血浆氯氮平和n -去甲基氯氮平(去氯氮平)的治疗监测:实际考虑

IF 1.7 Q3 PSYCHIATRY
R. Flanagan, S. Gee, S. Belsey, L. Couchman, J. Lally
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引用次数: 9

摘要

难治性精神分裂症患者氯氮平剂量评估比较复杂。氯氮平的有效剂量和潜在毒性剂量之间的差距很小,个体间代谢能力的差异很大。此外,吸烟习惯的改变、感染/炎症、某些药物(特别是氟伏沙明)的联合处方以及年龄等因素也会改变个体的剂量需求。血浆氯氮平和n -去甲基氯氮平(去甲氯氮平)的治疗药物监测(TDM)有助于评估依从性、指导剂量和预防毒性。本文概述了氯氮平的药代动力学和影响氯氮平剂量要求的因素。然后概述氯氮平TDM的程序和过程,从采集血液样本进行实验室分析或接触点(手指刺破)测试(POCT)到解释和根据结果采取行动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Therapeutic monitoring of plasma clozapine and N-desmethylclozapine (norclozapine): practical considerations
SUMMARY Clozapine dose assessment in treatment-refractory schizophrenia is complicated. There is a narrow margin between an effective and a potentially toxic dose and wide inter-individual variation in clozapine metabolic capacity. Moreover, factors such as changes in smoking habit, infection/inflammation, co-prescription of certain drugs, notably fluvoxamine, and age alter the dose requirement within individuals. Therapeutic drug monitoring (TDM) of plasma clozapine and N-desmethylclozapine (norclozapine) can help assess adherence, guide dosage and guard against toxicity. This article gives an overview of clozapine pharmacokinetics and factors affecting clozapine dose requirements. It then outlines the procedures and processes of clozapine TDM, from taking the blood sample for laboratory assay or point-of-contact (finger-prick) testing (POCT) to interpreting and acting on the results.
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来源期刊
BJPsych Advances
BJPsych Advances PSYCHIATRY-
CiteScore
2.50
自引率
7.70%
发文量
75
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