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Reuter SE, Stocker SL, Alffenaar JWC, Baldelli S, Cattaneo D, Jones G, Koch BCP, Kocic D, Mathew SK, Molinaro M, Neely M, Sandaradura I, Marriott DJE. Optimal Practice for Vancomycin Therapeutic Drug Monitoring: Position Statement From the Anti-infectives Committee of the International Association of Therapeutic Drug Monitoring and Clinical Toxicology. Ther Drug Monit 2022; 44:121-132. [PMID: 34882107 DOI: 10.1097/ftd.0000000000000944] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/08/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Individualization of vancomycin dosing based on therapeutic drug monitoring (TDM) data is known to improve patient outcomes compared with fixed or empirical dosing strategies. There is increasing evidence to support area-under-the-curve (AUC24)-guided TDM to inform vancomycin dosing decisions for patients receiving therapy for more than 48 hours. It is acknowledged that there may be institutional barriers to the implementation of AUC24-guided dosing, and additional effort is required to enable the transition from trough-based to AUC24-based strategies. Adequate documentation of sampling, correct storage and transport, accurate laboratory analysis, and pertinent data reporting are required to ensure appropriate interpretation of TDM data to guide vancomycin dosing recommendations. Ultimately, TDM data in the clinical context of the patient and their response to treatment should guide vancomycin therapy. Endorsed by the International Association of Therapeutic Drug Monitoring and Clinical Toxicology, the IATDMCT Anti-Infectives Committee, provides recommendations with respect to best clinical practice for vancomycin TDM.
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Affiliation(s)
- Stephanie E Reuter
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Sophie L Stocker
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, Australia
- St Vincent's Clinical School, Faculty of Medicine, The University of New South Wales, Sydney, Australia
| | - Jan-Willem C Alffenaar
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Department of Pharmacy, Westmead Hospital, Sydney, Australia
- Marie Bashir Institute of Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia
| | - Sara Baldelli
- Unit of Clinical Pharmacology, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
| | - Dario Cattaneo
- Unit of Clinical Pharmacology, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
| | - Graham Jones
- St Vincent's Clinical School, Faculty of Medicine, The University of New South Wales, Sydney, Australia
- Department of Chemical Pathology and Clinical Pharmacology, SydPath, St Vincent's Hospital, Sydney, Australia
| | - Birgit C P Koch
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - Danijela Kocic
- St Vincent's Clinical School, Faculty of Medicine, The University of New South Wales, Sydney, Australia
- Department of Chemical Pathology and Clinical Pharmacology, SydPath, St Vincent's Hospital, Sydney, Australia
| | - Sumith K Mathew
- Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, India
| | - Mariadelfina Molinaro
- Department of Diagnostic Medicine, Clinical and Experimental Pharmacokinetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Michael Neely
- Department of Pediatrics, Keck School of Medicine, University of Southern California, and Division of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, California, Los Angeles, CA
| | - Indy Sandaradura
- Marie Bashir Institute of Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Centre for Infectious Diseases and Microbiology, Westmead Hospital, Sydney, Australia
- Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Sydney, Australia; and
| | - Deborah J E Marriott
- St Vincent's Clinical School, Faculty of Medicine, The University of New South Wales, Sydney, Australia
- Department of Clinical Microbiology and Infectious Diseases, St Vincent's Hospital, Sydney, Australia
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Peck Palmer OM, Dasgupta A. Review of the Preanalytical Errors That Impact Therapeutic Drug Monitoring. Ther Drug Monit 2021; 43:595-608. [PMID: 33928931 DOI: 10.1097/ftd.0000000000000901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/06/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Preanalytical errors comprise the majority of testing errors experienced by clinical laboratories and significantly impact the accuracy of therapeutic drug monitoring (TDM). METHODS Specific preanalytical factors in sample timing, collection, transport, processing, and storage that lead to errors in TDM were reviewed. We performed a literature search using several scientific databases including PubMed, ScienceDirect, Scopus, Web of Science, and ResearchGate for human studies published in the English language from January 1980 to February 2021, reporting on TDM and the preanalytical phase. RESULTS Blood collection errors (ie, wrong anticoagulant/clot activator used, via an intravenous line, incorrect time after dosing) delay testing, cause inaccurate results, and adversely impact patient care. Blood collected in lithium heparin tubes instead of heparin sodium tubes produce supertoxic lithium concentrations, which can compromise care. Specimens collected in serum separator gel tubes cause falsely decreased concentrations due to passive absorption into the gel when samples are not processed and analyzed quickly. Dried blood spots are popular for TDM as they are minimally invasive, allowing for self-sampling and direct shipping to a clinical laboratory using regular mail. However, blood collection techniques, such as trauma to the collection site, filter paper fragility, and hematocrit (Hct) bias, can adversely affect the accuracy of the results. Volumetric absorptive microsampling is a potential alternative to dried blood spot that offers fast, volume-fixed sampling, low pain tolerance, and is not susceptible to Hct concentrations. CONCLUSIONS The identification of preanalytical factors that may negatively impact TDM is critical. Developing workflows that can standardize TDM practices, align appropriate timing and blood collection techniques, and specimen processing will eliminate errors.
