四种抗癫痫药物血药浓度监测的结果分析

目的分析儿童抗癫痫药物（AED）的血药浓度监测结果，指导临床合理用药。方法采用荧光偏振免疫法（FPIA）对我院2001年1月-2003年12月服用丙戊酸钠（VPA）、卡马西平（CBZ）、苯巴比妥（PB）、苯妥英钠（PHT）患者共1598例／次进行血药浓度监测，了解儿童抗癫痫药物在我院应用的现状和趋势。结果血药浓度在正常治疗范围内的患者占50．3％，小于正常治疗范围的患者占42．9％，高于正常治疗范围的患者占6．8％，联合用药的患者中，血药浓度低于或高于正常治疗浓度的患者总达44.1％。结论癫痫患者应重视血药浓度监测，确保患者用药安全、有效。     

四种抗癫痫药物血药浓度监测的结果分析

目的分析儿童抗癫痫药物(AED)的血药浓度监测结果,指导临床合理用药.方法采用荧光偏振免疫法(FPIA)对我院2001年1月-2003年12月服用丙戊酸钠(VPA)、卡马西平(CBZ)、苯巴比妥(PB)、苯妥英钠(PHT)患者共1598例/次进行血药浓度监测,了解儿童抗癫痫药物在我院应用的现状和趋势.结果血药浓度在正常治疗范围内的患者占50.3%,小于正常治疗范围的患者占42.9%,高于正常治疗范围的患者占6.8%,联合用药的患者中,血药浓度低于或高于正常治疗浓度的患者总达44.1%.结论癫痫患者应重视血药浓度监测,确保患者用药安全、有效.     

四种抗癫痫药物血药浓度监测的结果分析

目的分析儿童抗癫痫药物(AED)的血药浓度监测结果,指导临床合理用药。方法采用荧光偏振免疫法(FPIA)对我院2001年1月-2003年12月服用丙戊酸钠(VPA)、卡马西平(CBZ)、苯巴比妥(PB)、苯妥英钠(PHT)患者共1598例/次进行血药浓度监测,了解儿童抗癫痫药物在我院应用的现状和趋势。结果血药浓度在正常治疗范围内的患者占50.3%,小于正常治疗范围的患者占42.9%,高于正常治疗范围的患者占6.8%,联合用药的患者中,血药浓度低于或高于正常治疗浓度的患者总达44.1%。结论癫痫患者应重视血药浓度监测,确保患者用药安全、有效。     

抗癫痫药物血药浓度监测结果分析

目的：评价治疗药物监测对临床治疗的指导作用。方法分析227例服用抗癫痫药物患者的血药浓度监测结果。结果共监测4种抗癫痫药物,其中卡马西平血药浓度在推荐浓度范围内的比例最高,苯妥英钠偏离推荐浓度的比例最高。结论抗癫痫药物血药浓度个体差异较大,影响因素较多,应结合其他临床指标综合分析监测结果。     

抗癫痫药物血药浓度监测180例次结果分析

目的 分析4种常用抗癫痫药的血药浓度监测情况,指导患者合理用药.方法 对180例次应用抗癫痫药治疗患者的血药浓度监测结果进行回顾性分析.结果 达到有效治疗浓度者为55.6％;低于有效治疗浓度者为40.0％;高于有效治疗浓度者4.4％.79.5％联合用药者的血药浓度监测结果不在治疗浓度范围内.结论 血药浓度监测结果是指导临床用药的依据之一,血药浓度不在治疗窗内的原因很多,应结合其它临床指标综合分析、解释监测结果.     

1990～1995年我院四种抗癫痫药物血药浓度监测回顾性分析

１９９０～１９９５年我院四种抗癫痫药物血药浓度监测回顾性分析赵志刚周诚彭名炜（北京天坛医院药剂科１０００５０）血药浓度监测（ＴｈｅｒａｐｅｕｔｉｃＤｒｕｇＭｏｎｉｔｏｒ－ｉｎｇ，ＴＤＭ）是我院药剂科临床药学室从１９９０年９月开展的一项工作，其中抗癫痫...     

