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Book Details
Abstract
The New, Expanded Sixth Edition of Clinical Pharmacokinetics
In the evolving practice of pharmacokinetics (PK), it is important to keep on top of the latest advances. John E. Murphy, Pharm.D., FASHP, FCCP, a well-known leader in the field of clinical pharmacokinetics, has updated and expanded his widely used textbook and reference.
Clinical Pharmacokinetics, Sixth Edition, includes the most current information, covering issues such as rational use of drug concentration measurements, changes in dosing obese patients, and considerations for a wider variety of drugs for special populations. There is also a new chapter focused on pharmacogenomics and its impact on pharmacokinetic parameters, as well as discussion of pharmacogenomics throughout the book.
Everything You Need to Know About PK Today
- Drugs, dosing, and therapeutic monitoring
- Drug concentration measurements
- New chapter on the impact of pharmacogenomics
- Neonatal, pediatric, obese, and geriatric dosing
- Dosing in renal disease and creatinine clearance estimation
- Drugs sorted by family and as single drugs
Written in a straightforward style, with numerous charts and lists, the sixth edition makes complicated dosing and monitoring information easy to find and understand. Whether you are a student or practitioner, it is a resource you will turn to for reliable guidance throughout your pharmacy career.
John E. Murphy, PharmD, FASHP, FCCP
John E. Murphy, PharmD, FASHP, FCCP, is Professor of Pharmacy Practice and Science and Associate Dean for Academic and Professional Affairs at the College of Pharmacy, and Professor of Family and Community Medicine at the College of Medicine, the University of Arizona in Tucson. He is also an Honorary Professor at the University of Otago School of Pharmacy in Dunedin, New Zealand. John received BS in pharmacy and PharmD degrees from the University of Florida in Gainesville, where he was a recipient of the Distinguished Pharmacy Alumnus Award in 1998.
Long active in pharmacy organizations, Dr. Murphy was president of the American College of Clinical Pharmacy (ACCP) from 2008-2009, the American Society of Health-System Pharmacists (ASHP) from 1997-1998, and the Georgia Society of Hospital Pharmacists.
Dr. Murphy has published over 200 papers, ~ 100 abstracts, five editions of Clinical Pharmacokinetics, and the Resident Survival Guide. He is co-editor of the Pharmacotherapy Self-Assessment Program (PSAP 8) for ACCP with Mary Lee and is currently writing a new basic and applied pharmacokinetic self-assessment textbook for ASHP. He is a frequent speaker at international, national, and statewide continuing education meetings.
