When should trough levels be drawn?
The trough level is the lowest concentration in the patient's bloodstream, therefore, the specimen should be collected just prior to administration of the drug. The peak level is the highest concentration of a drug in the patient's bloodstream.
aminoglycoside, which is a polycationic agent that kills aerobic gram- negative bacteria. Special Instructions: Peak levels should be drawn 30-60 minutes after infusion of the drug. Trough levels should be drawn just before next dose.
- CNS findings in cases of VPA overdose may include the following:
- Worsened seizure control.
- Mood stabilizers, described below, are highly effective in stabilizing and maintaining a remission of manic symptoms.
- Valproate or Valproic Acid (Depakote)
- Carbamazepine (Tegretol)
- Gabapentin (Neurontin)
- Topiramate (Topamax)
- Oxcarbazepine (Trileptal)
- Lamotigrine (Lamictal)
- The DSM-IV-TR defines a hypomanic episode as including, over the course of at least four days, elevated mood plus three of the following symptoms OR irritable mood plus four of the following symptoms: pressured speech. inflated self-esteem or grandiosity. decreased need for sleep.
Patients who require treatment with gentamicin often require monitoring, which includes peak and trough levels. Peak levels are typically evaluated 30 minutes after completion of the infusion. Trough levels should be drawn immediately before the dose is administered.
- Carbamazepine (Tegretol) is an iminostilbene that has been used as a first-line medication for both generalized and partial complex seizure disorders. The therapeutic reference range of carbamazepine is 4-12 mg/L. The minimum toxic level is 10 mg/kg.
- The therapeutic ranges for adults taking phenytoin have been established at 10.0-20.0 mcg/mL for total phenytoin (bound plus unbound) and 1.0-2.0 mcg/mL for free phenytoin (unbound only). The range for percent free phenytoin is 8-14%.
- Pharmacokinetics. Aminoglycosides are too water soluble (because they are highly polar cations) to be absorbed if given orally; therefore they are usually used parenterally. Except in neonates, aminoglycosides exhibit marginal penetration of the central nervous system because of this high degree of hydrophilicity.
Because the goal is to administer the vancomycin such that a minimumally effective concentration is always maintained in the blood, measurement of blood levels is usually timed to reflect the trough and, sometimes peak, to evaluate the adequacy of dosing and clearance of the drug from the body.
- This form of vancomycin is used to treat a certain intestinal condition (colitis) caused by bacteria. This condition causes diarrhea and stomach/abdominal discomfort or pain. When vancomycin is taken by mouth, it stays in the intestines to stop the growth of certain bacteria that cause these symptoms.
- Vancomycin has only rarely been implicated as a cause of thrombocytopenia, and there is only limited evidence that this complication is caused by immune mechanisms. We conducted a study to determine whether thrombocytopenia is caused by vancomycin-dependent antibodies in patients being treated with vancomycin.
- In medicine and pharmacology, a trough level or trough concentration is the lowest concentration reached by a drug before the next dose is administered, often used in therapeutic drug monitoring. It helps in therapeutic drug monitoring.
Updated: 25th November 2019