常用抗癫痫药物的血药浓度监测方法评价

目的：对常用抗癫痫的血药浓度监测方法评价,以提高较适合的测定方法。方法：对近年来各种抗癫痫药物的血药浓度监测方法加以归纳,综述。结果：光谱法简易快速,色谱法灵敏度高,免疫法可直接测定,样品需要量少。结论：应根据自己的实际情况选择相应的测定方法。     

抗癫痫药物的临床应用与血药浓度监测

癫痫是一个由于各种原因引起的脑灰质的偶然、突然、过度、快速和局限性的放电而导致神经系统功能紊乱的慢性疾病。具有突然性、暂时性、反复发作的特点。临床上根据其发作时的症状表现分为大发作、小发作、局限性发作及精神运动性发作。实践证明,按类型选择用药会提高抗癫痫效果,1980     

我院4种抗癫痫药物血药浓度监测结果回顾性分析

目的:提高临床对血药浓度监测工作的重视程度。方法:运用回顾性调查方法,对我院自1998年～2005年所监测的应用苯巴比妥、苯妥英钠、卡马西平、丙戊酸钠4种抗癫痫药治疗的1443例/次患者的血药浓度结果进行分析。结果:血药浓度在高、低及正常治疗浓度范围内的患者分别为10.40%、36.59%、53.01%。联合用药的患者中,血药浓度在正常治疗浓度范围内者为28.45%。结论:抗癫痫药的血药浓度监测对临床调整用药剂量有指导意义;及时监测血药浓度,实施个体化给药是确保临床治疗效果和用药安全的重要措施之一。     

我院抗癫痫类药物血药浓度监测回顾

目的：为临床合理应用抗癫痫药提供参考。方法：采用荧光偏振免疫法对我院1997年1月－2001年3月服用苯妥英，卡马西平，丙戊酸或苯巴比妥患者的667份血样进行血药浓度监测，了解抗癫痫药物在我院应用的现状和趋势。结果：本类药物治疗指数小，安全度较低，其作用的个体差异大。结论：癫痫患者应重视血药浓度监测，并结合其他因素调整用药方案，以达到安全，有效，合理应用本类药物。     

5种治疗药物945例次血药浓度监测结果分析

目的对我院治疗药物浓度监测数据进行分析,为临床合理用药提供参考。方法采用系统回顾性方法,对我院2003年11月--2006年5月期间的血药浓度监测结果进行分析。结果5种药物进行945例次监测。达有效血药浓度的590例次,占总数62．4％;未达有效血药浓度的269例次。占总数28．5％;达中毒血药浓度的86例次,占总数9．1％。结论TDM在我院开展,多种原因导致药物未在治疗窗内。监测次数偏少。临床药师和医师应联合,充分利用TDM技术,建立一个长期有效的治疗方案,最大限度保证患者用药安全、有效、经济。     

7种治疗药物1580例次监测结果分析

目的:了解患者体内血药浓度,以便调整用药方案,实行个体化给药.方法:7种药物以荧光偏振免疫法进行检测.结果:7种药物进行1580例次监测,达有效血药浓度的1035例次,占总数65.51%;未达有效血药浓度的382例次,占总数24.18%;达中毒血药浓度的163例次,占总数10.31%.结论:监测结果显示,临床不合理用药占相当大比例,提示临床加强治疗药物监测重要性和必要性的认识,实行个体化给药,保证患者用药安全、有效,发挥药物的最佳效应.     

Pitfalls in TDM of antibiotic drugs: analytical and modelling issues

The quality assurance program of the Dutch KKGT [Association for Quality Assessment in therapeutic drug monitoring (TDM) and Clinical Toxicology] has been running for more than 25 years. One of these programs concerns TDM of the antibiotic drugs gentamicin, tobramycin, amikacin, and vancomycin. We present two issues encountered in a recent survey. In a case of gentamicin monitoring and dose-adjustment, a systematic analytical error in some centers led to a dosing recommendation that differed from that of the organizers. Correction of the analytical results on the basis of a standard control sample resulted in concentration differences of more than 20% and different dosing recommendations in these centers. In a case of vancomycin TDM, the choice of the population model proved to be critical for dose adjustment. We illustrate this example by presenting the plasma profiles derived from the different population models used by the participants.     

三年来我室TDM室间质评结果回顾

目的：对我室３年来ＴＤＭ室间质评估结果的准确性作一个客观的评价,同时分析存在的问题及产生这些问题的原因。方法：对我室３年来参加室间质评的茶碱,苯妥英,地高辛３个监测品种的平均成绩进行纵向及横向对比,分析。结果;茶碱和苯妥英成绩较好,地高辛成绩呈逐年上升的趋势。结论;通过采取一系列有效措施后,我的治疗药物监测可成为临床用药较为可靠的参考。     

9种治疗药物监测结果分析

目的:分析9种药物血药浓度监测结果,为临床合理用药提供参考。方法:分别采用 FPIA 法、ELISA 法和 UV 法测定9种药物的血药浓度,对7757例患者31423例次血药浓度监测结果进行比较分析。结果:9种药物31423例次血药浓度监测结果在治疗窗浓度范围内的25221例次,占总数的80.3%,小于治疗窗浓度范围的3033例次,占总数的9.6%,大于治疗窗浓度范围的3169例次,占总数的10.1%。结论:治疗药物监测能为临床合理用药提供客观的依据。     

