| Description |
In recent year, significant advances were made in the determination of optimal therapeutic dosage regimens for many drugs. Perhaps the main thrust in this area has been in the development of sensitive assay techniques allowing effective selection of dosage regimens on the basis of pharmacokinetic and biopharmaceutic knowledge. This has resulted in more accurate dosage selection with concomitant improvement in therapy and decreased incidence of adverse effects. Furthermore, the availability of serum assays for drugs has made it possible to maintain drug concentration in a therapeutic range for longer periods of time without risking the danger of serious toxicity, or subtherapeutic effect. This is especially important for those drugs having a narrow therapeutic index and a high variable half-life such as the seen with the digitalis glycosides. Digitalis glycoside serum assay utilization at its inception was low. However, as techniques of measurement improved and became increasingly more available, the frequency with which digitalis glycoside assays are ordered has dramatically risen. With this increase, much confusion has developed concerning assay interpretation resulting in severe criticism of the clinically utility of digitalis glycoside assays. It was the purpose of the presnet study to examine some of these problems with regard to the use of digitalis glycoside serum assays as they occur in a semi-private hospital setting. The study was designed to gain additional knowledge in the following areas: a) frequency of assay utilization , b) appropriateness of assay indication, c) appropriateness of assay use as measured by blood sampling time, d) actual assay levels, e) appropriateness of dosage adjustments, f) patient costs and g) physician understanding of digitalis glycoside assay utilization. |