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Affiliation(s)
- Octavia M Peck Palmer
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and
| | - Amitava Dasgupta
- Department of Pathology and Laboratory Medicine, University of Texas McGovern Medical School at Houston, Texas
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Bioanalysis of doxorubicin aglycone metabolites in human plasma samples-implications for doxorubicin drug monitoring. Sci Rep 2020; 10:18562. [PMID: 33122763 PMCID: PMC7596548 DOI: 10.1038/s41598-020-75662-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/14/2020] [Indexed: 11/18/2022] Open
Abstract
The widespread clinical use of the cytostatic doxorubicin together with the induction of chronic cardiomyopathy necessitates the conduct of further pharmacokinetic trials. Novel analytical technologies suitable for point-of-care applications can facilitate drug level analyses but might be prone to interferences from structurally similar compounds. Besides the alcohol metabolite doxorubicinol, aglycone metabolites of doxorubicin might affect its determination in plasma. To evaluate their analytical relevance, a validated HPLC method for the quantification of doxorubicin, doxorubicinol and four aglycones was used. The degradation pattern of doxorubicin in plasma under long-term storage was analysed with respect to the formation of aglycone products. In addition, overall 50 clinical samples obtained within the EPOC-MS-001-Doxo trial were analysed. Substantial degradation of doxorubicin in plasma occurred within a storage period of one year, but this did not lead to the formation of aglycones. In clinical samples, 7-deoxydoxorubicinolone was the major aglycone detectable in 35/50 samples and a concentration range of 1.0–12.7 µg L−1. If at all, the other aglycones were only determined in very low concentrations. Therefore, analytical interferences from aglycones seem to be unlikely with the exception of 7-deoxydoxorubicinolone whose concentration accounted for up to 65% of the doxorubicin concentration in the clinical samples analysed.
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Chen PH. “Plasma Concentration-Time Profile” as an Indefinite Claim Term: A Lesson from Forest Labs., Inc. v. Teva Pharm. USA, Inc. Biotechnol Law Rep 2019. [DOI: 10.1089/blr.2019.29116.phc] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ping-Hsun Chen
- Ping-Hsun Chen is Associate Professor at the Graduate Institute of Technology, Innovation, and Intellectual Property Management at National Chengchi University in Taipei, Taiwan. Mr. Chen holds a JD (’10) and LLM (’08) from Washington University in St. Louis School of Law; an LLM (’07) from National Chengchi University in Taiwan; and a BS (’97) and MS (’99) in Chem. Eng. from National Taiwan University in Taiwan. E-mail for Mr. Chen:
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McBride C, Miller-Hoover S, Proudfoot JA. A Standard Push-Pull Protocol for Waste-Free Sampling in the Pediatric Intensive Care Unit. JOURNAL OF INFUSION NURSING 2018; 41:189-197. [PMID: 29659467 PMCID: PMC6214664 DOI: 10.1097/nan.0000000000000279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Blood sampling is a major source of blood loss in the pediatric intensive care unit (PICU). Blood-sparing sampling techniques such as the push-pull method can significantly reduce sampling-related blood loss and protect patients from anemia and blood transfusions. The push-pull method is supported by research evidence for central venous catheter (CVC) sampling, but research protocols differ and not all CVCs and laboratory tests have been studied. A standard push-pull protocol for the PICU was developed, implemented, and evaluated in this evidence-based practice project. Results show that the protocol can be used safely and reliably as a standard waste-free sampling method in the PICU.
