Therapeutic Index

[TheSeanieB]

Can someone point me in the direction of a resource in which I can look up the therapeutic index of a medication??? After much time on google and Amazon, I have found nothing that gives the number for each drug. Thanks.

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[STAR3URY]

Can someone point me in the direction of a resource in which I can look up the therapeutic index of a medication??? After much time on google and Amazon, I have found nothing that gives the number for each drug. Thanks.

Clinical Pharmacology

 

[TheSeanieB]

Clinical Pharmacology

Can you be more specific? Thanks. If you are referring to the title of a book, there are many with that title.

 

[STAR3URY]

I'm assuming you don't have access to this. It's a drug information resource similar to micromedex or Lexi comp, it requires a subscription. Usually this is available through your school in order to log in

 

[Pharmdoc2013]

You can usually find clinicical pharmacology database at most libraries and hospitals if you have access.

 

[TheSeanieB]

Yes, I just found it. Our school does give us access to Clinical Pharmacology.

Can you tell me how to get to the info on therapeutic index. Thanks again!

 

[OleMissRx]

Yes, I just found it. Our school does give us access to Clinical Pharmacology.

Can you tell me how to get to the info on therapeutic index. Thanks again!

Seriously? Type in the name of the drug, click "search" and read about it?

 

[TheSeanieB]

Seriously? Type in the name of the drug, click "search" and read about it?

I did. There is lots of interesting information but no therapeutic index, not even for acetamenophen.

Does the pharmacology book "Facts and Comparisons" have the therapeutic index?

 

[OleMissRx]

I did. There is lots of interesting information but no therapeutic index, not even for acetamenophen.

Does the pharmacology book "Facts and Comparisons" have the therapeutic index?

Not all drugs are monitored for a therapeutic range. Clinical Pharmacology, Facts and Comparisons, etc... should all have the same basic information. Look up the drugs Vancomycin, or Phenytoin for example. You should find a therapeutic range mentioned.

Online database called daily med has package inserts.

 

[TheSeanieB]

Not all drugs are monitored for a therapeutic range. Clinical Pharmacology, Facts and Comparisons, etc... should all have the same basic information. Look up the drugs Vancomycin, or Phenytoin for example. You should find a therapeutic range mentioned.

Online database called daily med has package inserts.

OK. I'll check that out. I don't understand why this number is such a big secret. Is it not calculated for every medication? Do pharmacists not have access to this kind of info? I even checked the other pharm databases that my school subscribes to.

 

[OleMissRx]

It's not a big secret. It's just that that kind of monitoring is not needed for every drug. We know which drugs need monitoring and where to find the information (package inserts, facts, clinical pharmacology, etc...) if needed.

 

[TheSeanieB]

Can you recommend another metric that is accessible and standardized such that one drug could be compared to another?

 

[OleMissRx]

Can you recommend another metric that is accessible and standardized such that one drug could be compared to another?[/QUOTE


You don't like Clinical Pharmacology or Facts and Comparisons?

I don't know of any resource, other than what has been mentioned, that has something like this.

 

[TheSeanieB]

Can you recommend another metric that is accessible and standardized such that one drug could be compared to another?[/QUOTE


You don't like Clinical Pharmacology or Facts and Comparisons?

I don't know of any resource, other than what has been mentioned, that has something like this.

You are misunderstanding what I am saying. A metric is a measurement. Therapeutic index is an example of a metric. Other examples of metrics would be BMI, fasting glucose, etc. I am asking if there is another measurement (metric) that I could look at regarding drugs to compare their strength, toxicity, etc, that is standardized.

 

[bob1234]

You are misunderstanding what I am saying. A metric is a measurement. Therapeutic index is an example of a metric. Other examples of metrics would be BMI, fasting glucose, etc. I am asking if there is another measurement (metric) that I could look at regarding drugs to compare their strength, toxicity, etc, that is standardized.

I know not of a source that has the therapeutic index for every drug, but it is possible they are available in the literature. The point they were trying to make is that therapeutic index ITSELF doesn't really matter as a metric. Physicians aren't going to stop prescribing warfarin because it has a narrow therapeutic index, it's just the nature of the drug and care must be taken when dosing, just with any other drug.
http://en.wikipedia.org/wiki/Therapeutic_index

Here are links to some drugs with narrow therapeutic indexes.
http://www.ncbop.org/faqs/Pharmacist/faq_NTIDrugs.htm
http://ecapps.health.state.pa.us/pdf/ddc/nti.pdf
http://www.fda.gov/downloads/Drugs/...dNewDrugApplicationANDAGenerics/UCM292676.pdf

 

[TheSeanieB]

Thanks for all of the discussion. Let me provide some prospective. I am not a physician. I am a 3rd year medical student that it trying to organize lists of drugs (ie. antibiotics) by some quantitiative standardized measure. I am a visual spacial learner. I literally get questions correct on tests by remembering where it was on a list.

So let me try asking the question like this. How can I list the antibiotics so that the most dangerous (or any other adjective you like) one are on top? Are there any standardized numbers (anything standardized) for the antibiotics?

 

[LucidDream]

Thanks for all of the discussion. Let me provide some prospective. I am not a physician. I am a 3rd year medical student that it trying to organize lists of drugs (ie. antibiotics) by some quantitiative standardized measure. I am a visual spacial learner. I literally get questions correct on tests by remembering where it was on a list.

So let me try asking the question like this. How can I list the antibiotics so that the most dangerous (or any other adjective you like) one are on top? Are there any standardized numbers (anything standardized) for the antibiotics?

If you are looking to study antibiotics by grouping them by a given measure, why not organize them by coverage? While studying for my ID module, I ended up making a grid with common pathogens/pathogen groups (MSSA, Strep, atypicals, etc.) in the columns and antibiotic classes as well as particular agents in rows. Then, I marked whether a particular drug was effective against a pathogen or not. That way I would be able to glance at the chart as a study tool and see everything that was active against MRSA, Pseudomonas, etc. Then, on the right side of the grid, I wrote down noteworthy adverse effects for the given antibiotic/class as well as therapeutic ranges for select agents that commonly require levels (aminoglycosides/vancomycin).

As a visual/spacial learner, this is how I learned to group antibiotics/classes and adverse effects. This is what worked for me and merely provides an "at a glance" view that could be useful to you as well. Hope this helps.

 

[lapharmacienne]

check this book out, this is the only reference that came to mind that includes therapeutic index for the most important medications

Basic Clinical Pharmacokinetics
http://www.amazon.com/Basic-Clinica...=1-1&keywords=Basic+Clinical+Pharmacokinetics

Also, Epocrates online under the Safety/Monitoring tab has a section for therapeutic levels

 

[TheSeanieB]

Thanks. I'll check it out.