頁籤選單縮合
題名 | 慈濟醫院藥物血中濃度監測報告=An Analysis of Therapeutic Drug Monitoring (TDM) Results from Tzu Chi General Hospital |
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作者 | 楊文琴; 莊美華; 謝維清; | 書刊名 | 慈濟醫學 |
卷期 | 11:4 1999.12[民88.12] |
頁次 | 頁343-349 |
分類號 | 418.11 |
關鍵詞 | 藥物血中濃度監測; Therapeutic drug monitoring; TDM; Digoxin; Phenytoin; Theophylline; |
語文 | 中文(Chinese) |
英文摘要 | Objective: Therapeutic drug monitoring (TDM) has been developed to provide a rigorous yet practical approach for the application ofpharmacokinetic methods, pharmacodynamic principles, and relevant pharmacotherapeutic data to optimize drug therapy for individual patients. In this article, we discussed some potential reasons for plasma concentrations outside the therapeutic range and suggested recommendations to correct the deviation from the optimal plasma levels in order to provide the best pharmaceutical care to all of the patients. Patients and Methods: We reviewed and analyzed all TDM cases that had been done at Tzu Chi General Hospital inpatient, outpatient, and emergency departments from July, 1995 to June, 1998. Results: Phenytoin (total 3374 cases, 50.44%), digoxin (total 1650 cases, 24.67%), and theophylline (total 1462 cases, 21.86%) were the three drugs that had been monitored most often for drug plasma concentrations. There were a total of 4897 TDM cases (73.21%) in the inpatient department, 999 (14.93%) in the emergency room, and 793 (11.86%) in the outpatient clinics. In addition, the percentages of digoxin, phenytoin, and theophylline within the targeted therapeutic drug concentration range in all TDM cases were 50.00%, 29.79%, and 58.21% respectively. Conclusions: Emergency room patients had more sub-target drug concentrations in plasma when compared with the other two major patient populations for these three agents. We may conclude that sub- or over-therapeutic drug concentrations might be a major cause of emergency room visits. Therefore, individual adjustments of drug concentrations in plasma may prevent or minimize adverse effects due to inadvertent overdosage and it may facilitate and increase the effectiveness of therapy. |
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