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Table of Contents
Intro
Foreword
Preface
Contents
About the Editors
Contributors
1: Therapeutic and Toxic Concentrations of Drugs in Biological Matrices
1.1 Introduction
1.2 Therapeutic Drug Monitoring
1.3 Biological Matrices
1.3.1 Blood
1.3.2 Urine
1.3.3 Saliva
1.3.4 Cerebrospinal Fluid (CSF)
1.3.5 Hair
1.4 Therapeutic Concentration of Drugs
1.5 Toxic Concentration of Drugs
1.6 Conclusion
References
2: Analytical Techniques for Therapeutic Drug Monitoring and Clinical Toxicology
2.1 Introduction
2.2 Immunoassays
2.3 Electrophoresis
2.4 Biosensors
2.5 Conventional HPLC and Emerging UHPLC Techniques
2.6 Gas Chromatography (GC)
2.7 Conclusion and Outlook
References
3: Plasma Therapeutic Drug Monitoring and Clinical Toxicology
3.1 Overview of Therapeutic Drug Monitoring (TDM)
3.1.1 Assumptions
3.1.2 Process of Therapeutic Drug Monitoring
3.2 Indications for Measuring Plasma Concentrations
3.2.1 Avoiding or Diagnosing Toxicity
3.2.2 Diagnosing Undertreatment and Monitoring Patient Adherence
3.2.3 Prophylaxis
3.2.4 Drug Interactions and Termination of Treatment
3.3 Proper Use of Measurements
3.3.1 Timing of Blood Samples
3.3.2 Type of Sample Used
3.3.3 Measurement Technique
3.3.4 Individualization of Results
3.4 Individualizing Therapy
3.4.1 Formulation and Diet
3.4.2 Pharmacokinetics: Ion Trapping
3.4.3 Pathologic Disease States
3.4.4 Cytochrome P450 Enzymes
3.4.5 Age
3.5 Serum Versus Plasma Monitoring
3.5.1 Drugs Requiring Monitoring: Digoxin
3.5.2 Drugs Requiring Monitoring: Phenytoin
3.6 Renal Clearance and Metabolism in Therapeutic Drug Monitoring
3.6.1 Critically Ill Patients
3.6.2 Geriatric Patients
3.6.3 Pediatric Patients
3.6.4 Acute or Chronic Renal Failure Patients
3.7 Role of Cytochrome P450 Systems in Liver Clearance and Metabolism
3.7.1 Acetaminophen
3.7.2 Rifampin
3.7.3 Erythromycin
3.8 Antiretrovirals and Glucose in Therapeutic Drug Monitoring
3.8.1 The Role and Influence of Glucose in Therapeutic Drug Monitoring
3.8.2 Therapeutic Drug Monitoring of Antiretroviral Drugs
3.9 Conclusion
References
4: Dried Blood Spots in Therapeutic Drug Monitoring and Toxicology
4.1 Introduction
4.2 Therapeutic Drug Monitoring (TDM)
4.2.1 DBS in PK Monitoring
4.2.2 Factors to Consider in PK Studies Using DBS Sampling
4.2.3 Toxicology
4.2.3.1 Toxicokinetics
4.2.3.2 Forensic Toxicology
4.2.3.3 Screening for Environmental Contaminants
4.3 The Hematocrit Factor
4.3.1 Holistic Analysis of Volumetrically Spotted DBS
4.3.2 Use of DPS in Place of DBS
4.3.3 Use of Special Filter Substrates
4.3.4 Use of Hematocrit Calibrators
Foreword
Preface
Contents
About the Editors
Contributors
1: Therapeutic and Toxic Concentrations of Drugs in Biological Matrices
1.1 Introduction
1.2 Therapeutic Drug Monitoring
1.3 Biological Matrices
1.3.1 Blood
1.3.2 Urine
1.3.3 Saliva
1.3.4 Cerebrospinal Fluid (CSF)
1.3.5 Hair
1.4 Therapeutic Concentration of Drugs
1.5 Toxic Concentration of Drugs
1.6 Conclusion
References
2: Analytical Techniques for Therapeutic Drug Monitoring and Clinical Toxicology
2.1 Introduction
2.2 Immunoassays
2.3 Electrophoresis
2.4 Biosensors
2.5 Conventional HPLC and Emerging UHPLC Techniques
2.6 Gas Chromatography (GC)
2.7 Conclusion and Outlook
References
3: Plasma Therapeutic Drug Monitoring and Clinical Toxicology
3.1 Overview of Therapeutic Drug Monitoring (TDM)
3.1.1 Assumptions
3.1.2 Process of Therapeutic Drug Monitoring
3.2 Indications for Measuring Plasma Concentrations
3.2.1 Avoiding or Diagnosing Toxicity
3.2.2 Diagnosing Undertreatment and Monitoring Patient Adherence
3.2.3 Prophylaxis
3.2.4 Drug Interactions and Termination of Treatment
3.3 Proper Use of Measurements
3.3.1 Timing of Blood Samples
3.3.2 Type of Sample Used
3.3.3 Measurement Technique
3.3.4 Individualization of Results
3.4 Individualizing Therapy
3.4.1 Formulation and Diet
3.4.2 Pharmacokinetics: Ion Trapping
3.4.3 Pathologic Disease States
3.4.4 Cytochrome P450 Enzymes
3.4.5 Age
3.5 Serum Versus Plasma Monitoring
3.5.1 Drugs Requiring Monitoring: Digoxin
3.5.2 Drugs Requiring Monitoring: Phenytoin
3.6 Renal Clearance and Metabolism in Therapeutic Drug Monitoring
3.6.1 Critically Ill Patients
3.6.2 Geriatric Patients
3.6.3 Pediatric Patients
3.6.4 Acute or Chronic Renal Failure Patients
3.7 Role of Cytochrome P450 Systems in Liver Clearance and Metabolism
3.7.1 Acetaminophen
3.7.2 Rifampin
3.7.3 Erythromycin
3.8 Antiretrovirals and Glucose in Therapeutic Drug Monitoring
3.8.1 The Role and Influence of Glucose in Therapeutic Drug Monitoring
3.8.2 Therapeutic Drug Monitoring of Antiretroviral Drugs
3.9 Conclusion
References
4: Dried Blood Spots in Therapeutic Drug Monitoring and Toxicology
4.1 Introduction
4.2 Therapeutic Drug Monitoring (TDM)
4.2.1 DBS in PK Monitoring
4.2.2 Factors to Consider in PK Studies Using DBS Sampling
4.2.3 Toxicology
4.2.3.1 Toxicokinetics
4.2.3.2 Forensic Toxicology
4.2.3.3 Screening for Environmental Contaminants
4.3 The Hematocrit Factor
4.3.1 Holistic Analysis of Volumetrically Spotted DBS
4.3.2 Use of DPS in Place of DBS
4.3.3 Use of Special Filter Substrates
4.3.4 Use of Hematocrit Calibrators