Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Therapeutic monitoring”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1978

[Assessment of blood pressure measurement for the diagnosis and therapeutic monitoring of hypertension (author's transl)].

Blood pressure readings are the central parameter in the diagnosis and therapeutic monitoring of arterial hypertension. Frequent measurements are therefore necessary because the blood pressures of healthy people, and in particular of patients with hypertension, are subject to considerable variability. Emotional factors, physical strain and diurnal differences have a modifying effect. Attempts to standardize a single measurement such as has been tried in the determination of the basic blood pressure or the diastolic levels have proved of little relevance for information on the daily blood pressure profile. The frequent determination of a random blood pressure after 2 to 3 minutes rest is a logical alternative. Regular monitoring is almost ideally obtained, especially under antihypertensive drug therapy, by the patient measuring his own blood pressure.

Adult↗
PubMed1979

Guidelines for therapeutic monitoring of tricyclic antidepressant plasma levels.

A brief review of the literature surrounding the relationship between plasma levels of tricyclic antidepressants currently available in the United States and clinical efficacy is presented. While therapeutic ranges for plasma levels of some tricyclic antidepressants are reasonably well established, the relationships between plasma levels of others and clinical efficacy require further clarification. Conditions under which plasma level measurements are clinically useful and factors that alter steady-state plasma levels are discussed.

Age Factors↗
PubMed1977

Drugs and children: methods for therapeutic monitoring.

In this era of polypharmacy, the incidence of adverse reactions due to drug therapy has increased alarmingly since the precise effects on the metabolism of a drug given in combination with other drugs can never be predicted with certainty. Inadequate therapy due to insufficient medication or to factors which diminish absorption or enhance metabolism may be equally undesirable. The consequences to patients in terms of increased morbidity and financial cost of prolonged hospitalization may be considerable. For pediatric patients, particularly in the newborn period, these hazards may be much more dangerous. There is a need for more investigation into the validity of procedures in current use for the determination of drug levels in biologic fluids and into the interpretation of the values they produce. In addition clinical chemists and clinical pharmacologists are faced with the challenge of defining those drugs for which blood level information would be advantageous and developing rapid, sensitive, and accurate assays which can be performed by the routine clinical laboratory. The day may be not too far away when a major proportion of the workload of the clinical laboratory consists of assays primarily designed as an aid to therapy rather than diagnosis.

Carbamazepine↗
PubMed1978

Therapeutic monitoring of anticonvulsant drugs in psychiatric patients: rapid, simultaneous gas-chromatographic determination of six commonly used anticonvulsants without interference from other drugs.

A simple, sensitive and precise gas-chromatographic method for simultaneous extraction, derivatization and determination of methsuximide, ethosuximide, diphenylhydantoin, carbamazepine, phenobarbital and primidone in the presence of other drugs has been described. The method is especially useful for drug monitoring in patients on multiple anticonvulsant therapy while also on combination therapy with psychotropic drugs. It overcomes the analytical interferences between mephenytoin and phenobarbital; methsuximide and primidone; kemadrin and primidone; cholesterol and primidone; prolixin, haldol and other drugs; encountered in other methods using underivatized, trimethylsilylated or methylated drugs. As little as 0.5 microgram/ml of a drug can be determined and if needed the method can be scaled down to 0.3 ml plasma. The method yielded recoveries of 97-103% with standard deviations of 0.7-1.8. For a constant check of the precision, an internal quality control using daily analysis of a sample from a frozen plasma pool supplemented with known concentrations of the anticonvulsants was used. The method is suitable for use in routine clinical laboratory.

Anticonvulsants↗
PubMed1979

Circulating immune complexes in experimental streptococcal endocarditis: a monitor of therapeutic efficacy.

