204. Voriconazole Restriction in Addition to Therapeutic Drug Monitoring (TDM) Protocol Results in Optimized Dosing Natasha Pettit, PharmD; Zhe Han, PharmD; Mildred Vicente, PharmD; Emily Landon, MD; Jennifer Pisano, MD; Allison H. Bartlett, MD, MS; Pharmacy Services, University of Chicago Medicine, Chicago, IL; Pharmacy Services, University of Chicago Medicine, Chicago, IL; Infectious Diseases...

Therapeutic drug monitoring (TDM) has declined with newer anti-epileptic drugs (AEDs) having no therapeutic window. Use of unbound (free) fraction has almost completely disappeared. The case reported highlights its importance and offers sound reason for its retention. A 66-year-old Caucasian man with known epilepsy was admitted with vomiting, ataxia and nystagmus presumably due to AED toxicity....

PURPOSE To evaluate therapeutic drug monitoring (TDM) of lamotrigine (LTG) with establishment of individual therapeutic thresholds (TT) in outpatients of a tertiary epilepsy centre on monotherapy. METHODS In the outpatient clinic of the Danish Epilepsy Centre, Dianalund, all patients treated in 2004 with LTG monotherapy were identified. Patients who had not reported seizures or adverse reacti...

Multidrug-resistant tuberculosis (MDR-TB) is emerging worldwide, with 3.7% of new cases and 20% of previously treated tuberculosis (TB) cases having MDR-TB. Unfortunately, second-line TB drugs, used for MDR-TB treatment, are less effective than first-line drugs [1]. Sputum culture rather than sputum smear microscopy is recommended to monitor treatment response [1]. Therapeutic drug monitoring (...

BACKGROUND Posaconazole is a novel antifungal drug for oral application intended especially for therapy of invasive mycoses. Due to variable gastrointestinal absorption, adverse side effects, and suspected drug-drug interactions, therapeutic drug monitoring (TDM) of posaconazole is recommended. METHOD A fast ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method ...

Levetiracetam (LVT) is a widely used antiepileptic drug (AED). A less invasive sampling method for therapeutic drug monitoring (TDM) would be very useful particularly for children. Saliva has been shown as an adequate sample for TDM of some AEDs. Due to the high hydrophilicity of LVT its separation on common stationary phases is quite a challenge so that previous methods for determination of LV...

BACKGROUND The value of therapeutic drug monitoring (TDM) for paclitaxel (PTX) was recently demonstrated in the largest TDM trial ever conducted in oncology. The trial demonstrated significant reduction in neuropathy when using TDM. Dose adjustment for PTX was based on time above a threshold concentration (Tc>0.05). Tc>0.05 must be calculated with a pharmacokinetic model and complex nonlinear m...

Linezolid is used off-label to treat multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) [1, 2]. Recently, two systematic reviews and meta-analyses pointed out its promising efficacy [3, 4]. However, linezolid toxicity may outweigh its potential benefits. Indeed, adverse events were notified in almost 60% of the treated cases, with a high incidence of severe events ...

Therapeutic drug monitoring (TDM) and model-informed precision dosing (MIPD) have evolved as important tools to inform rational of antibiotics in individual patients with infections. In particular, critically ill display altered, highly variable pharmacokinetics often suffer from infections caused by less susceptible bacteria. Consequently, TDM has been used individualize this patient group for...