Monographs on drugs which are frequently analyzed in therapeutic drug monitoring/Arzneimittel-Monographien für Medikamente, die regelmäßig im Rahmen des Therapeutic Drug Monitorings analysiert werden

In addition to the monographs which have been published in the last 6 years by the working group "Drug Monitoring” of the Swiss Society of Clinical Chemistry (SSCC) [Rentsch, Fathi, Grignaschi, Magnin, Printzen, Thormann, J Lab Med 29: 287-97, 2005 - Rentsch, Buhl, Eap, Fathi, Jöchle, Magnin, J Lab Med 34: 129-39, 2010], new monographs have been written. The data presented in these monographs provide an overview of the information which is important for the request and interpretation of the results. Therefore, laboratory health professionals and the receivers of the reports are the targeted readers. With the exception of digoxin, the drugs presented in this series are not administered frequently and are only analyzed in special situations. First, information about pharmacology and pharmacokinetics of these drugs (protein binding, metabolic pathways and enzymes involved, elimination half-life time and elimination route(s) of the parent drug and therapeutic as well as toxic concentrations) is given. Secondly, the indications for therapeutic drug monitoring are listed. Last but not least, important preanalytical information is provided, including time points of blood sampling and time interval after which steady-state concentrations are reached after changing the dose. Furthermore, the stability of the drug and its metabolite(s) after blood sampling are described. For readers with a specific interest, references to important publications are given. The number of the monographs will be further enlarged. The updated files are presented on the homepage of the SSCC (www.sscc.ch). We hope that these monographs are helpful for the better handling of therapeutic drug monitoring and we are looking forward to receiving comments from the readers.

Wearable Communications in 5G: Challenges and Enabling Technologies

As wearable devices become more ingrained in our daily lives, traditional communication networks primarily designed for human being-oriented applications are facing tremendous challenges. The upcoming 5G wireless system aims to support unprecedented high capacity, low latency, and massive connectivity. In this article, we evaluate key challenges in wearable communications. A cloud/edge communication architecture that integrates the cloud radio access network, software defined network, device to device communications, and cloud/edge technologies is presented. Computation offloading enabled by this multi-layer communications architecture can offload computation-excessive and latency-stringent applications to nearby devices through device to device communications or to nearby edge nodes through cellular or other wireless technologies. Critical issues faced by wearable communications such as short battery life, limited computing capability, and stringent latency can be greatly alleviated by this cloud/edge architecture. Together with the presented architecture, current transmission and networking technologies, including non-orthogonal multiple access, mobile edge computing, and energy harvesting, can greatly enhance the performance of wearable communication in terms of spectral efficiency, energy efficiency, latency, and connectivity.Comment: This work has been accepted by IEEE Vehicular Technology Magazin

Monographs on drugs which are frequently analyzed in therapeutic drug monitoring

In addition to the monographs which have been published in the past 4 years by the working group "Drug Monitoring” of the Swiss Society of Clinical Chemistry (SSCC) [1-4], new monographs have been written. The data presented in these monographs provide an overview of important information for the request and interpretation of results. Therefore, laboratory health professionals and the receivers of the reports are the targeted readers. In this series, several antiepileptic drugs are presented. Monographs on carbamazepine [1], lamotrigine [2], phenobarbital [2], and valproic acid [2] have been published previously. First, information about pharmacology and pharmacokinetics of these drugs (protein binding, metabolic pathways and enzymes involved, elimination half-life time and elimination route(s) of the parent drug and therapeutic as well as toxic concentrations) is given. Second, the indications for therapeutic drug monitoring are listed. Last but not least, important pre-analytical information is provided, including time points of blood sampling and time interval after which steady-state concentrations are reached after changing the dose. Furthermore, the stability of the drug and its metabolite(s) after blood sampling is described. For readers with a specific interest, references to important publications are given. The number of the monographs will be further enlarged. The updated files are presented on the homepage of the SSCC (www.sscc.ch). We hope that these monographs are helpful for the better handling of therapeutic drug monitoring and we are looking forward to comments from the reader

Clozapine once- versus multiple-daily dosing: a two-center cross-sectional study, systematic review and meta-analysis

Evidence regarding effectiveness and safety of clozapine once- vs. multiple-daily dosing is limited. We compared demographic and clinical parameters between patients with once- vs. multiple-daily dosing in the Department of Psychiatry and Psychotherapy, University of Regensburg, Germany (AGATE dataset), and the Department of Psychiatry, Lausanne University Hospital, Switzerland, using non-parametric tests. Effectiveness and safety outcomes were available in the AGATE dataset. We performed a systematic review in PubMed/Embase until February 2022, meta-analyzing studies comparing clozapine once- vs. multiple-daily-dosing. We estimated a pooled odds ratio for adverse drug-induced reactions (ADRs) and meta-analyzed differences regarding clinical symptom severity, age, percentage males, smokers, clozapine dose, and co-medications between patients receiving once- vs. multiple-daily dosing. Study quality was assessed using the Newcastle–Ottawa-Scale. Of 1494 and 174 patients included in AGATE and Lausanne datasets, clozapine was prescribed multiple-daily in 74.8% and 67.8%, respectively. In the AGATE cohort, no differences were reported for the clinical symptoms severity or ADR rate (p > 0.05). Meta-analyzing eight cohorts with a total of 2810 clozapine-treated individuals, we found more severe clinical symptoms (p = 0.036), increased ADR risk (p = 0.01), higher clozapine doses (p < 0.001), more frequent co-medication with other antipsychotics (p < 0.001), benzodiazepines (p < 0.001), anticholinergics (p = 0.039), and laxatives (p < 0.001) in patients on multiple- vs. once-daily dosing. Of six studies, five were rated as good, and one as poor quality. Patients responding less well to clozapine may be prescribed higher doses multiple-daily, also treated with polypharmacy, potentially underlying worse safety outcomes. Patient preferences and adherence should be considered during regimen selection

Nouvelles études psychopharmacologiques sur la méthadone: implications pour le traitement de la dépendance aux opiaces

New psychopharmacological studies performed these last few years should allow, in future, to improve methadone prescription. In particular, thanks to the identification of enzymes involved in the metabolism of this molecule, it is now possible to better understand the problems of metabolic interactions, to foresee and to avoid them. Studies showing the influence of genetic and environmental factors on blood concentrations of methadone, as well as a recent clinical study performed with methadone doses largely in excess of 100 mg/day, stress the importance of adapting methadone treatment individually, particularly as regards to the choice of the dose. This choice must not result from an administrative standardization, as it is essential for patients that, with an adequate social and psychological treatment, an adequate pharmacological treatment should be associate