Drug level monitoring of antiasthmatic drugs.
In general assays pertaining to drug level monitoring (DLM) of antiasthmatic agents (except theophylline), published during the period 1978-1983, used mostly high-performance liquid chromatographic (HPLC) methodology (approximately 45%) with mass spectrometric (MS) based assays in second place (approximately 30%) followed by immunochemical techniques (approximately 25%). Whenever nanogram or subnanogram antiasthmatic drug concentrations had to be measured such as for the adrenergic stimulants or for the prophylactic agents, then both HPLC-and MS-based methodologies were employed with about equal frequency. The trend in DLM for the phosphodiesterase inhibitor class (theophyllines) seemed to be shifting towards the HPLC methodologies. In part, this was justified by the need for improved selectivity. This criterion appears to have been better satisfied by HPLC, but for all practical purposes the immunochemical methods are and will probably continue to prevail in the clinical laboratory setting until HPLC procedures become truly automated. In the case of DLM of corticosteroids used for the asthmatic, the situation is in our opinion still unclear. This is caused by the presence of endogenous corticosteroids and metabolites, the levels of which in man are known to vary. The current immunochemical procedures offer a facile but less selective option. The future for selective routine corticosteroid assays may well be in HPLC or gas chromatography coupled with MS.
Kucharczyk
N
N
Segelman
F H
FH
D000305:Adrenal Cortex Hormones / Q000097:blood; D000318:Adrenergic beta-Agonists / Q000097:blood; D001249:Asthma / Q000188:drug therapy* / Q000517:prevention & control; D002845:Chromatography; D004205:Cromolyn Sodium / Q000097:blood; D006801:Humans; D007665:Ketotifen / Q000097:blood; D008991:Monitoring, Physiologic; D010276:Parasympatholytics / Q000097:blood; D010726:Phosphodiesterase Inhibitors / Q000097:blood
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D010276:Parasympatholytics; D010726:Phosphodiesterase Inhibitors; D004205:Cromolyn Sodium; D007665:Ketotifen