Blood Test : Therapeutic Drug Levels

Many medications must remain within a certain therapeutic range in the bloodstream in order to achieve their desired effects. In some cases, the level of medication in the blood may go beyond an acceptable limit and symptoms attributable to drug toxicity may develop. For this reason, monitoring certain drug levels has become increasingly important.

Below is a listing of medications which are routinely measured for the purposes of therapeutics. Included are their therapeutic blood levels and approximate levels at which point drug toxicity must be considered.

1. THEOPHYLLINE (10-20mcg/ml, toxic > 20mcg/ml)

2. AMINOPHYLLINE (measured as theophylline)

3. DIGOXIN (.8-2.0ng/ml, toxic > 2.5ng/ml)

4. PHENYTOIN (10-20mcg/ml, toxic > 20-50mcg/ml)

5. CARBAMAZEPINE (4.08.0 ug/ml, toxic > 10ug/ml

6. VALPROIC ACID (50-100 ug/ml, toxic > 150ug/ml)

7. PROCAINAMIDE (5-30ug/ml, toxic >40 ug/ml)

8. LITHIUM (0.5-1.5meq/l, toxic > 1.5meq/l)

9. QUINIDINE (2.4-5.0mcg/ml, toxic >6mcg/ml)

10. PHENOBARBITAL (15-39mcg/ml, toxic > 40mcg/ml)

11. GENTAMICIN (4-10mcg/ml, toxic > 12 mcg/ml)

12. TOBRAMYCIN (4-10mcg/ml, toxic >12 mcg/ml)

13. CYCLOSPORINE (250-875ng/ml for kidney transplant, 360-1200 ng/ml for non-kidney transplant)

* The normal therapeutic ranges for the above medications can vary from person to person. There is wide variability in patients as to what is considered a "toxic level." Some people may manifest signs and symptoms of toxicity at levels below those listed here as toxic.

* These medications, along with their potential drug side effects and drug interactions.


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