Among various professional and teaching awards received over the years, Dr. Murphy received the Award for Sustained Contributions to the Literature of Pharmacy Practice from the ASHP Research and Education Foundation in 2003 and the Education Award from ACCP in 2012.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Titlepage | 1 | ||
| Table of Contents | 5 | ||
| Preface | 11 | ||
| Contributors | 13 | ||
| Introduction - GENERAL PHARMACOKINETIC PRINCIPLES | 17 | ||
| Section 1 - BASIC CONCEPTS AND SPECIAL POPULATIONS | 27 | ||
| Ch 1 - RATIONAL USE OF DRUG CONCENTRATION MEASUREMENTS | 29 | ||
| EVALUATING THE NEED FOR A DRUG CONCENTRATION MEASUREMENT | 29 | ||
| APPROACHES TO DOSING WITH LIMITED NEED FOR DRUG CONCENTRATION MEASUREMENTS | 32 | ||
| CONCLUSION | 33 | ||
| Ch 2 - ESTIMATING CREATININE CLEARANCE | 35 | ||
| FACTORS AFFECTING ESTIMATES OF GLOMERULAR FILTRATION RATE | 35 | ||
| CREATININE ASSAY STANDARDIZATION | 36 | ||
| FORMULAS TO ESTIMATE CREATININE CLEARANCE IN ADULTS | 37 | ||
| BODY WEIGHT | 40 | ||
| LOW SERUM CREATININE IN ELDERLY OR UNDERWEIGHT PATIENTS | 41 | ||
| AMPUTATIONS | 41 | ||
| SPINAL CORD INJURY | 42 | ||
| CHRONIC RENAL INSUFFICIENCY | 42 | ||
| DIALYSIS | 42 | ||
| LIVER DISEASE | 42 | ||
| PEDIATRICS | 42 | ||
| PATIENTS WITH UNSTABLE RENAL FUNCTION | 44 | ||
| ESTIMATING TIME TO STEADY STATE SERUM CREATININE CONCENTRATION | 44 | ||
| CREATININE CLEARANCE ESTIMATION IN UNSTABLE RENAL FUNCTION | 44 | ||
| Ch 3 - RENAL DRUG DOSING CONCEPTS | 49 | ||
| CLINICAL ASSESSMENT OF KIDNEY FUNCTION | 49 | ||
| MECHANISMS OF DRUG CLEARANCE | 50 | ||
| NONRENAL MECHANISMS | 52 | ||
| VOLUME OF DISTRIBUTION | 53 | ||
| DRUG DOSING STRATEGIES FOR CKD PATIENTS | 53 | ||
| HEMODIALYSIS AND CONTINUOUS RENAL REPLACEMENT THERAPY | 57 | ||
| CONCLUSION | 63 | ||
| Ch 4 - MEDICATION DOSING IN OVERWEIGHT AND OBESE PATIENTS | 67 | ||
| OBTAINING AN ACCURATE WEIGHT | 67 | ||
| BODY COMPOSITION CHANGES ASSOCIATED WITH OBESITY | 67 | ||
| SIZE DESCRIPTORS | 69 | ||
| PHARMACOKINETIC CONSIDERATIONS | 71 | ||
| ORAL ABSORPTION | 71 | ||
| CONCEPT OF DOSE PROPORTIONALITY | 74 | ||
| RECOMMENDATIONS FOR DOSING MEDICATIONS IN OBESE PATIENTS | 75 | ||
| GENETIC AND GENOMIC CONSIDERATIONS | 76 | ||
| Ch 5 - THE ROLE OF PHARMACOGENOMICS IN PHARMACOKINETICS | 81 | ||
| INTRODUCTION | 81 | ||
| BASIC DEFINITIONS | 81 | ||
| HISTORY OF PHARMACOGENETICS AND PHARMACOGENOMICS | 82 | ||
| CYTOCHROME P450 ENZYMES AND SOLUTE CARRIER TRANSMEMBRANE PROTEINS | 83 | ||
| IMPACT OF THE BLOOD–BRAIN BARRIER | 83 | ||
| SPECIAL POPULATIONS | 85 | ||
| PHARMACOGENOMIC EXAMPLES IN THERAPEUTICS | 86 | ||
| SUMMARY | 87 | ||
| Ch 6 - DRUG DOSING IN PEDIATRIC PATIENTS | 91 | ||
| GENERAL PHARMACOKINETIC INFORMATION | 92 | ||
| DISTRIBUTION | 95 | ||
| ELIMINATION | 95 | ||
| METABOLISM | 97 | ||
| FACTORS INFLUENCING DRUG DISPOSITION | 97 | ||
| PHARMACOGENOMICS IN CHILDREN | 102 | ||