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Affiliation(s)
- Clare McBride
- Oregon Health and Science University, Doernbecher Children's Hospital, Portland, Oregon (Ms McBride); Rady Children's Hospital, San Diego, California (Dr Miller-Hoover); and University of California at San Diego, Altman Clinical and Translational Research Institute, San Diego, California (Mr Proudfoot). Clare McBride, BSN, RN, CCRN, is a pediatric intensive care and cardiac nurse at Oregon Health and Science University's Doernbecher Children's Hospital. She previously worked at Rady Children's Hospital in San Diego and presented this evidence-based practice project at the American Association of Critical Care Nurses' annual teaching conference. Suzan Miller-Hoover, DNP, RN, CCNS, CCRN-K, has been in the nursing profession for more than 35 years. An experienced national speaker and peer-reviewed author, Dr Miller-Hoover is passionate about evidence-based best practice and pediatrics. James A. Proudfoot, MSc, is a senior statistician at the University of California at San Diego, Altman Clinical and Translational Research Institute. He has consulted on numerous clinical trials and is a coauthor of more than 25 articles
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Serrano LA, Yang Y, Salvati E, Stellacci F, Krol S, Guldin S. pH-Mediated molecular differentiation for fluorimetric quantification of chemotherapeutic drugs in human plasma. Chem Commun (Camb) 2018; 54:1485-1488. [PMID: 29359205 DOI: 10.1039/c7cc07668a] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
At present, drug dosage is based on standardised approaches that disregard pharmakokinetic differences between patients and lead to non-optimal efficacy and unnecessary side effects. In this work, we demonstrate the potential of pH-mediated fluorescence spectroscopy for therapeutic drug monitoring in complex media. We apply this principle to the simultaneous quantification of the chemotherapeutic prodrug Irinotecan and its active metabolite SN-38 from human plasma across the clinically relevant concentration range, i.e. from micromolar to nanomolar at molar ratios of up to 30 : 1.
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Affiliation(s)
- Luis A Serrano
- Department of Chemical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK.
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Shih AW, Crowther MA, Jamula E, El-Sharkawy R, Brown M, Paterson G, Lui M, Don-Wauchope AC. Assessment of the Measurement Error in Cyclosporine Levels Drawn Between Peripheral and Central Sources. Am J Clin Pathol 2017; 149:76-81. [PMID: 29272889 DOI: 10.1093/ajcp/aqx145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Cyclosporine is often monitored by drug levels drawn through central venous catheters (CVCs), which may be falsely elevated due to reversible drug adsorption onto the catheter. Therefore, we assessed the correlation between cyclosporine levels drawn peripherally and through CVCs. METHODS Bone marrow transplantation patients had a weekly collection of both peripheral and CVC draws from dual-lumen catheters simultaneously to assess cyclosporine levels after research ethics approval. Our primary outcome was the proportion of paired samples that were incongruent-defined as the mean of the CVC level being greater than 2 standard deviations from the peripheral level mean. RESULTS After approaching 27 eligible patients, 20 patients (77.8%) provided samples. Of 53 paired samples, seven were incongruent (13.2%). Peripheral and CVC levels correlated (r = 0.91) and agreed well. CONCLUSION Despite potential for preanalytical error due to adsorption, cyclosporine infusion and monitoring via CVCs produce results similar to monitoring via peripheral blood draws.
