治疗药物水平

定义

治疗药物水平 are lab tests to look for the amount of a drug or medicine in the blood.

选择的名字

治疗药物监测

如何执行测试

需要血液样本. 大多数时候，血液是 从静脉中抽出 located on the inside of the elbow or the back of the hand.

如何准备考试

You will need to prepare for some drug level tests.

• Your health care provider will tell you if you need to change the times you take any of your medicines.
• DO NOT stop or change your medicines without talking to your provider first.

考试的感觉如何

You may feel slight pain or a sting when the needle is inserted. You may also feel some throbbing at the site after the blood is drawn.

为什么要进行测试

With most medicines, you need a certain level of the drug in your blood to get the proper effect. Some medicines are harmful if the level rises too high and do not work if the levels are too low.

Monitoring the amount of the drug found in your blood allows your provider to make sure the drug levels are in the proper range.

Drug level testing is important in people taking drugs such as:

• Flecainide, procainamide or digoxin, which are used to treat abnormal beating of the heart
• Lithium, used to treat bipolar disorder
• Phenytoin or valproic acid, which are used to treat seizures or other conditions
• Gentamicin or amikacin, which are antibiotics used to treat infections
• 他克莫司, 西罗莫司或环孢素, which are used to suppress immune system activity against transplanted organs
  

Testing may also be done to determine how well your body breaks down the drug or how it interacts with other drugs you need.

正常的结果

Following are some of the drugs that are commonly checked and the normal target levels:

• 对乙酰氨基酚:因用途而异
• 阿米卡星:15至25微克/毫升(25.62 to 42.70 micromol / L)
• 阿米替林:120至150 ng/mL (432.60 to 540.75 nmol / L)
• 卡马西平:5至12微克/毫升(21.16 to 50.80 micromol / L)
• 环孢素:100 ~ 400 ng/mL (83.20 to 332.80 nmol / L)(给药后12小时)
• 地西帕明:150至300 ng/mL (563.10 to 1126.20 nmol / L)
• 地高辛:0.8 to 2.0 ng/mL (1.02 to 2.56 nanomol / L)
• 二丙酰胺:2 ~ 5微克/毫升.89 to 14.73 micromol / L)
• 乙氧索酰亚胺:40至100微克/毫升(283.36 to 708.40 micromol / L)
• 氟卡尼:0.2 to 1.0微克/毫升.5 to 2.4 micromol / L)
• 庆大霉素:5至10微克/毫升(10.45 to 20.90 micromol / L)
• 丙咪嗪:150 ~ 300 ng/mL (534.90 to 1069.80 nmol / L)
• 卡那霉素:20至25微克/毫升(41.60 to 52.00 micromol / L)
• 利多卡因:1.5 to 5.0 mcg/mL (6.40 to 21.34 micromol / L)
• 锂:0.8 to 1.2 mEq/L (0.8 to 1.2更易/ L)
• 甲氨蝶呤:因用途而异
• 去甲替林:50 ~ 150 ng/mL (189.85 to 569.55 nmol / L)
• 苯巴比妥:10至30微克/毫升(43.10 to 129.30 micromol / L)
• 苯妥英:10至20微克/毫升(39.68 to 79.36 micromol / L)
• Primidone: 5 ~ 12mcg /mL (22.91 to 54.98 micromol / L)
• 普鲁卡因胺:4至10微克/毫升(17.00 to 42.50 micromol / L)
• 奎尼丁:2至5微克/毫升(6.16 to 15.41 micromol / L)
• 水杨酸盐:因用途而异
• Sirolimus: 4 to 20 ng/mL (4 to 22 nmol/L) (12 hours after dose; varies with use)
• 他克莫司: 5 to 15 ng/mL (4 to 25 nmol/L) (12 hours after dose)
• 茶碱:10 ~ 20微克/毫升(55.50 to 111.00 micromol / L)
• 妥布霉素:5至10微克/毫升(10.69 to 21.39 micromol / L)
• 丙戊酸:50至100微克/毫升(346.70 to 693.40 micromol / L)

Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

异常结果意味着什么

Values outside the target range may be due to minor changes or be a sign that you need to adjust your dosages. Your provider may tell you to skip a dose if the values measured are too high.

Following are toxic levels for some of the drugs that are commonly checked:

• Acetaminophen: greater than 250 mcg/mL (1653.50 micromol / L)
• Amikacin: greater than 25 mcg/mL (42.70 micromol / L)
• Amitriptyline: greater than 500 ng/mL (1802.50 nmol / L)
• Carbamazepine: greater than 12 mcg/mL (50.80 micromol / L)
• Cyclosporine: greater than 400 ng/mL (332.80 micromol / L)
• Desipramine: greater than 500 ng/mL (1877.00 nmol / L)
• 地高辛:大于2.4 ng/mL (3.07年nmol / L)
• Disopyramide: greater than 5 mcg/mL (14.73 micromol / L)
• Ethosuximide: greater than 100 mcg/mL (708.40 micromol / L)
• Flecainide:大于1.0 mcg/mL (2.4 micromol / L)
• Gentamicin: greater than 12 mcg/mL (25.08年micromol / L)
• Imipramine: greater than 500 ng/mL (1783.00 nmol / L)
• Kanamycin: greater than 35 mcg/mL (72.80 micromol / L)
• 利多卡因:大于5微克/毫升(21.34 micromol / L)
• 锂:大于2.0 mEq/L (2.00毫克分子/ L)
• Methotrexate: greater than 10 mcmol/L (10,000 nmol / L) over 24 hours after dose
• Nortriptyline: greater than 500 ng/mL (1898.50 nmol / L)
• Phenobarbital: greater than 40 mcg/mL (172.40 micromol / L)
• Phenytoin: greater than 30 mcg/mL (119.04 micromol / L)
• Primidone: greater than 15 mcg/mL (68.73 micromol / L)
• Procainamide: greater than 16 mcg/mL (68.00 micromol / L)
• Quinidine: greater than 10 mcg/mL (30.82 micromol / L)
• Salicylate: greater than 300 mcg/mL (2172.00 micromol / L)
• Theophylline: greater than 20 mcg/mL (111.00 micromol / L)
• Tobramycin: greater than 12 mcg/mL (25.67 micromol / L)
• Valproic acid: greater than 100 mcg/mL (693.40 micromol / L)

参考文献

Bluth MH, Pincus MR, Abraham NZ. Toxicology and therapeutic drug monitoring. 见:McPherson RA, Pincus MR，编辑. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24日艾德. Philadelphia, PA: Elsevier; 2022:chap 24.

克拉克W. Overview of therapeutic drug monitoring. 见:克拉克W，达斯古普塔A编. Clinical Challenges in Therapeutic Drug Monitoring. Cambridge, MA: Elsevier; 2016:chap 1.

Diasio RB. 药物治疗原则. 参见:Goldman L, Schafer AI主编. Goldman-Cecil医学. 26日艾德. Philadelphia, PA: Elsevier; 2020:chap 26.

纳尔逊LS. 急性中毒. 参见:Goldman L, Schafer AI主编. Goldman-Cecil医学. 26日艾德. Philadelphia, PA: Elsevier; 2020:chap 102.