Appropriateness of therapeutic drug monitoring of valproic acid in Hospital Tengku Ampuan Rahimah / Nurul-Shazalina Zubir

TDM, although very useful in individualizing dose regimen, are often done inappropriately. For a drug lacking extensive research and having less predictable pharrnacokinetics such as VPA, there is always the potential of overlooking certain factors while ensuring its optimum use. The main aim of thi...

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Main Author:	Zubir, Nurul-Shazalina
Format:	Thesis
Language:	English
Published:	2008
Subjects:	Pharmaceutical dosage forms Pharmaceutical chemistry
Online Access:	https://ir.uitm.edu.my/id/eprint/101087/1/101087.PDF
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id	my-uitm-ir.101087
record_format	uketd_dc
spelling	my-uitm-ir.1010872024-09-28T23:39:45Z Appropriateness of therapeutic drug monitoring of valproic acid in Hospital Tengku Ampuan Rahimah / Nurul-Shazalina Zubir 2008 Zubir, Nurul-Shazalina Pharmaceutical dosage forms Pharmaceutical chemistry TDM, although very useful in individualizing dose regimen, are often done inappropriately. For a drug lacking extensive research and having less predictable pharrnacokinetics such as VPA, there is always the potential of overlooking certain factors while ensuring its optimum use. The main aim of this study is to compare the methods applied by the pharmacists in HT AR in individualizing dose regimen to the methods applied by the researcher based on literature review. Retrospective review of both TDM forms and laboratory values of HT AR in-patients taking VP A for epilepsy were carried out. Calculations of expected levels, loading dose and maintenance dose made by both the researcher and the TDM pharmacists in HTAR are compared using Wilcoxon Signed Ranks Test (p < 0.05) to detect significant difference between the two median values. There were significant difference (p<0.05) for both expected level (z ratio= ±6.900) and maintenance dose (z ratio= ±5.232) but no significant difference was found (p>0.05) for the loading dose (z ratio = ± 0.980). For expected level and loading dose, the calculation methods differ from those applied by HT AR pharmacist only in the choice of values of pharmacokinetic parameters and the target steady-state concentration respectively. However, the researcher has found that two important factors, hepatic function and concomitant use of hepatic enzyme inducers were not taken into account in the calculations of maintenance dose of VPA applied in HTAR. A guideline for the calculations of VP A was proposed along with this research. 2008 Thesis https://ir.uitm.edu.my/id/eprint/101087/ https://ir.uitm.edu.my/id/eprint/101087/1/101087.PDF text en public degree Universiti Teknologi MARA (Kampus Puncak Alam) Faculty of Pharmacy Hannan, Osama Helweh
institution	Universiti Teknologi MARA
collection	UiTM Institutional Repository
language	English
advisor	Hannan, Osama Helweh
topic	Pharmaceutical dosage forms Pharmaceutical chemistry
spellingShingle	Pharmaceutical dosage forms Pharmaceutical chemistry Zubir, Nurul-Shazalina Appropriateness of therapeutic drug monitoring of valproic acid in Hospital Tengku Ampuan Rahimah / Nurul-Shazalina Zubir
description	TDM, although very useful in individualizing dose regimen, are often done inappropriately. For a drug lacking extensive research and having less predictable pharrnacokinetics such as VPA, there is always the potential of overlooking certain factors while ensuring its optimum use. The main aim of this study is to compare the methods applied by the pharmacists in HT AR in individualizing dose regimen to the methods applied by the researcher based on literature review. Retrospective review of both TDM forms and laboratory values of HT AR in-patients taking VP A for epilepsy were carried out. Calculations of expected levels, loading dose and maintenance dose made by both the researcher and the TDM pharmacists in HTAR are compared using Wilcoxon Signed Ranks Test (p < 0.05) to detect significant difference between the two median values. There were significant difference (p<0.05) for both expected level (z ratio= ±6.900) and maintenance dose (z ratio= ±5.232) but no significant difference was found (p>0.05) for the loading dose (z ratio = ± 0.980). For expected level and loading dose, the calculation methods differ from those applied by HT AR pharmacist only in the choice of values of pharmacokinetic parameters and the target steady-state concentration respectively. However, the researcher has found that two important factors, hepatic function and concomitant use of hepatic enzyme inducers were not taken into account in the calculations of maintenance dose of VPA applied in HTAR. A guideline for the calculations of VP A was proposed along with this research.
format	Thesis
qualification_level	Bachelor degree
author	Zubir, Nurul-Shazalina
author_facet	Zubir, Nurul-Shazalina
author_sort	Zubir, Nurul-Shazalina
title	Appropriateness of therapeutic drug monitoring of valproic acid in Hospital Tengku Ampuan Rahimah / Nurul-Shazalina Zubir
title_short	Appropriateness of therapeutic drug monitoring of valproic acid in Hospital Tengku Ampuan Rahimah / Nurul-Shazalina Zubir
title_full	Appropriateness of therapeutic drug monitoring of valproic acid in Hospital Tengku Ampuan Rahimah / Nurul-Shazalina Zubir
title_fullStr	Appropriateness of therapeutic drug monitoring of valproic acid in Hospital Tengku Ampuan Rahimah / Nurul-Shazalina Zubir
title_full_unstemmed	Appropriateness of therapeutic drug monitoring of valproic acid in Hospital Tengku Ampuan Rahimah / Nurul-Shazalina Zubir
title_sort	appropriateness of therapeutic drug monitoring of valproic acid in hospital tengku ampuan rahimah / nurul-shazalina zubir
granting_institution	Universiti Teknologi MARA (Kampus Puncak Alam)
granting_department	Faculty of Pharmacy
publishDate	2008
url	https://ir.uitm.edu.my/id/eprint/101087/1/101087.PDF
_version_	1811769128730492928

Appropriateness of therapeutic drug monitoring of valproic acid in Hospital Tengku Ampuan Rahimah / Nurul-Shazalina Zubir

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