![]() ![]() HVPG monitoring also provides valuable prognostic information. ![]() Some of the monitored drugs tend to have a narrow therapeutic index, which is a ratio between the toxic and therapeutic (effective. However, there is growing evidence showing that alteration of LEV pharmacokinetics (PK) may occur in special populations calling for the need for. Therapeutic drug monitoring is the measurement of specific drugs and/or their breakdown products (metabolites) at timed intervals to maintain a relatively constant concentration of the medication in the blood. Overall response was associated with lower liver-related mortality (RR 0.58, CI 0.37-0.91).Ĭurrent evidence supports the validity of HVPG end points to monitor drug therapy efficacy for variceal bleeding prophylaxis. Therapeutic drug monitoring (TDM) of LEV is generally unnecessary given its linear and predictable dose-serum concentration relationship, lack of drug-drug interactions, and broad therapeutic window. Alcohol Monitoring Systems Brown said the current random drug testing performed by jurisdictions is a good system. Even considering nonvaluable patients because of bleeding as HVPG responders, the RR of bleeding was lower in overall responders than in nonresponders (0.66, CI 0.51-0.86). Could the technology be used to monitor for other drugs Probably not. Monit 10 MG Tablet is an effective medicine to prevent and treat the chest pain (angina) caused due to narrowing of blood vessels that carries blood to the. Heterogeneity was no longer significant after exclusion of an outlier trial, which showed the longest interval to HVPG remeasurement and the lowest quality score. Regression analysis identified the interval between the HVPG measurements significantly associated with the RR of bleeding. The RR of bleeding was lower in patients achieving an overall (HVPG or=20%) (0.27, 95% CI 0.14-0.52), complete (HVPG or=20%) (0.41, CI 0.20-0.81) response, with significant heterogeneity. Ten studies totaling 595 patients undergoing two HVPG measurements were identified. Heterogeneity was explored by metaregression analysis. Cohorts of patients on drug therapy from randomized and nonrandomized studies correlating variceal bleeding and HVPG change were used. Our aim was to establish whether target HVPG reduction predicts variceal bleeding in cirrhotic patients receiving variceal bleeding prophylaxis.ĭata sources were MEDLINE, EMBASE, Cochrane Controlled Trials Register, citation lists, and abstracts (most recent search March 2006). The use of the hepatic venous pressure gradient (HVPG) to assess the efficacy of the pharmacological treatment of portal hypertension in cirrhosis is controversial. ![]()
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