Therapeutic and toxic blood concentrations of nearly 1,000 drugs and other xenobiotics

  • Introduction: In order to assess the significance of drug levels measured in intensive care medicine, clinical and forensic toxicology, as well as for therapeutic drug monitoring, it is essential that a comprehensive collection of data is readily available. Therefore, it makes sense to offer a carefully referenced compilation of therapeutic and toxic plasma concentration ranges, as well as half-lives, of a large number of drugs and other xenobiotics for quick and comprehensive information. Methods: Data have been abstracted from original papers and text books, as well as from previous compilations, and have been completed with data collected in our own forensic and clinical toxicology laboratory. The data presented in the table and corresponding annotations have been developed over the past 20 years and longer. A previous compilation has been completely revised and updated. In addition, more than 170 substances, especially drugs that have been introduced to the market since 2003 as well as illegal drugs, which became known to cause intoxications, were added. All data were carefully referenced and more than 200 new references were included. Moreover, the annotations providing details were completely revised and more than 100 annotations were added. Results: For nearly 1,000 drugs and other xenobiotics, therapeutic ("normal") and, if data were available, toxic and comatose-fatal blood-plasma concentrations and elimination half-lives were compiled in a table. Conclusions: In case of intoxications, the concentration of the ingested substances and/or metabolites in blood plasma better predicts the clinical severity of the case when compared to the assumed amount and time of ingestion. Comparing and contrasting the clinical case against the data provided, including the half-life, may support the decision for or against further intensive care. In addition, the data provided are useful for the therapeutic monitoring of pharmacotherapies, to facilitate the diagnostic assessment and monitoring of acute and chronic intoxications, and to support forensic and clinical expert opinions.

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  • Additional file 1: Therapeutic ("normal"), toxic, and comatose-fatal blood-plasma concentrations (mg/L) in man. A table containing therapeutic ("normal"), toxic, and comatose-fatal blood-plasma concentrations (mg/L) of nearly 1,000 drugs and other xenobiotics in humans, including annotations and references.

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Author:Martin SchulzORCiD, Stefanie Iwersen-BergmannORCiDGND, Hilke AndresenORCiDGND, Achim SchmoldtGND
URN:urn:nbn:de:hebis:30:3-256697
DOI:https://doi.org/10.1186/cc11441
ISSN:1875-7081
ISSN:1574-4280
Pubmed Id:https://pubmed.ncbi.nlm.nih.gov/22835221
Parent Title (English):Critical care
Publisher:Bohn Stafleu Van Loghum
Place of publication:Houten
Document Type:Article
Language:English
Date of Publication (online):2012/07/26
Date of first Publication:2012/07/26
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2012/08/24
Volume:16.2012
Issue:R136
Page Number:4
HeBIS-PPN:357885392
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 3.0