MLT Therapeutic Drug Monitoring
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| What are some of the most common monitored therapeutic drugs(TD)? | Theophylline, Lidocaine, Valproic acid, Vancomycin, Digoxin, Phenobarbitals, Chloramphenicol, and Ethanol.
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| Theophylline is an effective muscle relaxant for what type of muscle tissue? | Smooth Muscle.
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| What TD stimulates CNS and increases resp rate? | Theophylline.
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| What testing methodology is used to monitor theophylline? | Fluorescent Polarized Immuno Assay. (FPIA)
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| Specimen of choice for theophylline | Non-hemolyzed serum/heparinized plasma.
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| Therapeutic range for theophylline | 10-20 ug/mL
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| Theophylline toxic level | Toxic > 25 ug/mL
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| What TD is absorbed 70% orally? | Digoxin
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| How is Digoxin useful? | Improves cardiac contractions in CHF.
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| What is the testing methodology for digoxin? | FPIA
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| Specimen of choice for digoxin is... | Non-hemolyzed serum/plasma
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| What is important to consider when obtaining a specimen that is being monitored during digoxin therapy? | Timing: collect 8 hours after dose. The level may rise to 8-10 ng/mL in the first 8hrs.
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| Therapeutic range for Digoxin... | 0.8 - 2.0 ng/mL
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| Digoxin therapy levels are considered toxic when.... | digoxin levels > 3 ng/mL
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| What TD corrects ventricular arrhythmias associated with MI, cardiac surgery, and digitalis intoxication? | Lidocaine
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| What testing methodology is utilized when monitoring lidocaine usage? | EIA or HPLC
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| Specimen of choice when collecting lidocaine... | Non-hemolyzed serum/plasma
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| Therapeutic range for lidocaine... | 1.5 - 5.0 ug/mL
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| Lidocaine levels considered toxic when... | lidocaine > 5.0 ug/mL
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| Phenobarbitals are monitored when being used as treatment for febrile seizures and... | neonatal seizures
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| Testing methodology of choice for phenobarbitals is... | FPIA
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| Specimen of choice... | Non-hemolyzed serum/plasma
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| Primary drug in the treament of absence(petit-mal) and myoclonic seizures... | Valproic acid
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| Testing methodology of choice for valproic acid is... | FPIA
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| Specimen of choice for valproic acid is... | Non-Hemolyzed serum/plasma
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| What is the therapeutic range for valproic acid? | 50 - 100 ug/mL
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| When is valproic acid levels considered toxic... | valproic acid > 100 ug/mL
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| Name this TD...Multipurpose Antibiotic. Quickly diminished due to dose related toxicities, primarily aplastic anemia. | Chloramphenicol
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| Testing methodology of choice for chloramphenicol... | HPLC or GLC
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| Specimen collection of choice for chloramphenicol... | Non-hemolyzed serum/plasma
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| Therapeutic range for chloramphenicol... | 10 - 20 ug/mL
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| When is chloramphenicol levels considered toxic... | chloramphenicol > 25 ug/mL
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| What TD is an effective antibiotic against GPC/GPR, prevents wall synthesis, and is effective against S. Epi and S. aureus? | Vancomycin
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| Testing methodology of choice when monitoring vancomycin levels is.... | FPIA
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| Therapeutic Range for vancomycin... | Trough: 5 - 10 ug/mL Peak: 30 - 40 ug/mL
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| Cholinesterase is an essential enzyme, why do we monitor the levels of this enzyme in our body? | Deficiency can lead to serious illness.
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| Uses for this drug include evaluation of secondary to insecticide exposure or monitoring organphosphorous or carbamate insecticide poisoning.... | cholinesterase
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| Testing methodology of choice for cholinesterase is... | spectrophotometry
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| Specimen requirements... | Plasma(EDTA), you must seperate plasma from cells immediately.
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| Name the percentages of insecticide poisoning... | 15-25% Slight Poison, 25-35% moderate poison, 35-50% severe poison
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| What is the normal reference range for cholinesterase? | 4,000 - 12,000 U/L
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| When determining the level of ethanol in blood, the amount of ethanol in the blood is directly proportional to the amount of what? | NADH(this is what the test actually measures to determine ethanol levels)
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| What is the testing methodology of choice for ethanol? | REA(reactive enzyme assay)
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| Ethanol collection specimen requirements... | Non-Hemolyzed serum/plasma(in a gray top tube, sodium fluoride) or Whole Blood
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| Recording or interpreting of ethanol levels should be expressed in... | mg/dL or gm%
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| This TD is a commonly used analgesic where abuse can lead to respiratory alkalosis. | Salicylate
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| Testing methodology of choice for salicylate is... | FPIA
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| Specimen collection of choice for Salicylate... | Non-hemolyzed serum/plasma(heparinized)
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| Therapeutic range for salicylate... | salicylate < 30 mg/dL
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| Salicylate levels considered toxic when... | salicylate > 30 mg/dL
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| This TD is also a commonly used analgesic that is taken PRN and poses no risk....however there can be delayed toxicity: liver necrosis 3-4 days post OD.(due to the metabolite, not the parent drug) | acetaminophen
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| What is the antidote for an acetaminophen OD? | N-acetylcysteine
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| Testing methodology of choice for acetaminophen... | FPIA
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| Specime requirements for acetaminophen collection... | Non-hemolyzed serum/plasma(heparinized)
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| Therapeutic range for acetaminophen... | 10 - 25 mg/mL
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| Acetaminophen levels considered toxic when... | acetaminophen is 100 - 250 mg/mL
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| What is the Initial and Confirmatory test level for Marijuana? | initial: 50 ng/mL confirmatory: 15 ng/mL
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| What is the Initial and Confirmatory test level for Cocaine? | initial: 300 ng/mL Confirmatory: 150 ng/mL
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| What is the Initial and Confirmatory test level for an Opiate metabolite? | initial: 300 ng/mL Confirmatory: 300 ng/mL
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| list the screening methods for abused drugs... | EIA or FPIA
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| list the confirmatory methods for abused drugs... | GC/MS
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Created by:
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