Pharmacopsychiatry 2024; 57(02): 94
DOI: 10.1055/s-0044-1779583
Abstracts │ XVth Symposium of the Task Force Therapeutic Drug Monitoring of the AGNP
Poster Abstracts

Update on dose-related reference ranges for psychotropic drugs

Autoren

  • F. J. Amann

    1   Central Institute of Mental Health, Department of Molecular Neuroimaging, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany

  • K. Endres

    2   Klinikum Starnberg, Hospital Pharmacy, Starnberg, Germany

  • C. Hiemke

    3   Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP), Working Group "Therapeutic Drug Monitoring"
    4   Department of Psychiatry and Psychotherapy, University Medical Center of Mainz, Mainz, Germany
    5   Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of Mainz, Mainz, Germany

  • G. Zernig

    3   Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP), Working Group "Therapeutic Drug Monitoring"
    6   Medical University of Innsbruck, Department of Pharmacology, Innsbruck, Austria
    7   Private Practice for Psychotherapy and Court-Certified Witness, Hall in Tirol, Austria

  • G. Gründer

    1   Central Institute of Mental Health, Department of Molecular Neuroimaging, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
    3   Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP), Working Group "Therapeutic Drug Monitoring"

  • X. M. Hart

    1   Central Institute of Mental Health, Department of Molecular Neuroimaging, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
    3   Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP), Working Group "Therapeutic Drug Monitoring"
    8   Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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Dose-related reference ranges (DRRs) are substance and dosage form specific blood concentration ranges predicted for a given dosage. Comparing measured blood concentrations with these calculated ranges enables the detection of pharmacokinetic peculiarities or compliance issues. Previously, a validated methodology to calculate DRRs was published. This presentation will illustrate what pitfalls should be considered when using the validated method to calculate DRRs for the update of the AGNP TDM guidelines.

Pharmacokinetic parameters and product informations were extracted from literature. For calculation of new DRRs, an updated methodology was used.

The validity of a DRR is determined by the methodology used and the statistical dispersion around the pharmacokinetic parameters that define its limits. Indeed, these limits must be defined to precisely reflect the pharmacokinetic data of so-called normal patients. The most robust approach to derive valid pharmacokinetic parameters is a well-conducted systematic literature review including a meta-analysis of extracted data. In cases where a systematic literature review is not feasible or when pharmacokinetic data are limited, less sophisticated methods can be used to approximate the DRR.

Methodological shortcomings in the calculations of DRRs pose the risk of systematic misinterpretation of Therapeutic Drug Monitoring data. Recalculations of current DRRs have been performed and findings are presented in this work. Ranges calculated in the future should account for subgroups with distinct pharmacokinetic properties (i.e. elderly or comorbid patients).



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Artikel online veröffentlicht:
12. März 2024

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