An important problem in the management of infective endocarditis has been the delineation of laboratory procedures that are sensitive, reliable indicators of therapeutic efficacy. Because circulating, complement-containing immune complexes of the IgG type (CICs) have been demonstrated in most humans with infective endocarditis, serum CIC levels during the natural course of the infection and in response to penicillin therapy were studied in 42 rabbits with right-sided endocarditis due to Streptococcus salivarius. A significant rise in the level of CICs in both 21 control rabbits and 21 treated rabbits was observed after induction but before treatment of infective endocarditis (P less than 0.01). In the 17 successfully treated rabbits, CIC levels fell sharply during the first week of therapy and remained at preinduction levels thereafter (P less than 0.005). In contrast, CIC values did not change significantly either in control animals or in the four treated animals with refractory endocarditis, although in the latter animals, serum bactericidal titers remained less than or equal to 1:32. These findings suggest that serial measurements of CIC levels during antimicrobial therapy of infective endocarditis may aid in monitoring therapeutic efficacy.

Animals↗
PubMed1979

The 1978 College of American Pathologists Therapeutic Drug Monitoring Interlaboratory Survey Program.

In 1978 the College of American Pathologists introduced a Therapeutic Drug Monitoring Interlaborabory Survey Program. Each participant recieved six vials of lyophilized human serum on two occasions, approximately 13 weeks apart. The specimens contained various combinations of 12 drugs in subtherapeutic, therapeutic, and toxic concentrations. The drugs included in the specimens were phenytoin, phenobarbital, primidone, ethosuximide, carbamazepine, digoxin, procainamide, N-acetylprocainamide, quinidine, theophylline, lithium, and gentamicin. The weighed-in quantity of each drug was used as the target value for that drug. The specimens were analyzed by a variety of analytic methods. Statistics were calculated for all results regardless of the analytic method used and for each individual method. This report presents the data from the Program.

Anticonvulsants↗
PubMed2026

Therapeutic-drug-monitoring-based ATG Targeted Dosing Strategy in Unmanipulated Haploidentical Haematopoietic Stem Cell Transplantation: a randomized, multicenter, phase 3 clinical trial.

Anti-thymocyte globulin (ATG) has been a standard prophylaxis for graft-versus-host disease (GVHD). However, the pharmacokinetics of ATG in vivo vary significantly, and weight-based fixed dosing may not optimize efficacy while minimizing toxicity. We investigated the clinical results of a therapeutic-drug-monitoring (TDM)-based, dose-optimized ATG strategy versus weight-based fixed dosing in haploidentical haematopoietic stem cell transplantation (NCT05166967). Patients were randomly assigned in a 1:1 ratio to receive a targeted dose of ATG or a fixed dose of 10&#x202f;mg/kg. The primary endpoint was the 365-day graft-versus-host disease-free and relapse-free survival (GRFS). From January 1, 2022, to January 16, 2024, 204 patients were enrolled, with 102 patients in each group. The 365-day GRFS was higher in the targeted dose group (66.7%) than in the fixed dose group (50.0%; hazard ratio [HR], 0.666; 95% confidence interval [CI], 0.4456 to 0.9954; P&#x202f;=&#x202f;0.048). The cumulative incidence of moderate to severe chronic GVHD at day 365 was significantly lower in the targeted dose group (9.8%; 95% CI, 5.0 to 16.5) compared with the fixed dose group (22.5%; 95% CI, 15.0 to 31.1; P&#x202f;=&#x202f;0.026). Fewer grade 3-5 infections were reported in the targeted dose group (44.1%) than in the fixed dose group (70.6%; P&#x202f;<&#x202f;0.001). More patients in the targeted dose group achieved optimal ATG exposure (P&#x202f;=&#x202f;0.007) and superior CD4+ T-cell reconstitution (P&#x202f;=&#x202f;0.002). These findings support the clinical utility of a TDM-based individualized ATG dosing strategy that balances efficacy and toxicity for GVHD prophylaxis in allogeneic stem cell transplantation. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05166967.

Humans↗
PubMedDate not supplied

Therapeutic drug monitoring: measurements of antiepileptic and barbiturate drug levels in blood by gas chromatography with nitrogen - selective detector.

