Abstract:
BACKGROUND:Pentobarbital is used for management of intractable seizures and for reducing elevated intracranial pressure. Dosing of pentobarbital can be aided by therapeutic drug monitoring (TDM). There is no commercially available automated assay for measurement of pentobarbital serum/plasma concentrations; consequently, chromatography-based assays are often used. METHODS:Pentobarbital TDM was studied over a 14-year period at an academic medical center. 154 patients (94 adult, 60 pediatric) were identified who had pentobarbital levels ordered at least once during a hospital encounter. Chart review included patient diagnosis, indication for pentobarbital therapy, recent or concomitant medication with other barbiturates, patient disposition, organ donation, pentobarbital dosing changes, and neurosurgical procedures. Pentobarbital serum/plasma concentrations were determined on an automated clinical chemistry platform with a laboratory-developed test adapted from a urine barbiturates immunoassay. RESULTS:Chart review showed therapeutic use of pentobarbital generally consistent with previously published literature. The most common errors observed involved confusion in barbiturate names (eg, mix-up of pentobarbital and phenobarbital in test ordering or in provider notes) that seemed to have minimal impact on TDM effectiveness, with pentobarbital serum/plasma concentrations generally within target ranges. The laboratory-developed pentobarbital immunoassay showed cross-reactivity with phenobarbital and butalbital that was eliminated by alkaline and heat pretreatment. The immunoassay was linear to 20 mcg/mL and correlated closely with gas chromatography-mass spectrometry measurements at a reference laboratory. CONCLUSIONS:Pentobarbital TDM can be performed by immunoassay on an automated clinical chemistry platform, providing an alternative to chromatography-based methods. Confusion in barbiturate names is common, especially pentobarbital and phenobarbital.
journal_name
Ther Drug Monitjournal_title
Therapeutic drug monitoringauthors
Humble RM,Ehlers A,Pakalniskis BL,Morris C,Drees D,Kulhavy J,Krasowski MDdoi
10.1097/FTD.0000000000000217subject
Has Abstractpub_date
2015-12-01 00:00:00pages
783-91issue
6eissn
0163-4356issn
1536-3694pii
00007691-201512000-00013journal_volume
37pub_type
杂志文章abstract:BACKGROUND:Several reports of loss of efficacy or adverse effects have been described after generic substitution of antipsychotics. To date, studies comparing serum drug levels in patients switched to generic antipsychotics in a standard clinical setting are lacking. The aim of this study was to investigate if switchin...
journal_title:Therapeutic drug monitoring
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abstract::The high incidence of psychiatric illness in the postpartum period and the increasing percentage of women who breastfeed has focused attention on the treatment of breastfeeding women with psychotropic medications and, additionally, the exposure of nursing infants to these medications. Consequently, there has been an i...
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journal_title:Therapeutic drug monitoring
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journal_title:Therapeutic drug monitoring
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journal_title:Therapeutic drug monitoring
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abstract::A high-performance liquid chromatography (HPLC) method was developed for the simultaneous analysis of trimethoprim (TMP), sulphamethoxazole (SMX), and acetylsulphamethoxazole (AcSMX) in small amounts of blood. The method involved precipitation with 50 microL trichloracetic acid (1M) to 125 microL plasma or serum sampl...
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journal_title:Therapeutic drug monitoring
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Therapeutic drug monitoring
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更新日期:1995-04-01 00:00:00
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journal_title:Therapeutic drug monitoring
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journal_title:Therapeutic drug monitoring
pub_type: 临床试验,杂志文章
doi:10.1097/00007691-200608000-00007
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journal_title:Therapeutic drug monitoring
pub_type: 杂志文章
doi:
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pub_type: 杂志文章
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journal_title:Therapeutic drug monitoring
pub_type: 杂志文章
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journal_title:Therapeutic drug monitoring
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