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This therapeutic drug monitoring (TDM) grand round describes a patient with serious valproic acid intoxication. A total valproic acid level of 844 mg/L and an unbound valproic acid level of 604 mg/L were observed. Meropenem was administered to enhance the clearance of valproic acid. This off-label usage of meropenem is based on the drug-drug interaction between carbapenems and valproic acid, which reduced the level of valproic acid within 24 hours after administration.

Item does not contain fulltext Recent years have seen important changes in pharmacology. New techniques have been developed which are increasingly aimed at smaller groups of patients or even individual patients. In the past, thousands of chemical molecules were tested on a potential molecular target and the most effective molecules were selected. Nowadays a growing number of drugs are designed to aim at a specific molecular target, an example being monoclonal antibodies. There are developments that go fundamentally further and enable patients to be treated in an increasingly targeted and individual manner. These new therapies (i.e., Advanced Therapy Medicinal Products) are based on different principles than those of classical pharmacotherapy, and require different risk assessments as well as a different regulatory system. In this paper we discuss a selection of the developments in pharmacotherapy that have taken place during the past decade. In addition, we look into what sort of developments can be expected in the future.

Contains fulltext : 220841pub.pdf (Publisher’s version ) (Open Access) 16 juli 2020

Item does not contain fulltext Iron deficiency anaemia is a common problem. The majority of patients are treated with oral iron supplements. The current recommended dosage for oral supplementation of 200 mg ferrous fumarate 3x per day however, is based on a single small study of poor quality. There is no consensus concerning parenteral dosing. In recent years, new insights have been gained regarding both the dosage of oral supplementation and the indication for parenteral supplementation. Oral therapy is preferred. In principle, 100 mg ferrous fumarate once a day is sufficient for the treatment of symptom-free patients with anaemia. In cases of severe anaemia, or in patients with symptoms, 200 mg/day should be prescribed. If side effects appear, it can be dosed every other day. Where oral therapy does not show effectiveness, the anaemia is severe, or rapid increase of haemoglobin is indicated, parenteral supplementation should be chosen. Parenteral supplementation is more effective than oral supplementation in specific conditions, such as dialysis-dependent renal insufficiency, heart failure or active IBD.

Contains fulltext : 22409___.PDF (Publisher’s version ) (Open Access)

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Contains fulltext : 88324.pdf (Publisher’s version ) (Closed access)

Contains fulltext : 89852.pdf (Publisher’s version ) (Closed access)

Large-scale implementation of carbon capture and storage needs a whole new infrastructure to transport and store CO2. Tools that can support planning and designing of such infrastructure require incorporation of both temporal and spatial aspects. Therefore, a toolbox that integrates ArcGIS, a geographical information system with elaborate spatial and routing functions, and MARKAL, an energy bottom-up model based on linear opt imization has been developed. Application of this toolbox for devising blueprint s of a CO2 infrastructure in the Netherlands, shows that early knowledge on the availability, potential, and suitability of sinks is of major importance for a cost-effective design of the infrastructure. © 2009 Elsevier Ltd. All rights reserved.

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Item does not contain fulltext In this case report, we describe a man who developed recurrent depression and suicidal ideation with a serious plan to commit suicide as definite adverse effect of ciprofloxacin, which had been prescribed for recurrent prostatitis.