In 1988 a therapeutic drug monitoring programme for anticonvulsants was introduced in the paediatric neurology clinic at King Edward VIII Hospital, Durban. Although before this serum drug levels were routinely measured, the new approach involved the application of clinical pharmacokinetics to the results so that an individualised drug profile was available for use in conjunction with clinical evaluation at the patient's next visit. Case reports are presented to illustrate the value of using serum levels in this way. Of the 58 patients entered into the study in the course of 1 year, 32 (55%) benefited from the monitoring programme in that the pharmacokinetic report contributed to a dosage adjustment that resulted in a reduction in either seizure frequency or side-effects. The greatest value of the programme proved to be in rationalizing the use of phenytoin. Because of wide inter-patient variation and non-linear kinetics, it is difficult to establish an optimum maintenance dose for this drug. The individualised dose achieved in the present study using Bayesian forecasting resulted in improved seizure control in 10 of the 11 patients (91%) receiving phenytoin.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Targeting RNA splicing modulation: new perspectives for anticancer strategy?
J Exp Clin Cancer Res
January 2025
Department of Pharmacology, School of Pharmacy, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, P. R. China.
The excision of introns from pre-mRNA is a crucial process in the expression of the majority of genes. Alternative splicing allows a single gene to generate diverse mRNA and protein products. Aberrant RNA splicing is recognized as a molecular characteristic present in almost all types of tumors.
View Article and Find Full Text PDFKaRhab: an international online registry for cardiac rhabdomyomas.
Orphanet J Rare Dis
January 2025
Institute of Human Genetics, Leipzig University Medical Center, Leipzig, Germany.
Background: Cardiac rhabdomyoma (RHM) is considered one of the most frequent benign heart tumors in children. However, encounters with cardiac RHM in clinical practice remain rare. Clinical information is primarily available in the form of single case reports or smaller studies with a shortage of large-scale reviews encompassing a substantial number of cases.
View Article and Find Full Text PDFBiomimetic polydopamine loaded with janus kinase inhibitor for synergistic vitiligo therapy via hydrogel microneedles.
J Nanobiotechnology
January 2025
Department of Dermatology and Venereology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China.
Background: Both oxidative stress and autoimmune responses play crucial roles in the development of vitiligo. Under oxidative stress, the apoptotic melanocytes expose self-antigens and release high mobility group box 1 (HMGB1), triggering autoimmune activation and recruiting CD8 T cells. This process further leads to the destruction of melanocytes, resulting in the lack of melanin granules.
View Article and Find Full Text PDFMiCML: a causal machine learning cloud platform for the analysis of treatment effects using microbiome profiles.
BioData Min
January 2025
Department of Applied Mathematics and Statistics, The State University of New York, Korea, Incheon, South Korea.
Background: The treatment effects are heterogenous across patients due to the differences in their microbiomes, which in turn implies that we can enhance the treatment effect by manipulating the patient's microbiome profile. Then, the coadministration of microbiome-based dietary supplements/therapeutics along with the primary treatment has been the subject of intensive investigation. However, for this, we first need to comprehend which microbes help (or prevent) the treatment to cure the patient's disease.
View Article and Find Full Text PDFIdentification and validation of a prognostic signature of drug resistance and mitochondrial energy metabolism-related differentially expressed genes for breast cancer.
J Transl Med
January 2025
Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
Background: Drug resistance constitutes one of the principal causes of poor prognosis in breast cancer patients. Although cancer cells can maintain viability independently of mitochondrial energy metabolism, they remain reliant on mitochondrial functions for the synthesis of new DNA strands. This dependency underscores a potential link between mitochondrial energy metabolism and drug resistance.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!