Title Terapijsko praćenje olanzapina: validacija metode i klinička primjena
Title (english) Therapeutic drug monitoring of olanzapine: method validation and clinical application
Author Mihovil Horvat
Mentor Lidija Bach-Rojecky (mentor)
Mentor Mila Lovrić (mentor)
Committee member Lidija Bach-Rojecky (predsjednik povjerenstva)
Committee member Mila Lovrić (član povjerenstva)
Committee member Višnja Drinovac (član povjerenstva)
Granter University of Zagreb Faculty of Pharmacy and Biochemistry (Department of pharmacology) Zagreb
Defense date and country 2018-07-12, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Pharmacy Medical Biochemistry
Abstract Olanzapin, antipsihotik druge generacije, ima visoku kliničku potentnost u uklanjanju simptoma shizofrenije. Zbog vrlo niske ekstrapiramidne toksičnosti, olanzapin se koristi kao lijek izbora umjesto konvencionalnih antipsihotičnih agenasa. S druge strane, moguće nuspojave pri terapijskim dozama, interindividualna varijabilnost farmakokinetike olanzapina, loša adherencija pacijenata i potencijalne lijek-lijek interakcije ukazuju na potrebu pažljivog titriranja doze za svakog pojedinog bolesnika. Individualizacija terapije osniva se na periodičnom praćenju koncentracije lijeka u krvi osjetljivim i selektivnim metodama kao što je tekućinska kromatografija visoke djelotvornosti. Cilj ovoga rada bio je ispitati pouzdanost HPLC metode u određivanju koncentracije olanzapina. Provedena je validacija parametara specifičnih za kvantitativne in-house metode, a to su: selektivnost, linearnost, granice detekcije i kvantifikacije (LOD i LOQ), točnost i preciznost (ponovljivost i intermedijarna preciznost). Pri validaciji metode korišteni su komercijalni uzorci i uzorci seruma pacijenata sa psihijatrijskih odjela. Na temelju mjerenja i analize podataka zaključeno je da metoda daje linearan odgovor u rasponu 4,8 – 960 nmol/L, što obuhvaća terapijski referentni raspon olanzapina u krvi (64 – 256 nmol/L). Selektivnost metode je potvrđena detektorom s nizom dioda na temelju uspoređivanja UV-spektara olanzapina. Definirana je i LOQ vrijednost od 7,794 nmol/L, dok je LOD iznosi 2,732 nmol/L. Rezultati ispitivanja preciznosti i točnosti zadovoljili su postavljene kriterije. Preciznost iz dana u dan ispitana je tijekom samo 12 dana. Dodatno je provedena verifikacija referentnog terapijskog raspona olanzapina u krvi na 58 ispitanika. Koncentracija olanzapina u krvi ne slijedi normalnu razdiobu, vrijednosti su pomaknute prema nižim koncentracijama referentnog raspona. U obzir nije uzet status pušenja, dodatna terapija i druge intra- i interindividualne varijabilnosti pa su ovakvi rezultati očekivani. Metoda je pokazala zadovoljavajuću validaciju i kliničku primjenu, ali poželjno je ispitati međupreciznost metode kroz dulje vrijeme. Također treba imati na umu da ova validacija nije obuhvatila ispitivanje stabilnosti uzoraka. Točnost mjerenja i pouzdanost rezultata validacije dodatno potvrđuje i redovito sudjelovanje laboratorija u procjeni vanjske kontrole kvalitete.
Abstract (english) Olanzapine, second-generation antipsychotic, has high clinical potential in removing symptoms of schizophrenia. Because of very low extrapyramidal toxicity, olanzapine is drug of choice, instead of conventional antipsychotic drugs. On the other hand, because of possible side effects at therapeutic doses, interindividual variability of pharmacokinetics, poor patient adherence and potential drug-drug interactions, careful dose titration is necessary for every patient. Individualization of therapy is based on periodical following of blood drug concentration with sensitive and selective methods such as high performance liquid chromatography. Aim of this study was to examine reliability of HPLC method in quantification of olanzapine. Validation of parameters for specific quantitative in-house methods was performed, namely: selectivity, linearity, limit of detection and quantification (LOD and LOQ), accuracy and precision (repeatability and intermediate precision). For method validation commercial samples and serum samples of patients from departments of psychiatry were used. Based on measurement and data analysis it was concluded that the method provides linear response in the range of 4,8 – 960 nmol/L, which includes therapeutic reference range for olanzapine in blood (64-256 nmol/L). Selectivity of the method is confirmed by a diode array detector based on comparing of UV-spectra of olanzapine. A LOQ value of 7,796 nmol/L and LOD of 2,732 nmol/L were also defined. The precision and accuracy results met the set criteria. However, day-to-day precision was examined only during 12 days. Additionally, verification of therapeutic reference range for olanzapine in blood is conducted on 58 patients' samples. Concentration of olanzapine in blood does not follow normal distribution and values are shifted to lower concetrations of reference range. Status of smoking, additional therapy and other intra- and interindividual variabilities were not considered so these results were expected. Method has shown satisfactory validation and clinical application, but it is desirable to examine intermediate precision during longer period of time. Also, it should be kept in mind that this validation did not include evaluation of stability of samples. Accuracy of measurements and reliability of validation results are additionally confirmed by regular participation of laboratory in external quality control assessment.
Keywords
olanzapin
TDM
HPLC
validacija
Keywords (english)
olanzapine
TDM
HPLC
validation
Language croatian
URN:NBN urn:nbn:hr:163:376872
Study programme Title: Medical biochemistry Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: magistar/magistra medicinske biokemije (magistar/magistra medicinske biokemije)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2019-11-29 10:06:34