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Affiliation(s)
- Andrew W Shih
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
- McMaster Centre for Transfusion Research, McMaster University, Hamilton, Canada
| | - Mark A Crowther
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Erin Jamula
- McMaster Centre for Transfusion Research, McMaster University, Hamilton, Canada
| | - Rami El-Sharkawy
- Department of Pharmacy, Juravinski Cancer Centre, Hamilton, Canada
| | - Mark Brown
- Department of Pharmacy, Juravinski Cancer Centre, Hamilton, Canada
| | | | - Michelle Lui
- Department of Pharmacy, Juravinski Cancer Centre, Hamilton, Canada
| | - Andrew C Don-Wauchope
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
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Krischke M, Hempel G, Völler S, André N, D'Incalci M, Bisogno G, Köpcke W, Borowski M, Herold R, Boddy AV, Boos J. Pharmacokinetic and pharmacodynamic study of doxorubicin in children with cancer: results of a "European Pediatric Oncology Off-patents Medicines Consortium" trial. Cancer Chemother Pharmacol 2016; 78:1175-1184. [PMID: 27770238 PMCID: PMC5114325 DOI: 10.1007/s00280-016-3174-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 10/12/2016] [Indexed: 11/26/2022]
Abstract
Purpose Doxorubicin is a key component in many pediatric oncology treatment regimens; still pharmacology data on which current dosing regimens are based are very limited. Methods We conducted a multinational pharmacokinetic study investigating age dependency of doxorubicin metabolism and elimination in children with cancer. One hundred and one patients treated with doxorubicin according to a cancer-specific national or European therapeutic trial were recruited. Doses of doxorubicin ranged from 10.4 to 57.7 mg/m2. Blood samples for measurement of doxorubicin and its metabolite doxorubicinol were collected after two administrations, with five samples collected in children <3 years and eight in children ≥3 years. A population pharmacokinetic approach was used for analysis, including pharmacogenetic covariates. Natriuretic peptides and cardiac troponins were measured to evaluate their role as early indicators of cardiotoxicity. Results Age dependence of doxorubicin clearance was demonstrated, with children less than 3 years having a statistically significant lower clearance (21.1 ± 5.8 l/h/m2) than older children (26.6 ± 6.7 l/h/m2) (p = 0.0004) after correcting for body surface area. No effect of the investigated genetic polymorphisms on the pharmacokinetics could be observed. Although natriuretic peptides were transiently elevated after each doxorubicin administration and troponin levels increased with increasing doxorubicin exposure, only limited correlation could be observed between their blood levels and doxorubicin pharmacokinetics. Conclusion In the European framework of funding and regulatory support, an add-on study to existing therapeutic trials was developed. The pediatric need concerning missing PK data could be addressed with limited burden for the patients. Empirically used dose adaptations for infants were generally found to be justified based on our PK analyses. Electronic supplementary material The online version of this article (doi:10.1007/s00280-016-3174-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Miriam Krischke
- Pediatric Hematology and Oncology, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany
- Zentrum für Klinische Studien (ZKS), University Hospital Münster, Von-Esmarch-Straße 62, 48149, Münster, Germany
| | - Georg Hempel
- Department of Pharmaceutical and Medical Chemistry, Clinical Pharmacy, Westfälische Wilhelms-Universität Münster, Corrensstraße 48, 48149, Münster, Germany
| | - Swantje Völler
- Department of Pharmaceutical and Medical Chemistry, Clinical Pharmacy, Westfälische Wilhelms-Universität Münster, Corrensstraße 48, 48149, Münster, Germany
| | - Nicolas André
- INSERM UMR 911, Centre de Recherche en Oncologie biologique et en Oncopharmacologie, Aix-Marseille University, Marseille, France
- Hematology and Pediatric Oncology Department, La Timone University Hospital of Marseille, Marseille, France
| | - Maurizio D'Incalci
- Department of Oncology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Via La Masa, 19, 20156, Milan, Italy
| | - Gianni Bisogno
- Dipartimento di Pediatria, Clinica di Oncoematologia, via Giustiniani, 3, 35100, Padua, Italy
| | - Wolfgang Köpcke
- Institute of Biostatistics and Clinical Research, Westfälische Wilhelms-Universität Münster, Schmeddingstraße 56, 48149, Münster, Germany
| | - Matthias Borowski
- Institute of Biostatistics and Clinical Research, Westfälische Wilhelms-Universität Münster, Schmeddingstraße 56, 48149, Münster, Germany
| | - Ralf Herold
- European Medicines Agency (EMA), 30 Churchill Place, Canary Wharf, London, E14 5EU, UK
| | - Alan V Boddy
- Northern Institute for Cancer Research, Newcastle University, Paul O'Gorman Building, Medical School, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
- Faculty of Pharmacy, University of Sydney, Sydney, Australia
| | - Joachim Boos
- Pediatric Hematology and Oncology, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany.