| Ch 7 - THERAPEUTIC DRUG MONITORING IN THE GERIATRIC PATIENT | 109 | ||
| PHYSIOLOGIC CHANGES | 111 | ||
| DRUG ELIMINATION | 115 | ||
| AGE-RELATED PHARMACODYNAMIC CHANGES INFLUENCING DRUG RESPONSE | 116 | ||
| SUMMARY OF CHANGES | 119 | ||
| Section 2 - SPECIFIC DRUGS AND DRUG CLASSES | 147 | ||
| Ch 8 - AMINOGLYCOSIDES | 149 | ||
| USUAL DOSAGE RANGE IN ABSENCE OF CLEARANCE ALTERING FACTORS | 149 | ||
| DOSAGE FORM AVAILABILITY | 150 | ||
| GENERAL PHARMACOKINETIC INFORMATION | 152 | ||
| DOSING STRATEGIES | 155 | ||
| THERAPEUTIC RANGES | 161 | ||
| THERAPEUTIC MONITORING | 162 | ||
| PHARMACODYNAMIC MONITORING | 168 | ||
| DRUG–DRUG INTERACTIONS | 170 | ||
| DRUG–DISEASE STATE OR CONDITION INTERACTIONS | 170 | ||
| PHARMACOGENOMIC IMPLICATIONS OF AMINOGLYCOSIDE USE | 172 | ||
| Ch 9 - ANTIDEPRESSANTS | 181 | ||
| USUAL DOSAGE RANGE IN ABSENCE OF CLEARANCE ALTERING FACTORS | 182 | ||
| DOSAGE FORM AVAILABILITY | 182 | ||
| GENERAL PHARMACOKINETIC INFORMATION | 182 | ||
| DOSING STRATEGIES | 186 | ||
| THERAPEUTIC RANGE | 188 | ||
| THERAPEUTIC MONITORING | 191 | ||
| FURTHER CONSIDERATIONS FOR SAMPLING | 192 | ||
| PHARMACODYNAMIC MONITORING | 192 | ||
| DRUG–DISEASE STATE OR CONDITION INTERACTIONS | 192 | ||
| Ch 10 - ANTIEPILEPTICS | 199 | ||
| FELBAMATE | 199 | ||
| GABAPENTIN | 201 | ||
| LAMOTRIGINE | 202 | ||
| TIAGABINE | 205 | ||
| TOPIRAMATE | 205 | ||
| LEVETIRACETAM | 207 | ||
| OXCARBAZEPINE | 208 | ||
| ZONISAMIDE | 209 | ||
| PREGABALIN | 211 | ||
| LACOSAMIDE | 212 | ||
| RUFINAMIDE | 214 | ||
| VIGABATRIN | 215 | ||
| EZOGABINE | 216 | ||
| CLOBAZAM | 217 | ||
| PERAMPANEL | 219 | ||
| ESLICARBAZEPINE | 220 | ||
| USE OF THE NEWER ANTIEPILEPTIC DRUGS | 221 | ||
| GENERIC SUBSTITUTION OF AEDS | 222 | ||
| Ch 11 - ANTIREJECTION AGENTS | 231 | ||
| USUAL DOSAGE RANGE IN ABSENCE OF CLEARANCE ALTERING FACTORS | 232 | ||
| GENERAL PHARMACOKINETIC INFORMATION | 235 | ||
| THERAPEUTIC RANGE | 240 | ||
| THERAPEUTIC MONITORING | 241 | ||
| PHARMACODYNAMIC MONITORING | 241 | ||
| DRUG–DRUG INTERACTIONS | 243 | ||
| DRUG–GENE INTERACTIONS | 244 | ||
| MOLECULAR WEIGHTS FOR UNIT CONVERSIONS | 246 | ||
| Ch 12 - CARBAMAZEPINE | 249 | ||
| USUAL DOSAGE RANGE IN THE ABSENCE OF CLEARANCE ALTERING FACTORS | 249 | ||
| GENERAL PHARMACOKINETIC INFORMATION | 251 | ||
| DOSING STRATEGIES | 254 | ||
| THERAPEUTIC RANGE | 255 | ||
| THERAPEUTIC MONITORING | 255 | ||
| PHARMACODYNAMIC MONITORING | 256 | ||
| DRUG–DRUG INTERACTIONS | 257 | ||
| DRUG–DISEASE STATE OR CONDITION INTERACTIONS | 258 | ||
| Ch 13 - DIGOXIN | 265 | ||
| USUAL DOSAGE RANGE IN ABSENCE OF CLEARANCE ALTERING FACTORS | 265 | ||
| DOSING STRATEGIES | 268 | ||
| THERAPEUTIC MONITORING | 270 | ||
| PHARMACODYNAMIC MONITORING | 271 | ||
| DRUG–DRUG INTERACTIONS | 273 | ||
| DRUG–DISEASE/CONDITION INTERACTIONS | 274 | ||
