Testing for drugs of abuse usually occurs in two circumstances: possible or known overdose or testing of clinically well persons to detect drug use. Overdose will be discussed in the section on toxicology. Drug screening has its own unique problems. For example, it is necessary to provide legal chain of custody protection to specimens so […]
Cyclosporine (previously called “cyclosporin A”) is a compound derived from a soil fungus that has strong immunosuppressive activity and is widely used to prevent transplant rejection. Cyclosporine is thought to inhibit helper T-cell function with minimal effect on B-cell function. Cyclosporine can be administered orally or intravenously. If given orally, it is absorbed through the […]
Gentamicin.Methods of estimating antibiotic therapeutic effectiveness have been discussed elsewhere (chapter 14). Several antibiotics possess therapeutic ranges whose upper limits border on toxicity. Serum assays for several of these have been developed, most commonly using some type of immunoassay. One example will be used to illustrate general principles. Gentamicin (Garamycin) is one of the aminoglycoside […]
Theophylline is used primarily as a bronchodilating agent for therapy of asthma. Over the therapeutic range there is a reasonably linear correlation between dosage and therapeutic effect. The drug is administered intravenously and orally. Oral medication is available in regular (noncoated or liquid) and slow-release (SR) forms. SR forms are available in twice-daily, and even […]
There is a large and ever-growing list of these medications, too many to include here. TDM data for some members of this group are summarized in Table 37-25. Several have been selected for more detailed discussion here. Procainamide. Procainamide is used to control certain ventricular arrhythmias and can be given orally or intravenously. Only about […]
Lithium carbonate. Lithium is used for control of the manic phase of manic-depressive psychiatric illness. Peak levels are reached in 1-3 hours, and plasma half-life (in young adults) is about 24 hours (range, 8-35 hours). Time to steady state is about 5 days (range, 2-7 days). Most excretion is through the kidneys, where there is […]
Most epileptics can be controlled with phenytoin (Dilantin), primidone (Mysoline), phenobarbital, or other agents. Frequently drug combinations are required. Therapy is usually a long-term project. When toxicity develops, many of these therapeutic agents produce symptoms that could also be caused by central nervous system (CNS) disease, such as confusion, somnolence, and various changes in mental […]
Various studies have shown that therapy guided by drug blood levels (therapeutic drug monitoring, TDM) has a considerably better chance of achieving therapeutic effect and preventing toxicity than therapy using empiric drug dosage. TDM can be helpful in a variety of circumstances, as can be seen in the following discussion. Новости SEO – www.seofull.ru Why […]
There are a large number of congenital and genetic disorders, too many to include all in this book. If such a condition is suspected, in general the best procedure is to refer the patient or family to a university center that has an active genetics diagnosis program. If the state government health department has a […]
In porphyric diseases, the main similarity is the abnormal secretion of substances that are precursors of the porphyrin compound heme (of hemoglobin). The known pathways of porphyrin synthesis begin with glycine and succinate, which are combined to eventually form a compound known as d-aminolevulinic acid (ALA). This goes on to produce a substance known as […]
