Guidelines for Therapeutic Drug Monitoring of Cardiovascular Drugs Clinical Use of Blood Drug Concentration Monitoring (JCS 2015)　― Digest Version ―

Direct analysis in real time-mass spectrometry for rapid quantification of five anti-arrhythmic drugs in human serum: application to therapeutic drug monitoring

“…Therapeutic drug monitoring prevents the drug concentration-dependent adverse reactions (ADR) and monitors the compliance. The concentrations of clinical TDM samples above the upper limits may have increased risks of ADRs 32 , 33 . The reported effective plasma concentration range was from 40 to over 3,000 ng/mL for propafenone and 500 to 2,500 ng/mL for amiodarone 32 .…”

“…The concentrations of clinical TDM samples above the upper limits may have increased risks of ADRs 32 , 33 . The reported effective plasma concentration range was from 40 to over 3,000 ng/mL for propafenone and 500 to 2,500 ng/mL for amiodarone 32 . Also, the patients’ compliance should be monitored for β-blockers and calcium-channel blockers 5 .…”

Avoidable lethal torsade de pointes during pacemaker generator exchange caused by bepridil intoxication

“…[3][4][5][6][7][8] Measurement of plasma bepridil concentration would be useful in preventing TdP as an adverse effect of bepridil use because a high plasma bepridil concentration of >800 ng/mL is considered a risk factor for TdP. 2,5 Plasma bepridil concentration varies greatly among individuals, even at the same dosage, because of its complex pharmacokinetics. 1,2,5 In addition, the treatment of bepridil intoxication can be difficult once adverse effects have occurred because bepridil has a very long elimination half-life of approximately 80 h after continued intake, which can be more prolonged due to less clearance in patients with low body weight and advanced age, like the present case.…”

“…Therefore, atrial fibrillation management should be conducted carefully and adequately, measuring plasma bepridil concentration regularly or timely, when an atrial fibrillation patient is treated using bepridil. 2 However, because atrial fibrillation is a common disease, the family physician often prescribes and manages arrhythmia. As regards pacemaker patients, because they visit the pacemaker clinic regularly, the responsibility of arrhythmia management might be obscured between the family physician and the electrophysiologist at the pacemaker clinic.…”

Porovnání DOS a Windows verze MwPharm - farmakokinetického softvéru pro PK/PD monitoring digoxinu

“…Therapeutic intervals for digoxin used in University hospital Ostrava are as follows: for children 0.8-2.0 μg/l [6], for adults 0.5-1.2 μg/l (especially, >65 years) [7], and for pregnant women 2.0-2.5 μg/l [8]. Inaccuracy was determined using three concentration levels of the commercial control samples.…”