Uloga Ivana Merza u liturgijskoj obnovi

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Does weight impact anidulafungin pharmacokinetics?

Pharmacolog

Application of Pharmacokinetics to Improve Antiretroviral Treatment.

Contains fulltext : 119483.pdf (publisher's version ) (Open Access)The introduction of protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) has allowed for treatment of HIV-infected patients with 'highly active antiretroviral treatment' (HAART). The studies in this thesis aimed to optimize dosage regimens for PIs and NNRTIs by the assessment and interpretation of the pharmacokinetic characteristics of these agents.The thesis first presents a review of the literature on analytical methods for measurement of PIs in plasma, and a review of the practice of Therapeutic Drug Monitoring (TDM) for antiretroviral drugs. Subsequently an international interlaboratory quality control (QC) program was developed for measurement of antiretroviral drugs in plasma. The program revealed large variability in the ability of laboratories to measure PIs and NNRTIs accurately. By participating in the program, laboratories were alerted to previously unknown errors in their methods. A series of pharmacokinetic studies evaluated undesirable pharmacokinetic interactions between antiretroviral drugs, food and other drugs. One study revealed that indinavir/ritonavir (800/100 mg BID) should preferably be administered with food to reduce high, nephrotoxic peak plasma (Cmax) values of indinavir. Based on other studies it was concluded that the addition of efavirenz to indinavir/ritonavir (800/100 mg BID) results in significant decreases in plasma concentrations of indinavir. These decreases are not strong enough to warrant dose modifications of the indinavir/ritonavir combination in treatment-naïve HIV-infected patients. A low-dose of ritonavir (100 mg BID) appeared to exert a modest inhibitory effect on the activity of CYP2D6 in extensive metabolizers for CYP2D6. Finally, pharmacokinetic studies were performed that evaluated the interaction between PIs and low-dose ritonavir as a means to achieve once-daily dosing for PIs. It was assessed that both nelfinavir and indinavir can be combined with low-dose ritonavir to yield adequate trough (Cmin) levels during a once-daily 24-h dosing interval.KUN, 2 december 2003Promotor : Hekster, Y.A. Co-promotores : Burger, D.M., Koopmans †, P.P

Shorter moxifloxacin-based regimens for drug-sensitive tuberculosis

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Fundament and Prerequisites for the Application of an Antifungal TDM Service

Item does not contain fulltextTherapeutic drug monitoring (TDM) involves the measurement of plasma or serum drug concentration to adapt dosages to achieve predefined target concentrations that are associated with optimal clinical response while minimizing the chance of encountering toxicity. Many papers in the field of antifungal drugs have focused on the evidence that supports the use of TDM thereby emphasizing the breakpoints or target concentrations in general literature. This review focuses on the process of TDM to inform health care workers on the fundaments and prerequisites that safeguard the good application of TDM. Knowledge on the complete process of TDM including pharmacokinetics (and relevant covariates), pharmacodynamic aspects, trials that are necessary to provide us with evidence, translation of knowledge to other populations and pathogens, and implications for the pre-analytical, analytical, and post-analytical phases (the process of TDM) are discussed in relevant detail. For each individual step, recommendations are made for the readers. We believe this will be a valuable resource and to be of added value to the many papers that focus on relations between exposure and efficacy or toxicity. It will help to achieve greater benefit of TDM

[Therapeutic drug monitoring of antimicrobials]

Item does not contain fulltextThe importance of dose adjustments of antimicrobials based on measured concentrations in an individual ('therapeutic drug monitoring', TDM) is increasingly recognized. There are several reasons for this. First, there is a better understanding of the relationships between doses administered, concentrations achieved and effects of antimicrobials. Second, adverse events from antimicrobials and their relationship to drug concentrations are better described. Third, analytical methods to measure concentrations have become more widely available. In this article, we provide an overview of the situation of available antimicrobials in the Netherlands for which TDM is or could be indicated

Xanthine oxidase inhibition by allopurinol increases in vitro pyrazinamide-induced hepatotoxicity in HepG2 cells.

Contains fulltext : 87446.pdf (publisher's version ) (Open Access)Despite the important role of pyrazinamide in tuberculosis treatment, little is known about the mechanism of pyrazinamide-induced hepatotoxicity. We inhibited xanthine oxidase in HepG2 cells by using a nontoxic concentration of allopurinol, a well-known xanthine-oxidase inhibitor. This increased in vitro pyrazinamide toxicity in HepG2 cells, which suggests that the hydroxy metabolites of pyrazinamide are probably not fully responsible for pyrazinamide-induced toxicity, and that pyrazinoic acid and pyrazinamide are involved in pyrazinamide toxicity.1 juli 201

Ziekenhuisapotheker adviseert bij intoxicatie. Lithiumtabletten met gereguleerde afgifte.

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Klinische relevante interacties met anti-HIV-middelen

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Efavirenz

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