| Ch 14 - ETHOSUXIMIDE | 277 | ||
| USUAL DOSAGE RANGE IN ABSENCE OF CLEARANCE ALTERING FACTORS | 277 | ||
| GENERAL PHARMACOKINETIC INFORMATION | 277 | ||
| DOSING STRATEGIES | 279 | ||
| THERAPEUTIC RANGE | 279 | ||
| THERAPEUTIC MONITORING | 280 | ||
| PHARMACODYNAMIC MONITORING | 280 | ||
| DRUG–DRUG INTERACTIONS | 281 | ||
| DRUG–DISEASE STATE OR CONDITION INTERACTIONS | 281 | ||
| Ch 15 - UNFRACTIONATED HEPARIN, LOW MOLECULAR WEIGHT HEPARIN, AND FONDAPARINUX | 283 | ||
| UNFRACTIONATED HEPARIN | 283 | ||
| UFH: USUAL DOSAGE RANGE IN ABSENCE OF CLEARANCE-ALTERING FACTORS | 283 | ||
| UFH: DOSAGE FORM AVAILABILITY | 284 | ||
| UFH: GENERAL PHARMACOKINETIC INFORMATION | 284 | ||
| DOSING STRATEGIES | 286 | ||
| UFH: THERAPEUTIC RANGE | 290 | ||
| UFH: THERAPEUTIC MONITORING | 292 | ||
| UFH: PHARMACODYNAMIC MONITORING—CONCENTRATION-RELATED EFFICACY | 294 | ||
| UFH: PHARMACODYNAMIC MONITORING—CONCENTRATION-RELATED TOXICITY | 294 | ||
| REVERSING HEPARIN’S EFFECT | 295 | ||
| UFH: DRUG-DRUG INTERACTIONS | 296 | ||
| UFH: DRUG–DISEASE STATE OR CONDITION INTERACTIONS | 296 | ||
| LOW MOLECULAR WEIGHT HEPARINS | 296 | ||
| LMWH: USUAL DOSAGE RANGE IN THE ABSENCE OF CLEARANCE-ALTERING FACTORS | 298 | ||
| LMWH: DOSAGE FORM AVAILABILITY | 298 | ||
| LMWH: GENERAL PHARMACOKINETIC INFORMATION | 299 | ||
| LMWH: DOSING STRATEGIES | 299 | ||
| LMWH: THERAPEUTIC RANGE | 300 | ||
| LMWH: THERAPEUTIC MONITORING | 300 | ||
| LMWH: ASSAY ISSUES | 300 | ||
| LMWH: PHARMACODYNAMIC MONITORING—CONCENTRATION-RELATED EFFICACY | 300 | ||
| LMWH: PHARMACODYNAMIC MONITORING—CONCENTRATION-RELATED TOXICITY | 301 | ||
| LMWH: REVERSING THE EFFECT OF LMWHs | 301 | ||
| LMWH: DRUG–DRUG INTERACTIONS | 302 | ||
| LMWH: DRUG–DISEASE STATE OR CONDITION INTERACTION | 302 | ||
| FONDAPARINUX | 303 | ||
| FONDAPARINUX: DOSAGE RANGE | 303 | ||
| Ch 16 - LIDOCAINE | 311 | ||
| USUAL DOSAGE RANGE IN ABSENCE OF CLEARANCE ALTERING FACTORS | 311 | ||
| DOSAGE FORM AVAILABILITY | 311 | ||
| GENERAL PHARMACOKINETIC INFORMATION | 313 | ||
| CLEARANCE | 315 | ||
| HALF-LIFE AND TIME TO STEADY STATE | 315 | ||
| DOSING STRATEGIES | 315 | ||
| THERAPEUTIC RANGE | 318 | ||
| PHARMACODYNAMIC MONITORING: CONCENTRATION RELATED EFFICACY AND TOXICITY | 319 | ||
| DRUG–DRUG INTERACTIONS | 319 | ||
| DRUG–DISEASE STATE OR CONDITION INTERACTIONS | 320 | ||
| Ch 17 - LITHIUM | 327 | ||
| USUAL DOSAGE RANGE IN ABSENCE OF CLEARANCE ALTERING FACTORS | 327 | ||
| DOSAGE FORM AVAILABILITY | 329 | ||
| GENERAL PHARMACOKINETIC INFORMATION | 329 | ||
| THERAPEUTIC RANGE | 334 | ||
| THERAPEUTIC MONITORING | 334 | ||
| PHARMACODYNAMIC MONITORING | 337 | ||
| DRUG–DISEASE STATE INTERACTIONS AND SPECIAL POPULATIONS | 338 | ||
| Ch 18 - PHENOBARBITAL | 349 | ||
| USUAL DOSAGE RANGE IN ABSENCE OF CLEARANCE ALTERING FACTORS | 349 | ||
