Voriconazole therapeutic drug monitoring (TDM) – current guidelines and the real practice

MARKOVÁ, Eliška. Voriconazole therapeutic drug monitoring (TDM) – current guidelines and the real practice. In Student scientific conference - doctoral students 2022. 2022.

Basic information

Original name

Voriconazole therapeutic drug monitoring (TDM) – current guidelines and the real practice

Authors

MARKOVÁ, Eliška

Edition

Student scientific conference - doctoral students 2022, 2022

---

Other information

Type of outcome

Prezentace na konferencích

Confidentiality degree

není předmětem státního či obchodního tajemství

Keywords (in Czech)

vorikonazol, terapeutické monitorování léčiv, farmakokinetický model, TDM

Keywords in English

voriconazole, therapeutic drug monitoring, pharmacokinetic model, TDM

---

Abstract

V originále

Over the past years, pharmacotherapy became more individualized for each specific patient. One of the main tools for achieving such treatment is therapeutic drug monitoring (TDM). TDM contributes to safe and effective therapy. Besides, TDM plays a role in cost-effective pharmacotherapy – it can shorten the hospitalization length and eliminate the expenses caused by the therapy failure or treatment of adverse effects associated with the therapy. According to current guidelines, a routine TDM is newly recommended for the second-generation triazole voriconazole. Voriconazole´s levels should be monitored because of its indication for life-threatening infections with limited therapeutic options, voriconazole´s non-linear pharmacokinetics, variable metabolism (drug interactions, CYP2C19 polymorphism), and gastrointestinal absorption. In general, TDM of voriconazole during therapy or prophylaxis is recommended for the majority of patients. This study aims to evaluate the reliability of voriconazole´s pharmacokinetic modeling for both adult and pediatric patients in the setting of routine clinical practice. In this study were enrolled all patients treated with voriconazole and had at least one voriconazole plasma level measured. In addition to the drug plasma levels, the descriptive patient data, results of basic biochemical and hematological tests, and data of concomitant medication were collected. The preliminary data prove the importance of routine voriconazole´s TDM and will be discussed in this presentation. Specifically, one patient´s case report will demonstrate the unpredictable pharmacokinetics of voriconazole.