What Target Pralidoxime Concentration?

Pralidoxime for organophosphate poisoning

From their randomised trial, Kirti Pawar and colleagues report in today’s Lancet on two pralidoxime-dosing schemes in 200 patients who had moderately severe self-poisoning with organophosphorus insecticide. After a 2-g loading dose over 30 min, half received a high-dose regimen of 1 g/h pralidoxime iodide for 48 h. The other half received a lower dose: 1 g/h every 4 h. After 48 h, the lower dos...

Target concentration intervention: beyond Y2K.

Target concentration intervention (TCI) is proposed as an alternative conceptual strategy to therapeutic drug monitoring (TDM). It is argued that the idea of a therapeutic range has limited the interpretation of measured drug concentrations and diminished the anticipated clinical benefit to patients by use of an oversimplified pharmacodynamic model. TCI on the other hand embraces pharmacokineti...

High-dose pralidoxime for organophosphorus poisoning.

Target cardiovascular risk rather than cholesterol concentration.

The recent American “Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults” heralds a new era in the prevention of atherosclerotic cardiovascular disease and stroke by focusing on reducing risk and abandoning cholesterol concentrations as targets. The new guidelines indicate that once lifestyle interventions have been exhausted drugs should be s...

What determines the intracellular ATP concentration.

Analysis is made of the mechanisms that control the intracellular ATP level. The balance between energy production and expenditure determines the energy charge of the cell and the ratio of [ATP] to the adenylate pool. The absolute ATP concentration is determined by the adenylate pool, which, in its turn, depends on the balance between the rates of AMP synthesis and degradation. Experimental dat...