Two Clinically Important but Underutilized and Misunderstood Tools: Formulas to Estimate Creatinine Clearance and Therapeutic Drug Monitoring.

Journal of Psychiatric Practice
Sheldon H Preskorn

Abstract

This column first reviews 2 key equations that are central to clinical pharmacology. Clinicians can use the first equation to predict the effect of a specific dose of a specific drug in specific circumstances on the basis of 3 variables: (1) the drug's pharmacodynamics, (2) the drug's pharmacokinetics, and (3) biological variance in the individual patient. Clinicians can use the second equation to determine the concentration of a drug that a patient will achieve on a given dose depending on the patient's ability to clear the drug from the body. These 2 equations allow prescribers to predict whether the dose of a drug a patient is receiving is likely to achieve the desired clinical response (not so low that it is clinically ineffective or so high that it causes adverse effects that interfere with the patient's ability to tolerate or benefit from the treatment). The author then describes 2 tools clinicians can use to determine a patient's ability to clear a drug from the body, and thus calculate the concentration of the drug using Equation 2. These tools are: (1) estimation of creatinine clearance and (2) therapeutic drug monitoring.

References

Oct 4, 2008·Journal of Psychiatric Practice·Sheldon H Preskorn
Mar 20, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Wieneke Marleen MichelsRaymond Theodorus Krediet
Apr 2, 2013·The Journal of Clinical Psychiatry·Sheldon H PreskornChristine J Guico-Pabia
Jul 19, 2014·Journal of Psychiatric Practice·David McMahon, Sheldon H Preskorn
Jan 12, 2019·Journal of Psychiatric Practice·Sheldon H Preskorn

❮ Previous
Next ❯

Citations


❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.