Therapeutic drug monitoring of psychotropic drugs. TDM "nouveau"

TDM applied in psychiatry dates back several decades. The reason for this is that, after the advent of modern clinical psychopharmacology around the middle of the past century, an insight came to common knowledge about the existence of (1) a large interindividual pharmacokinetic (PK) variability for virtually all psychoactive drugs and (2) a worse clinical efficacy not only in inadequate drug concentrations but also in excessively high concentrations. From this concept, the definition of a therapeutic concentration "window" was evidenced for a substantial number of, primarily, antidepressant drugs. However, with the further extensive development of the clinically available pharmacopoeia of psychoactive drugs from the later 1980s until today, the concept of less toxic compounds than before has commonly been launched in the marketing strategies for these newer drugs. This concept also led to the idea that TDM was no longer necessary for the newer types of psychoactive drugs, a position backed up by difficulties in unraveling concentration-effect relationships generally for these drugs in clinical trials. The present survey summarizes the background history for TDM in psychiatry and makes a critical appraisal of why a "lack" of definition of concentration-effect relationships for newer psychoactive drugs is now common. This survey also provides the reader with a novel concept challenging ambient TDM strategies (referred to as TDM "traditionelle") in psychiatry by forwarding a theoretical model called TDM "nouveau." In this model both inter- and intraindividual (over time) PK variation is suggested to be used for dose optimization by TDM in a naturalistic clinical setting. The previous concept of a simple, common concentration "window" existing for all such drugs is questioned by promotion of the use of available PK data merely as "guiding principles" rather than as "reference values" when interpreting the TDM outcome in individual cases.     

646例药源性心血管疾病的文献分析

目的 :了解药源性心血管疾病的发生情况及一般规律 ,从而指导合理用药。方法 :用文献计量学方法 ,对1995年～2000年国内公开报道的646例药源性心血管疾病的病例进行分析。结果 :646例药物引起的心血管疾病中 ,心律失常的发病率为59 8 %。诱发的药物涉及155种 ,其中心血管系统用药占37 2 % (240/646) ,为最多 ;品种以普罗帕酮引起的最多 (75例 )。致死病例35例(5 4 % ) ,致死药物亦以心血管系统用药居首位。药源性心血管疾病以中、老年人多见。结论 :做到合理用药 ,对心血管病患者的用药严密监测 ,可降低药源性心血管疾病的发病率     

646例药源性心血管疾病的文献分析

目的了解药源性心血管疾病的发生情况及一般规律,从而指导合理用药.方法用文献计量学方法,对1995年～2000年国内公开报道的646例药源性心血管疾病的病例进行分析.结果646例药物引起的心血管疾病中,心律失常的发病率为59.8%.诱发的药物涉及155种,其中心血管系统用药占37.2%(240/646),为最多;品种以普罗帕酮引起的最多(75例).致死病例35例(5.4%),致死药物亦以心血管系统用药居首位.药源性心血管疾病以中、老年人多见.结论做到合理用药,对心血管病患者的用药严密监测,可降低药源性心血管疾病的发病率.     

Permeability of four disposable protective-clothing materials to seven antineoplastic drugs

The permeability of four types of protective-clothing material to seven injectable antineoplastic drugs was studied. The protective materials tested were Saranex-laminated Tyvek, polyethylene-coated Tyvek, nonporous Tyvek, and Kaycel. Circles 6 cm in diameter were cut from a single garment of each material and exposed to each drug. Permeation of cisplatin, etoposide, mitomycin, cyclophosphamide, carmustine, and thiotepa was assessed by the Salmonella mutagenicity test after four hours of exposure. Doxorubicin permeation was assessed qualitatively over an eight-hour exposure period using a coloration assay. Saranex-laminated Tyvek was not permeable under the test conditions. Polyethylene-coated Tyvek was slightly permeable to thiotepa and carmustine. Nonporous Tyvek was permeable to all seven drugs, and the Kaycel garment was permeable to all of the drugs except etoposide. In no instance did permeation exceed 3.3% of the applied drug dose. Saranex-laminated Tyvek was the most protective of the barrier garments, followed closely in effectiveness by the polyethylene-coated Tyvek. Clothing made from these two Tyvek composites would allow less air flow and, therefore, would be less comfortable to wear for extended periods. Garments made of nonporous Tyvek or Kaycel would be more comfortable, but their use should be accompanied by an awareness of their potential permeability to certain antineoplastic drugs.