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Establishing Serum Reference Ranges for Antihypertensive Drugs

Rognstad, Stine; Søraas, Camilla Lund; Bergland, Ola Undrum; Høieggen, Aud; Strømmen, Magnus; Helland, Arne; Opdal, Mimi Stokke
Peer reviewed, Journal article
Accepted version
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URI
https://hdl.handle.net/11250/2783588
Date
2020
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Original version
Therapeutic Drug Monitoring. 2020, 43 (1), 116-125.   10.1097/FTD.0000000000000806
Abstract
Background:

Therapeutic drug monitoring (TDM) involves the measurement of serum drug concentrations to optimize pharmacotherapy. Traditionally, blood pressure measurements alone, and not TDM, have been used to evaluate the antihypertensive drug response. However, approximately 50% of hypertensive patients treated with lifestyle changes and antihypertensive drugs fail to achieve blood pressure control. Serum drug concentration measurements could be useful to select the optimal drugs in adjusted doses and to identify nonadherence. Implementation of TDM in clinical routine for antihypertensive drugs depends on established serum reference ranges.

Methods:

Commonly used antihypertensive drugs were identified based on prescription data. The authors performed a review of authoritative literature on reported serum drug concentrations and calculated expected concentrations from previously reported pharmacokinetic parameters with commonly prescribed daily doses. Finally, serum drug concentrations in samples from patients undergoing antihypertensive treatment were measured.

Results:

Serum reference ranges for 24 frequently used antihypertensive drugs were established based on results from 3 approaches.

Conclusions:

Serum drug concentration measurements, interpreted in light of the established reference ranges, together with blood pressure measurements and other clinical data, may help identify nonadherent patients and tailor individual antihypertensive treatment when deviant drug responses appear in line with the concept of personalized medicine.
Publisher
Lippincott, Williams & Wilkins
Journal
Therapeutic Drug Monitoring
Copyright
This is the authors' accepted manuscript to an article published by Lippincott, Williams & Wilkins. Locked until 28.2.2022 due to copyright restrictions.

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