Abstract:
:PROTEASE INHIBITOR TDM: This study examines the importance of therapeutic drug monitoring (TDM) of protease inhibitors (PI) in adults and children infected with the human immunodeficiency virus (HIV). Pediatric patients were included because information in this population is limited. A high performance liquid chromatographic (HPLC) assay measured indinavir, saquinavir, ritonavir and nelfinavir simultaneously in 0.2 mL of plasma. Initially, the reliability, sensitivity and specificity of the assay were verified in stored samples of plasma from adult patients who had been receiving PIs. Non-detectable concentrations (ND) were <25-50 ng/mL. In 96 out of 293 stored samples from adult patients, selected randomly, concentrations of PIs were ND. In a second prospective study of 10 adults (9 mothers and one father, aged 24-42 years) and 15 children (2.9-18 years) ND levels of PI were observed frequently (27% or 4 out of 15 pediatric subjects). In the latter study, drug-drug interactions, dosing errors, noncompliance and other important problems were identified and corrected. Routine monitoring and interpretation of PI concentrations (TDM) may improve the management of adult and pediatric patients infected with HIV, especially in those who fail to respond, develop adverse effects or viral resistance, or lack compliance.
journal_name
Ther Drug Monitjournal_title
Therapeutic drug monitoringauthors
Walson PD,Cox S,Utkin I,Gerber N,Crim L,Brady M,Koranyi Kdoi
10.1097/00007691-200312000-00002subject
Has Abstractpub_date
2003-12-01 00:00:00pages
650-6issue
6eissn
0163-4356issn
1536-3694journal_volume
25pub_type
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journal_title:Therapeutic drug monitoring
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