Peak concentrations, monitoring

Monitoring Perform auditory function serial tests and monitor serum levels. When monitoring vancomycin serum levels, draw a peak concentration 1.5 to 2.5 hours after the completion of a 1-hour infusion and a trough concentration within 1 hour of the next scheduled dose. Peak levels are generally expected to be in the 30 to 40 mg/mL range and trough levels in the 10 to 15 mg/mL range. 

The 3M Monitor was also compared to charcoal tubes in its ability to handle (integrate) high peak concentrations or excursions. Table XI summarizes this data. Three concentration levels were chosen and achieved by injection ... 

In clinical practice, serum concentration monitoring is routinely performed on patients receiving aminoglycosides. Despite the lack of supporting evidence for its usefulness or need, serum vancomycin concentration monitoring is also widespread. Flucytosine serum concentration monitoring has been shown to reduce toxicity when doses are adjusted to maintain peak concentrations below 100 mcg/mL. 

Passive samplers are not useful to monitor peak concentrations, but offer a convenient way to regard for example, long term exposure of persons in an indoor environment. A more detailed description of the passive sampling technique is given in Chapter 3. 

The amikacin dosing regimen is best determined using therapeutic drug monitoring. The suggested peak concentration of amikacin (1 h after administration) is 25 xg/ml and the trough concentration should be <5 xg/ml. 

THCCOOH concentrations were monitored in human plasma for 7 days after controUed cannabis smoking (Huestis et al. 1992b). This inactive metabolite was detected in all subjects plasma by 8 min after the start of smoking. THCCOOH concentrations in plasma increased slowly and plateaued for up to 4 h. Peak concentrations were consistenUy lower than peak THC concentrations, but... 

Traditional methods of aminoglycoside serum concentration monitoring (evaluating peak and trough serum concentrations) cannot be applied to extended-interval dosing... 

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