title: [Expanding therapeutic reference ranges using dose-related reference ranges].
abstract: Evidence-based therapeutic drug monitoring (TDM), which may be successfully employed to guide drug therapy in clinical routine, supplies all the information from laboratory determination of a drug concentration in a patient's blood specimen. This value is interpreted first of all in relation to a therapeutic reference range that must be established according to the same rules that are generally accepted for clinical studies aimed to license a new drug. The drug concentration may be furthermore interpreted in reference to a dose-related reference range. Thereby a signal is created to alert for individual abnormalities such as drug/drug interactions, gene polymorphisms that give rise to slow/rapid metabolizers, altered function of the excretion organs liver and kidneys by age and/or disease, compliance problems, a missing pharmacokinetic steady state, and even signal overlay in the laboratory analysis. We return all information available and clinical pharmacological comments to physicians who send specimens to our laboratory.
authors.affiliation: Klinische Pharmakologie, Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie, Universität Regensburg, Universitätsstrasse 84, Regensburg, Germany. ekkehard.haen@klinik.uni-regensburg.de
authors.forename: E
authors.initials: E
authors.lastname: Haen
authors.forename: C
authors.initials: C
authors.lastname: Greiner
authors.forename: W
authors.initials: W
authors.lastname: Bader
authors.forename: M
authors.initials: M
authors.lastname: Wittmann
mesh_terms: D000465:Algorithms; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring / Q000379:methods* / Q000592:standards*; D004358:Drug Therapy / Q000592:standards*; D005858:Germany; D004364:Pharmaceutical Preparations / Q000097:blood*
chemical_list: D004364:Pharmaceutical Preparations