The nitrogen-specific detector for gas chromatography consists of a non-volatile rubidium silicate bead, around which nitrogen-containing compounds are pyrolyzed. Speed, sensitivity, specificity, accuracy, small sample size and minumum sample handling are characteristics of the nitrogen detector that render it superior to conventional gas chromatographic detectors. The detector has been utilized to effect a simple and rapid quantitation of allobarbital, amobarbital, butabarbital, heptabarbital, pentabarbital, phenobarbital and secobarbital, plus the anticonvulsants diphenylhydantoin and primidone. Extraction of the drugs from acidified serum into organic solvent containing internal standard is followed by oncolumn methylation with methanolic trimethylphenyl ammonium hydroxide. The drugs, separated on a column of 3 percent OV-101 on Gas-Chrom Q, 100-120 mesh are readily quantitated by simple calculations based on peak-height ratios. Therapeutic drug monitoring is discussed in relation to recent concepts of drug-protein binding, drug-drug interactions, drug biotransformation and problems of multiple drug therapy.

Amobarbital↗
PubMed1978

[Thrombolytic treatment (theoretical basis, therapeutic protocols, monitoring)].

Thrombolytic therapy is aimed at dissolving thrombi. Streptokinase (SK) and urokinase (UK) are currently used in France but their mode of action has not been completely elucidated, which renders the establishment of therapeutic protocols and the choice of doses difficult. This treatment has a certain number of contraindications which must be strictly respected. The effectiveness of SK and UK in high doses has been demonstrated, in particular in pulmonary embolism and acute arterial obstruction of the limbs, but there is a risk of haemorrhage, whilst UK in moderate doses is usually well tolerated but has yet to prove its effectiveness in randomised double blind trials. Laboratory control has been simplified but it is essential not to forget the importance of clinical monytoring. Finally, drugs have recently been used in association with thrombolytics and more particularly the administration of plasminogen or defibrinating agents before or after thrombolytics.

Arterial Occlusive Diseases↗
PubMed2026

Metabolomics in breast cancer: insights into treatment responses, disease progression, and prognostic assessment.

BACKGROUND: Alterations in metabolic pathways are a hallmark of cancer and play a pivotal role in breast cancer development and progression. The inherent metabolic heterogeneity of breast cancer contributes to differences in therapeutic response and patients' prognosis. Clinical metabolomics has emerged as a promising approach for identifying metabolic biomarkers that reflect tumor biology, treatment-related changes after diagnosis, and patients' outcomes. AIMS OF REVIEW: This review summarizes the metabolomic profiles of breast cancer patients, using various biological materials and analytical methods, to assess their potential role as biomarkers for monitoring therapeutic response, adverse treatment effects, tracking disease progression, and predicting prognosis. KEY SCIENTIFIC CONCEPT OF REVIEW: Metabolomic shifts generate unique signatures with promising potential as biomarkers for evaluating treatment response, monitoring therapeutic adverse effects, disease progression, and predicting clinical outcomes in breast cancer patients. Biological matrices, such as serum, plasma, and tumor tissue, were commonly used in both untargeted and targeted metabolomics approaches. Liquid chromatography-mass spectrometry is the most commonly used analytical method in clinical metabolomics studies. Altered metabolites were identified and linked to metabolic pathways, particularly amino acids, glucose, and fatty acids metabolism. When integrated with genomic and transcriptomic data, these metabolic fingerprints offer a multidimensional perspective on disease trajectory, thereby enhancing patient stratification and informing personalized therapeutic strategies.

Humans↗
PubMed1978

Osseous metastases: radiographic monitoring of therapeutic response.

The application of standard radiographs (metastatic series) and radionuclide scanning in the serial evaluation of patients treated for metastatic osseous lesions is reviewed. False positive interpretations of bone scans are related to the inability to distinguish osteoblastic healing response from osteoblastic response to progressive tumor. False negative scans are uncommon and are related generally to symmetrical osteoblastic activity or to inadequate (subthreshold) osteoblastic response to tumor. Standard radiographs are preferable to bone scans in the serial evaluation of the effectiveness of therapy for osseous metastases in that anatomic quantitation of lesions as well as the dynamic evolution of lytic lesions to "blastic" healing may be appreciated. Serial bone scanning should be performed in conjunction with standard radiographs of abnormal areas of radionuclide accumulation.

Adult↗