The routine practice of therapeutic drug monitoring - some of the results of work in the system of CHI
Abstract
We’ve analyzed results of the therapeutic drug monitoring (TDM). TDM is a routine investigation into the compulsory health insurance system and more than 3 000 TDM-tests are performed annually. The most demanded TDM was the monitoring of antiepileptic drugs, cyclosporin, tacrolimus; rarely were monitored digoxin and antibacterial agents. It turned out that more than % of patients with the application of standard doses of antiepileptic drugs do not reach the therapeutic concentrations of these drugs in the blood of patients. In some patients were observed excess of the therapeutic concentration range: for valproate in 15% of cases, for carbamazepine in 7% of cases. Patients treated with cyclosporine in 9%, and tacrolimus in 17% of cases required a dose adjustment. It is found that the application of various drugs containing the same drug substance in the blood concentration may vary considerably.
Keywords
терапевтический лекарственный мониторинг,
противоэпилептические средства,
циклоспорин,
такролимус,
вальпроевая кислота,
карбамазепин,
therapeutic drug monitoring,
antiepileptic drugs,
cyclosporine,
tacrolimus,
valproic acid,
carbamazepine
Conflicts of Interest Disclosure:
The authors declares that there is no conflict of interest.
Article info:
Date submitted: 16.05.2018
All authors have read and approved the final manuscript.
Peer review info:
"Kachestvennaya Klinicheskaya Praktika = Good Clinical Practice" thanks the anonymous reviewer(s) for their contribution to the peer review of this work.
Editorial comment:
In case of any discrepancies in a text or the differences in its layout between the pdf-version of an article and its html-version the priority is given to the pdf-version.
About the Authors
V. A. Baturin
Stavropol State Medical University of Ministry of Health of Russia
Russian Federation
M. V. Baturina
Stavropol State Medical University of Ministry of Health of Russia; Center of Clinical Pharmacology and Pharmacotherapy
Russian Federation
A. A. Kotova
Center of Clinical Pharmacology and Pharmacotherapy
Russian Federation
A. A. Skripnyuk
Center of Clinical Pharmacology and Pharmacotherapy
Russian Federation
References
1. Батурин В.А., Руденко С.Н., Барабаш С.В. Совершенствование стандартов лечения эпилепсии // Проблемы стандартизации в здравоохранении. - 2010. - № 9-10. - С. 3-5.
2. Батурин В.А., Руденко С.Н. Изменение познавательных способностей у детей, больных эпилепсией, при лечении бензоналом в зависимости от индивидуальных особенностей его фармакокинетики // Медицинский вестник Северного Кавказа. - 2015. - №4. - С. 398-402.
3. Броун Т. Эпилепсия / Т.Броун, Г.Холмс // Клиническое руководство. пер. с англ. М.: «Издательство БИНОМ», 2006. - 288 с.
4. Батурин В.А., Шичкина А.Е., Руденко С.Н. Особенности фармакокинетики противоэпилептических средств у детей больных эпилепсией, проживающих в экологически неблагоприятных условиях // Южно-Российский медицинский журнал. - 2002. - №4. - С. 52-54.
5. Батурин В.А., Колодийчук Е.В., Руденко С.Н. Фармакоэкономические аспекты лекарственного мониторинга // Проблемы стандартизации в здравоохранении. - 2000. - №4. - С. 90.
For citations:
Baturin V.A.,
Baturina M.V.,
Kotova A.A.,
Skripnyuk A.A.
The routine practice of therapeutic drug monitoring - some of the results of work in the system of CHI. Kachestvennaya Klinicheskaya Praktika = Good Clinical Practice. 2016;(1):47-49.
(In Russ.)
Views:
1186