| GENERAL PHARMACOKINETIC INFORMATION | 350 | ||
| HALF-LIFE AND TIME TO STEADY STATE | 352 | ||
| THERAPEUTIC RANGE | 352 | ||
| DRUG MONITORING ASSAY CONSIDERATIONS | 352 | ||
| SUGGESTED SAMPLING TIMES AND EFFECT ON THERAPEUTIC RANGE | 352 | ||
| PHARMACODYNAMIC MONITORING—CONCENTRATION RELATED EFFICACY | 353 | ||
| PHARMACODYNAMIC MONITORING—CONCENTRATION RELATED TOXICITY | 354 | ||
| DRUG−DRUG INTERACTIONS | 354 | ||
| DRUG–DISEASE STATE OR CONDITION INTERACTIONS | 356 | ||
| Ch 19 - PHENYTOIN AND FOSPHENYTOIN | 359 | ||
| USUAL DOSAGE RANGE IN ABSENCE OF CLEARANCE ALTERING FACTORS | 359 | ||
| DOSAGE FORM AVAILABILITY | 360 | ||
| GENERAL PHARMACOKINETIC INFORMATION | 360 | ||
| THERAPEUTIC RANGE | 366 | ||
| THERAPEUTIC MONITORING | 366 | ||
| PHARMACODYNAMIC MONITORING | 367 | ||
| DRUG–DRUG INTERACTIONS | 368 | ||
| DRUG–DISEASE STATE OR CONDITION INTERACTIONS | 369 | ||
| Ch 20 - THEOPHYLLINE | 377 | ||
| USUAL DOSAGE RANGE IN ABSENCE OF CLEARANCE ALTERING FACTORS | 377 | ||
| DOSAGE FORM AVAILABILITY | 378 | ||
| GENERAL PHARMACOKINETIC INFORMATION | 378 | ||
| DOSING STRATEGIES | 382 | ||
| THERAPEUTIC RANGE | 383 | ||
| THERAPEUTIC MONITORING | 383 | ||
| PHARMACODYNAMIC MONITORING | 384 | ||
| DRUG–DRUG INTERACTIONS | 386 | ||
| DRUG–DISEASE STATE OR CONDITION INTERACTIONS | 387 | ||
| Ch 21 - VALPROATE | 391 | ||
| USUAL DOSAGE RANGE IN THE ABSENCE OF CLEARANCE ALTERING FACTORS | 391 | ||
| GENERAL PHARMACOKINETIC INFORMATION | 392 | ||
| DOSING STRATEGIES | 395 | ||
| DOSAGE ADJUSTMENT | 395 | ||
| THERAPEUTIC RANGE | 396 | ||
| EFFECT OF AGE AND PREGNANCY ON THERAPEUTIC RANGE | 396 | ||
| THERAPEUTIC MONITORING | 397 | ||
| PHARMACODYNAMIC MONITORING—CONCENTRATION-RELATED EFFICACY | 397 | ||
| DRUG–DRUG INTERACTIONS | 398 | ||
| DRUG–DISEASE STATE OR CONDITION INTERACTIONS | 399 | ||
| Ch 22 - VANCOMYCIN | 403 | ||
| USUAL DOSAGE RANGE IN ABSENCE OF CLEARANCE ALTERING FACTORS | 403 | ||
| DOSAGE FORM AVAILABILITY | 404 | ||
| GENERAL PHARMACOKINETIC INFORMATION | 405 | ||
| DOSING STRATEGIES | 407 | ||
| THERAPEUTIC RANGE | 411 | ||
| THERAPEUTIC DRUG MONITORING | 413 | ||
| PHARMACODYNAMIC MONITORING | 413 | ||
| DRUG–DRUG INTERACTIONS | 417 | ||
| DRUG–DISEASE STATE INTERACTIONS | 418 | ||
| ASSAY ISSUES | 421 | ||
| Ch 23 - WARFARIN | 429 | ||
| USUAL DOSAGE RANGE IN ABSENCE OF CLEARANCE ALTERING FACTORS | 430 | ||
| DOSAGE FORM AVAILABILITY | 430 | ||
| GENERAL PHARMACOKINETIC INFORMATION | 431 | ||
| THERAPEUTIC RANGE | 436 | ||
| THERAPEUTIC MONITORING | 437 | ||
| PHARMACODYNAMIC MONITORING | 438 | ||
| DRUG–DRUG INTERACTIONS | 440 | ||
| DRUG–DISEASE STATE OR CONDITION INTERACTIONS | 441 | ||
| App A - THERAPEUTIC RANGES OF DRUGS IN TRADITIONAL AND SI UNITS | 451 | ||
| App B - NONDRUG REFERENCE RANGES FOR COMMON LABORATORY TESTS INTRADITIONAL AND SI UNITS | 453 | ||
| INDEX | 455 |