Detection of Populations at Risk Using Drug Monitoring Data

Abstract

One of the aims of clinical pharmacokinetics is to detect patient subpopulations at risk of showing abnormally high or abnormally low blood concentrations when given normal doses of a drug. Numerous publications have reported that factors such as age (Nies et al. 1977), phenothiazine co-medication (Brøsen et al. 1986 a; Balant-Gorgia et al. 1986), tobacco and alcohol (Sutfin et al. 1988; Vandel et al. 1982) as well as genetic factors (Brøsen et al. 1986b) are responsible for the large inter-individual variability affecting steady-state concentrations of tricyclic antidepressants. The clinical relevance of this information is clear since concentration-response curves of these drugs tend to be biphasic, with clinical deterioration and more frequent and severe side effects with increasing blood levels (Molnar and Gupta 1980).