Therapeutic Drug Monitoring Characteristics in a Tertiary University Hospital in 2019

Özünal, Zeynep Güneş; Ipek, Belkiz Ongen

doi:10.7759/cureus.7612

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…Belkiz [28] Methods to predict the dosage of lithium have limitations and should be used with caution. One reason for failure in dosage predictions could be variations in GFR due to changes in mental and physical activity.…”

Section: Ozunal Andmentioning

confidence: 99%

Challenges of Therapeutic Drug Monitoring and Usage of Lithium in Managing Psychiatric Disorders: A Review

Leo¹,

Mathews²,

Ikhsan³

et al. 2023

Prog Drug Discov Biomed Sci

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Lithium is referred by all key guidelines as a first-line treatment for bipolar disorder (BD) maintenance therapy. Therapeutic drug monitoring (TDM) is necessary while using lithium as lithium treatment. The concern arose when there is one article discussed about the declining of usage of lithium in certain countries such as US and Canada. However, the prescription rates of lithium in United Kingdom and Scandinavia do not show a downward trend. The aim of this study was to determine the challenges of TDM and usage of lithium in managing psychiatric disorders. A total of 32 articles have mentioned the challenges in TDM and usage of lithium. Descriptive statistics was done to identify the challenges in TDM and usage of lithium in psychiatric disorders. There is a total of 25 and 27 challenges found in TDM and usage of lithium in psychiatric disorders respectively. The most stated challenges in TDM of lithium were drug-drug and drug-disease interactions (16.07%), poor compliance (14.28%) and different therapeutic levels or dose suggested by different authors or guidelines (14.28%). The most stated challenges in usage of lithium in psychiatric disorders were potential toxicity (16.85%), side effects of lithium (16.85%), narrow therapeutic range (15.73%) and needs frequent monitoring (15.73%). However, the usage of lithium in certain countries remains still high may be due to the benefits of lithium to psychiatric patients in reducing risk of manic relapse and depressive relapse. Although there are 52 challenges found in the TDM and usage of lithium, there is no definite article or statement stating that the usage of lithium is declining. Future multi-national study is needed to study the extend challenges in TDM and usage of lithium in developed countries as compared to developing countries.

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Section: Ozunal Andmentioning

confidence: 99%

Challenges of Therapeutic Drug Monitoring and Usage of Lithium in Managing Psychiatric Disorders: A Review

Leo¹,

Mathews²,

Ikhsan³

et al. 2023

Prog Drug Discov Biomed Sci

View full text Add to dashboard Cite

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Evaluation of Serum Drug Concentrations in a Tertiary Care Hospital: A Cross-Sectional Study

BECİT-KIZILKAYA,

ONCU,

ÇAVUŞOĞLU

et al. 2024

Journal of Basic and Clinical Health Sciences

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Background: Serum drug concentration (SDC) is an important parameter used in drug efficacy and treatment follow-up. Aim: This study aimed to evaluate SDC and the influencing factors for carbamazepine, phenytoin, phenobarbital, lithium and digoxin. Materials and Methods: This is a cross-sectional study, evaluating the outpatients’ and inpatients’ SDC data treated at Research and Application Hospital of Afyonkarahisar Health Sciences University between January 1, 2012 and December 31, 2019, and having SDC data. The relations between dependent and independent variables was evaluated with chi-square analysis and Students’ T-test. P

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Current Status of Therapeutic Drug Monitoring in Mental Health Treatment: A Review

et al. 2022

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Therapeutic drug monitoring (TDM) receives growing interest in different psychiatric clinical settings (emergency, inpatient, and outpatient services). Despite its usefulness, TDM remains underemployed in mental health. This is partly due to the need for evidence about the relationship between drug serum concentration and efficacy and tolerability, both in the general population and even more in subpopulations with atypical pharmacokinetics. This work aims at reviewing the scientific literature published after 2017, when the most recent guidelines about the use of TDM in mental health were written. We found 164 pertinent records that we included in the review. Some promising studies highlighted the possibility of correlating early drug serum concentration and clinical efficacy and safety, especially for antipsychotics, potentially enabling clinicians to make decisions on early laboratory findings and not proceeding by trial and error. About populations with pharmacokinetic peculiarities, the latest studies confirmed very common alterations in drug blood levels in pregnant women, generally with a progressive decrease over pregnancy and a very relevant dose-adjusted concentration increase in the elderly. For adolescents also, several drugs result in having different dose-related concentration values compared to adults. These findings stress the recommendation to use TDM in these populations to ensure a safe and effective treatment. Moreover, the integration of TDM with pharmacogenetic analyses may allow clinicians to adopt precise treatments, addressing therapy on an individual pharmacometabolic basis. Mini-invasive TDM procedures that may be easily performed at home or in a point-of-care are very promising and may represent a turning point toward an extensive real-world TDM application. Although the highlighted recent evidence, research efforts have to be carried on: further studies, especially prospective and fixed-dose, are needed to replicate present findings and provide clearer knowledge on relationships between dose, serum concentration, and efficacy/safety.

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Therapeutic Drug Monitoring Characteristics in a Tertiary University Hospital in 2019

Cited by 3 publications

References 11 publications

Challenges of Therapeutic Drug Monitoring and Usage of Lithium in Managing Psychiatric Disorders: A Review

Challenges of Therapeutic Drug Monitoring and Usage of Lithium in Managing Psychiatric Disorders: A Review

Evaluation of Serum Drug Concentrations in a Tertiary Care Hospital: A Cross-Sectional Study

Current Status of Therapeutic Drug Monitoring in Mental Health Treatment: A Review

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