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A trough level is contrasted with a "peak level" (C max), which is the highest level of the medicine in the body, and the "average level", which is the mean level over time. It is widely used in clinical trials for newer medicines to investigate therapeutic effectiveness and safety.
Serum vancomycin levels may be monitored in an effort to reduce side effects, [27] but the value of such monitoring has been questioned. [28] Peak and trough levels are usually monitored, and for research purposes the area under the concentration curve is also sometimes used. [29] Toxicity is best monitored by looking at trough values. [29]
That immediately gets the drug's concentration in the body up to the therapeutically-useful level. First day: 1000 mg; the body clears 100 mg, leaving 900 mg. On the second day, the patient takes 100 mg, bringing the level back to 1000 mg; the body clears 100 mg overnight, still leaving 900 mg, and so forth.
The use of trapezoidal rule in AUC calculation was known in literature by no later than 1975, in J.G. Wagner's Fundamentals of Clinical Pharmacokinetics. A 1977 article compares the "classical" trapezoidal method to a number of methods that take into account the typical shape of the concentration plot, caused by first-order kinetics. [8]
MDCalc is a free online medical reference for healthcare professionals that provides point-of-care clinical decision-support tools, including medical calculators, scoring systems, and algorithms. [1]
This definition is slightly different from C trough, the concentration immediately prior to administration of the next dose. [1] C min is the opposite of C max, the maximum concentration that the drug reaches. C min must be above certain thresholds, such as the minimum inhibitory concentration (MIC), to achieve a therapeutic effect. [2]
In pharmacology, the volume of distribution (V D, also known as apparent volume of distribution, literally, volume of dilution [1]) is the theoretical volume that would be necessary to contain the total amount of an administered drug at the same concentration that it is observed in the blood plasma. [2]
C max is the opposite of C min, which is the minimum (or trough) concentration that a drug achieves after dosing.The related pharmacokinetic parameter t max is the time at which the C max is observed.