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Therapeutic Drug Monitoring of Pentobarbital: Experience at an Academic Medical Center. Ther Drug Monit 2015; 37:783-91. [PMID: 26565790 DOI: 10.1097/ftd.0000000000000217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pentobarbital is used for management of intractable seizures and for reducing elevated intracranial pressure. Dosing of pentobarbital can be aided by therapeutic drug monitoring (TDM). There is no commercially available automated assay for measurement of pentobarbital serum/plasma concentrations; consequently, chromatography-based assays are often used. METHODS Pentobarbital TDM was studied over a 14-year period at an academic medical center. 154 patients (94 adult, 60 pediatric) were identified who had pentobarbital levels ordered at least once during a hospital encounter. Chart review included patient diagnosis, indication for pentobarbital therapy, recent or concomitant medication with other barbiturates, patient disposition, organ donation, pentobarbital dosing changes, and neurosurgical procedures. Pentobarbital serum/plasma concentrations were determined on an automated clinical chemistry platform with a laboratory-developed test adapted from a urine barbiturates immunoassay. RESULTS Chart review showed therapeutic use of pentobarbital generally consistent with previously published literature. The most common errors observed involved confusion in barbiturate names (eg, mix-up of pentobarbital and phenobarbital in test ordering or in provider notes) that seemed to have minimal impact on TDM effectiveness, with pentobarbital serum/plasma concentrations generally within target ranges. The laboratory-developed pentobarbital immunoassay showed cross-reactivity with phenobarbital and butalbital that was eliminated by alkaline and heat pretreatment. The immunoassay was linear to 20 mcg/mL and correlated closely with gas chromatography-mass spectrometry measurements at a reference laboratory. CONCLUSIONS Pentobarbital TDM can be performed by immunoassay on an automated clinical chemistry platform, providing an alternative to chromatography-based methods. Confusion in barbiturate names is common, especially pentobarbital and phenobarbital.
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Krischke M, Boddy AV, Boos J. Sources of preanalytical error in pharmacokinetic analyses - focus on intravenous drug administration and collection of blood samples. Expert Opin Drug Metab Toxicol 2014; 10:825-38. [PMID: 24738965 DOI: 10.1517/17425255.2014.907273] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Pharmacokinetic (PK) studies for long-established drugs are generally performed outside the well-standardized settings of pharmaceutical industry trials. Instead, such studies are usually performed within daily clinical practice of hospitals. AREAS COVERED This article describes aspects of intravenous (i.v.) drug administration and blood sampling that contribute to potential sources of preanalytical errors for PK investigations. Parameters that bias determination of start and end time of i.v. infusions, as well as consistent rate of drug delivery, are discussed. Causes for drug loss in the infusion device, including adsorption and insufficient flushing, are outlined. The advantages and disadvantages of different blood sampling techniques are reviewed, with an emphasis on pediatric studies. EXPERT OPINION For PK studies that are integrated into the general hospital routine, a variety of potential sources of error exist. Potential pitfalls depend on the specific drug and trial characteristics and they must be anticipated and discussed in advance. Working procedures need to be developed that address the anticipated problems and in detail describe procedures that need compliance between bed and bench.
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Affiliation(s)
- Miriam Krischke
- University Hospital Muenster, Centre for Clinical Trials (ZKS) , Von-Esmarch-Straße 62, 48149 Muenster , Germany +49 251 83 57104 ; +49 251 57026 ;
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Bielohuby M, Popp S, Bidlingmaier M. A guide for measurement of circulating metabolic hormones in rodents: Pitfalls during the pre-analytical phase. Mol Metab 2012; 1:47-60. [PMID: 24024118 DOI: 10.1016/j.molmet.2012.07.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 07/18/2012] [Accepted: 07/18/2012] [Indexed: 12/26/2022] Open
Abstract
Researchers analyse hormones to draw conclusions from changes in hormone concentrations observed under specific physiological conditions and to elucidate mechanisms underlying their biological variability. It is, however, frequently overlooked that also circumstances occurring after collection of biological samples can significantly affect the hormone concentrations measured, owing to analytical and pre-analytical variability. Whereas the awareness for such potential confounders is increasing in human laboratory medicine, there is sometimes limited consensus about the control of these factors in rodent studies. In this guide, we demonstrate how such factors can affect reliability and consequent interpretation of the data from immunoassay measurements of circulating metabolic hormones in rodent studies. We also compare the knowledge about such factors in rodent studies to recent recommendations established for biomarker studies in humans and give specific practical recommendations for the control of pre-analytical conditions in metabolic studies in rodents.
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Affiliation(s)
- Maximilian Bielohuby
- Endocrine Research Unit, Medizinische Klinik und Poliklinik IV, LMU München, Ziemssenstrasse 1, 80336 Munich, Germany
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