Nishihara K
Hospital Pharmacy, Faculty of Medicine, University of Tokyo.
Nihon Rinsho. 1995 Sep;53(9):2301-9.
Antiepileptic drugs, cardiac glycosides (digoxin, etc.), theophylline, antiarrhythmic agents (quinidine, procainamide, lidocaine, etc.) and aminoglycosides have narrow therapeutic range and large interindividual variations have been reported for their pharmacokinetics. Therefore, to obtain the appropriate therapeutic effects without undesirable effects, monitorings of above drug concentrations are useful (therapeutic drug monitoring). There are many assay methods (high-performance liquid chromatography, immunoassay, enzyme immunoassay, etc.) to determine drugs in serum. In those assays various enzyme immunoassays, enzyme-multiplied immunoassay technique (EMIT), enzyme-linked immunosorbent assay (ELISA), apoenzyme reactivation immunoassay (ARIS), radial partition immunoassay (RPIA), etc., are developed and widely used in many clinical laboratories. These assay systems offer convenience and great rapidity of assay and satisfactory accuracy and reproducibility but lack a little specificity of antibody.
抗癫痫药物、强心苷(地高辛等)、茶碱、抗心律失常药(奎尼丁、普鲁卡因胺、利多卡因等)及氨基糖苷类药物治疗窗窄,且已报道其药代动力学存在较大个体差异。因此,为在不产生不良反应的情况下获得适当的治疗效果,监测上述药物浓度很有用(治疗药物监测)。有许多测定血清中药物的方法(高效液相色谱法、免疫测定法、酶免疫测定法等)。在这些测定方法中,各种酶免疫测定法,如酶放大免疫测定技术(EMIT)、酶联免疫吸附测定法(ELISA)、脱辅基酶复活免疫测定法(ARIS)、放射免疫扩散测定法(RPIA)等已得到发展并在许多临床实验室广泛应用。这些测定系统提供了测定的便利性和高速度以及令人满意的准确性和重现性,但抗体特异性稍有不足。