Therapeutic Drug Monitoring

Pharmacological treatments and their side effects can have an impact on the patients’ safety or life’s quality. Specifically, the so called ADME (absorption, distribution, metabolism, and excretion) of the drug can be highly influenced by the genetics, environment and administration of other drugs due to co-morbidities. Therefore, in some cases the treatment with a fixed drug dose can turn out risky for patients’ health. For this reason, the Monitoring of a drug therapy which is optimized for a specific case is necessary.
On one hand, this can be particularly needed for drugs that present a narrow therapeutic range, which can be easily exceeded causing many toxic effects and/or increasing drugdrug interactions (DDIs) (Tuzimski, et al. 2020_review). On the other hand, if the drug concentration is lower than the safety ranges the pharmacological activity might not occur.
In the light of this, Therapeutic Drug Monitoring (TDM) is a strategic way to “adjust” the treatment and the dose based on patient’s clinical case (Kuhlin_cMSpec_2018).

 

For a long time, immunoassays have been chosen as methods for TDM. However, the necessity to analyze specific metabolites and to avoid non-specific interference coming from other molecules or matrix led to switch to an alternative method which provides high selectivity and sensitivity, high-quality data and reproducibility. This has been found in liquid chromatography methods coupled with UV, fluorescence detectors (FLD) or MS detectors triple quad (Mass Spectrometry). Liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) techniques allows to analyze drugs with high selectivity and sensitivity.

ANTIEPILEPTICS
Lamotrigine in serum and/or in plasma by UV – FAST(100 tests)
Lamotrigine and 10,11-Dihydro-10-Hydroxycarbazepine  in serum and/or in plasma by UV – FAST (100 tests)

Antiepileptics 1 in serum and/or in plasma by UV – FAST (100 tests)

(Phenobarbital, Phenytoin and Carbamazepine )

Antiepileptics 3 in serum and/or in plasma by UV – FAST (100 tests)

(Ethosuximide, Primidone, Lamotrigine, Phelbamate, 10,11-Dihydro-10-Hydroxycarbazepine, Carbamazepine-epoxide,
Oxacarbazepine)

Antiepileptics 4 in serum and/or in plasma by UV – FAST(100 tests)
(Lamotrigine, Zonisamide, Monohydroxycarbazepine)
Antiepileptics 5 in serum and/or in plasma by UV – FAST (100 tests)
(Lacosamide, Rufinamide, Desmethylsuximide, Metosuximide, Phenytoin)
Antiepileptics 6 in serum and/or in plasma by UV – FAST (100 tests)
(Lacosamide, Ethosuximide, Zonisamide, Primidone, Lamotrigine , 10,11-Dihydro-10-Hydroxycarbamazepine)
Levetiracetam in plasma by UV – FAST (100 tests)
Perampanel in plasma by Fluorimetry – FAST (100 tests)
Topiramate in plasma by Fluorimetry (100 tests)
Valproic Acid in plasma by UV – FAST (100 tests)
 
ANTIARRYTHMICS
Amiodarone/Desethylamiodarone in serum and/or in plasma by UV – FAST (100 tests)
Antiarrythmics in plasma by UV – FAST (100 tests)
(Flecainide, Propafenone, Verapamil)
Sotalol  in plasma by Fluorimetry FAST  (100 tests)
Mychophenolic Acid  in serum and/or in plasma by UV – FAST(100 tests)
 
DRUGS FOR PANIC, ANXIETY OR MENTAL DISORDERS
Benzodiazepines 1 in serum and/or in plasma by UV – FAST (100 tests)

(Bromazepam, Lorazepam, Clonazepam, Flunitrazepam, Clordemetildiazepam)

Benzodiazepines 2 in serum and/or in plasma by UV – FAST (100 tests)

(Nordiazepam, Clobazam, Diazepam)

Tricyclic Antidepressants in serum and/or in plasma by UV (100 tests)

(Nordoxepine, Desipramine, Imipramine, Doxepine, Amitriptiline and Nortriptiline)

Clozapine and Norclozapine in serum and/or in plasma by UV – FAST(100 tests)
 
ANTI-INFECTIVE DRUGS
Antimycotics in plasma by Fluorimetry – FAST (100 tests)
Antibiotics in plasma by UV – FAST (100 tests)
(Ceftriaxone, Ampicillin, Ciprofloxacin, Levofloxacin, Linezolid, Piperacillin, Tazobactam, Ceftazidime, Meropenem, Cefoxitine, Daptomycin)
 
ANTI-DIABETES DRUGS
Metformin in serum by UV/VIS – FAST (100 tests)
(Atazanavir, Ritonavir, Efavirenz, Lopinavir)

 

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