pharmacokinetics analysis [ 55 ]. Such a pooled analysis has already been performed by Allegaert et al [ 57 ] with the aim to study all common covariates in adults in datasets on intravenous paracetamol.…”

Section: Discussionmentioning

confidence: 99%

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Paracetamol in Older People: Towards Evidence-Based Dosing?

et al. 2018

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Paracetamol is the most commonly used analgesic in older people, and is mainly dosed according to empirical dosing guidelines. However, the pharmacokinetics and thereby the effects of paracetamol can be influenced by physiological changes occurring with ageing. To investigate the steps needed to reach more evidence-based paracetamol dosing regimens in older people, we applied the concepts used in the paediatric study decision tree. A search was performed to retrieve studies on paracetamol pharmacokinetics and safety in older people (> 60 years) or studies that performed a (sub) analysis of pharmacokinetics and/or safety in older people. Of 6088 articles identified, 259 articles were retained after title and abstract screening. Further abstract and full-text screening identified 27 studies, of which 20 described pharmacokinetics and seven safety. These studies revealed no changes in absorption with ageing. A decreased (3.9–22.9%) volume of distribution (Vd) in robust older subjects and a further decreased Vd (20.3%) in frail older compared with younger subjects was apparent. Like Vd, age and frailty decreased paracetamol clearance (29–45.7 and 37.5%) compared with younger subjects. Due to limited and heterogeneous evidence, it was difficult to draw firm and meaningful conclusions on changed risk for paracetamol safety in older people. This review is a first step towards bridging knowledge gaps to move to evidence-based paracetamol dosing in older subjects. Remaining knowledge gaps are safety when using therapeutic dosages, pharmacokinetics changes in frail older people, and to what extent changes in paracetamol pharmacokinetics should lead to a change in dosage in frail and robust older people.Electronic supplementary materialThe online version of this article (10.1007/s40266-018-0559-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Paracetamol in Older People: Towards Evidence-Based Dosing?

et al. 2018

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“…[62][63][64] Noninvasive sampling technique such as dried blood spot analysis is another possibility but seems more appropriate for transplant patients with mild complaints who are in quarantine at home. 62,63,65,66 o For Tac, a target AUC 0-12h of 100-190 ng$h/mL ng.h/mL for twice daily regimen and AUC 0-24h of 180-350 ng$h/mL for once daily is proposed. These values correspond to a C 0 target between 5 and 10 ng/mL.…”

Section: Calcineurin Inhibitors and Mtorimentioning

confidence: 99%

Pharmacologic Treatment of Transplant Recipients Infected With SARS-CoV-2: Considerations Regarding Therapeutic Drug Monitoring and Drug–Drug Interactions

Elens

Langman

Hesselink

et al. 2020

Therapeutic Drug Monitoring

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Background: COVID-19 is a novel infectious disease caused by the severe acute respiratory distress (SARS)-coronavirus-2 (SARS-CoV-2). Several therapeutic options are currently emerging but none with universal consensus or proven efficacy. Solid organ transplant recipients are perceived to be at increased risk of severe COVID-19 because of their immunosuppressed conditions due to chronic use of immunosuppressive drugs (ISDs). It is therefore likely that solid organ transplant recipients will be treated with these experimental antivirals. Methods: This article is not intended to provide a systematic literature review on investigational treatments tested against COVID-19; rather, the authors aim to provide recommendations for therapeutic drug monitoring of ISDs in transplant recipients infected with SARS-CoV-2 based on a review of existing data in the literature. Results: Management of drug-drug interactions between investigational anti-SARS-CoV-2 drugs and immunosuppressants is a complex task for the clinician. Adequate immunosuppression is necessary to prevent graft rejection while, if critically ill, the patient may benefit from pharmacotherapeutic interventions directed at limiting SARS-CoV-2 viral replication. Maintaining ISD concentrations within the desired therapeutic range requires a highly individualized approach that is complicated by the pandemic context and lack of hindsight. Conclusions: With this article, the authors inform the clinician about the potential interactions of experimental COVID-19 treatments with ISDs used in transplantation. Recommendations regarding therapeutic drug monitoring and dose adjustments in the context of COVID-19 are provided.

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“…First, DBS collection is easy to perform, and the sampling volume is much smaller, which improves its use even in small animals. Furthermore, the storage and transport of the DBS poses less practical challenges and risks compared to plasma and urine due to increased analyte stability [10]. In that respect, DBSs are considered safe and non-contagious, in contrast to blood, plasma or serum, and this facilitates transport across the globe.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Dried Blood Spots for Multi-Mycotoxin Biomarker Analysis in Pigs and Broiler Chickens

Lauwers

Croubels

Baere

et al. 2019

Toxins

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Dried blood spots (DBSs), a micro-sampling technique whereby a drop of blood is collected on filter paper has multiple advantages over conventional blood sampling regarding the sampling itself, as well as transportation and storage. This is the first paper describing the development and validation of a method for the determination of 23 mycotoxins and phase I metabolites in DBSs from pigs and broiler chickens using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The targeted mycotoxins belong to groups for which the occurrence in feed is regulated by the European Union, namely, aflatoxins, ochratoxin A and several Fusarium mycotoxins, and to two groups of unregulated mycotoxins, namely Alternaria mycotoxins and Fusarium mycotoxins (enniatins and beauvericin). The impact of blood haematocrit, DBS sampling volume and size of the analysed DBS disk on the validation results was assessed. No effects of variation in size of the analysed disk, haematocrit and spotted blood volume were observed for most mycotoxins, except for the aflatoxins and β-zearalanol (BZAL) at the lowest haematocrit (26%) level and for the enniatins (ENNs) at the lowest volume (40 µL). The developed method was transferred to an LC-high resolution mass spectrometry instrument to determine phase II metabolites. Then, the DBS technique was applied in a proof-of-concept toxicokinetic study including a comparison with LC-MS/MS data from plasma obtained with conventional venous blood sampling. A strong correlation (r > 0.947) was observed between plasma and DBS concentrations. Finally, DBSs were also applied in a pilot exposure assessment study to test their applicability under field conditions.

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Dried blood spots in therapeutic drug monitoring and toxicology

Cited by 30 publications

References 16 publications

Paracetamol in Older People: Towards Evidence-Based Dosing?

Paracetamol in Older People: Towards Evidence-Based Dosing?

Pharmacologic Treatment of Transplant Recipients Infected With SARS-CoV-2: Considerations Regarding Therapeutic Drug Monitoring and Drug–Drug Interactions

Assessment of Dried Blood Spots for Multi-Mycotoxin Biomarker Analysis in Pigs and Broiler Chickens

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