优化氟哌啶醇剂量
监视患者的合规性
评估毒性
liquidChromatography-Tandemmass光谱法(LC-MS/MS)
霍尔多尔(氟哌啶醇)
光环
serum Red
Collection Container/Tube:红色顶部(血清凝胶/SST是不是acceptable)
提交容器/管:塑料小瓶
specimen Volume:1毫升
收集说明:
1.在下一次预定剂量之前立即抽血。
2.在收集后2小时内离心和等分的血清成塑料小瓶。
我f not ordering electronically, complete, print, and send a疗法test Request(T831)with the specimen.
0.3 mL
严重的溶血 | 好的 |
脂肪血症 | 好的 |
大黄色 | 好的 |
specimen Type | 温度 | 时间 | 特殊容器 |
---|---|---|---|
serum Red | 冷藏(首选) | 28 days | |
周围的 | 28 days | ||
Frozen | 28 days |
优化氟哌啶醇剂量
监视患者的合规性
评估毒性
氟哌啶醇(Haldol)是用于治疗精神病疾病(例如精神分裂症)的丁烷酮类药物的成员。它还用于控制与图雷特综合症相关的抽动和口头话语,以及对无法应对其他治疗方式的强烈过度过度的儿童的管理。
the daily recommended oral dose for patients with moderate symptoms is 0.5 to 2.0 mg; for patients with severe symptoms, 3 to 5 mg may be used. However, some patients will respond only at significantly higher doses.
氟哌啶醇在肝脏中代谢以降低氟哌啶醇,其主要代谢物。(1,2)
氟哌啶醇的使用与明显的毒性副作用有关,其中最严重的包括迟发性运动障碍,可能是不可逆转的,与帕金森样症状的锥体外反应以及神经蛋白酶的恶性肿瘤综合征。较不严重的副作用可能包括低血压,抗胆碱能效应(视力模糊,口干,便秘,尿retention留)和镇静。随着时间的推移累积剂量的增加,出现严重,不可逆转的副作用的风险似乎会增加。(1,3)
光环per我dol:
5-16 ng/ml
减少氟哌啶醇:
10-80 ng/ml
studies show a strong relationship between dose and serum concentration (4); however, there is a modest relationship of clinical response or risk of developing long-term side effects to either dose or serum concentration.
氟哌啶醇存在治疗窗口,但有些患者可能会对该范围以外的浓度做出反应。以5至16 ng/ml反应的血清浓度反应的患者在大于16至20 ng/ml的浓度下没有额外的改善。在获得足够的反应之前,浓度明显大于20 ng/ml。
由于个体差异,血清浓度仅应用作确定适当剂量的一个因素,并且必须与临床状况一起解释。
一种lthough the metabolite, reduced haloperidol, has minimal pharmacologic activity, evidence has been presented suggesting that an elevated ratio of reduced haloperidol-to-haloperidol (ie, >5) is predictive of a poor clinical response.(3,6) A reduced haloperidol-to-haloperidol ratio of less than 0.5 indicates noncompliance; the metabolite does not accumulate except during steady-state conditions.
潜在干扰药物包括羟嗪(干扰
1. Lawson GM:血清氟哌啶醇的监测。Mayo Clin。1994年2月; 69(2):189-190
2. Ereshefsky L,Davis CM,Harrington CA等人:氟哌啶醇和选定精神分裂症患者的氟哌啶醇血浆水平降低。J Clin Psychopharmacol。1984 Jun; 4(3):138-142
3. Volavka J, Cooper TB: Review of haloperidol blood level and clinical response: looking through the window. J Clin Psychopharmacol. 1987 Feb;7(1):25-30
4. Moulin MA, Davy JP, Debruyne D, et al: Serum level monitoring and therapeutic effect of haloperidol in schizophrenic patients. Psychopharmacology. 1982;76(4):346-350
5. Van Putten T,Marder SR,Mintz J,Porant RE:氟哌啶醇血浆水平和临床反应:治疗窗口关系。是J精神病学。1992年4月; 149(4):500-505
6. Shostak M,Perel JM,Stiller RL,Wyman W,Curran S:等离子体氟哌啶醇和临床反应:氟哌啶醇在抗精神病毒活性中降低的作用?J Clin Psychopharmacol。1987年12月; 7(6):394-400
7. Hiemke C,Bergemann N,Clement HW等:神经心理药理学治疗药物监测的共识指南:2017年更新。药物精神病学。2018年1月; 51(1-02):9-62。doi:10.1055/s-0043-116492
8. Rifai N, Horvath AR, Wittwer CT, eds: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018
liquid-liquid extraction with liquid chromatography-tandem mass spectrometry detection.(Unpublished Mayo method)
周二
this test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
80173