安徽医科大学国际教育学院教案与讲稿 LINEAR MODELS] 5min E=SXC+I E is the drug effect C is the drug concentration S is the slope of the line I is the y intercept FIXED-EFFECT MODELI 5min The link between a concentration and the probability of occurrence of a defined effect Concept of threshold concentration The threshold concentration is different from a subject to another one:it is a random variable, characterized by a distribution in the population We can association concentrations with a probability of occurrence of the effect Example:adverse effects of digoxin THERAPEUTIC DRUG MONITORING(TDM)I lmin TDM is a branch of clinical chemistry and clinical pharmacology that specializes in the measurement of medication concentrations in blood. Therapeutic failure results when either the concentration is too low,ineffective therapy,or is too high,producing unacceptable toxicity.Between these limits of concentration lies a region associated with therapeutic success-regarded as a Therapeutic window. [PURPOSE OF TDM] 2min To confirm“effective'”concentrations To investigate unexpected lack of efficacy To check compliance To avoid or anticipate toxic concentrations Before increasing to unusually large doses Limited role in toxicology-drug screen ITDM-THEORETICAL BASISI 2min Relates concentrations of drug in blood to response Blood concentrations surrogate for the concentration at the site of action Has been established on the principle that the concentration correlates better than the dose with the drug effect [FOR WHICH DRUGS IS MONITORING HELPFUL?] 1min Marked pharmacokinetic variability Concentration related to therapeutic and adverse effects Narrow therapeutic index Defined therapeutic (target)concentration range Desired therapeutic effect difficult to monitor [SAMPLING AND DRUGANALYSISI 2min 4安徽医科大学国际教育学院教案与讲稿 4 [LINEAR MODELS] 5min E = S×C + I E is the drug effect C is the drug concentration S is the slope of the line I is the y intercept [FIXED-EFFECT MODEL] 5min The link between a concentration and the probability of occurrence of a defined effect Concept of threshold concentration The threshold concentration is different from a subject to another one : it is a random variable, characterized by a distribution in the population We can association concentrations with a probability of occurrence of the effect Example: adverse effects of digoxin [THERAPEUTIC DRUG MONITORING (TDM)] 1min TDM is a branch of clinical chemistry and clinical pharmacology that specializes in the measurement of medication concentrations in blood. Therapeutic failure results when either the concentration is too low, ineffective therapy, or is too high, producing unacceptable toxicity. Between these limits of concentration lies a region associated with therapeutic success–regarded as a Therapeutic window. [PURPOSE OF TDM] 2min To confirm “effective” concentrations To investigate unexpected lack of efficacy To check compliance To avoid or anticipate toxic concentrations Before increasing to unusually large doses Limited role in toxicology - drug screen [TDM-THEORETICAL BASIS] 2min Relates concentrations of drug in blood to response Blood concentrations surrogate for the concentration at the site of action Has been established on the principle that the concentration correlates better than the dose with the drug effect [FOR WHICH DRUGS IS MONITORING HELPFUL?] 1min Marked pharmacokinetic variability Concentration related to therapeutic and adverse effects Narrow therapeutic index Defined therapeutic (target) concentration range Desired therapeutic effect difficult to monitor [SAMPLING AND DRUG ANALYSIS] 2min