神经精神药理学治疗药物监测共识指南:2017版  

Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology:update 2017

作　　者：C.Hiemke N.Bergemann H.W.Clement A.Conca J.Deckert K.Domschke G.Eckermann K.Egberts M.Gerlach C.Greiner G.Gründer E.Haen U.Havemann-Reinecke G.Hefner R.Helmer G.Janssen E.Jaquenoud G.Laux T.Messer R.M ssner M.J.Müller M.Paulzen B.Pfuhlmann P.Riederer A.Saria B.Schoppek G.Schoretsanitis M.Schwarz M.Silva Gracia B.Stegmann W.Steimer J.C.Stingl M.Uhr S.Ulrich S.Unterecker R.Waschgler G.Zernig G.Zurek P.Baumann 李文标(主译) 果伟(译) 贺静(译) 鲍爽(译) 路钊(译) 牛梦溪(译) 阮灿军(译) 臧彦楠(译) 王勇(译)[35] 张玲(译) 刘辰庚(译) 李洁(译)[35] 汤宜朗(审校) 王传跃(审校) 王刚(审校) LI Wen-biao;GUO Wei;HE Jing

机构地区：[1]Department of Psychiatry and Psychotherapy,University Medical Center of Mainz,Mainz,Germany [2]Institute of Clinical Chemistry and Laboratory Medicine,University Medical Center of Mainz,Mainz,Germany [3]Kitzberg Hospitals,Center for Psychosomatic Medicine and Psychotherapy,Bad Mergentheim,Germany [4]Department of Child and Adolescent Psychiatry,University of Freiburg,Freiburg,Germany [5]Servizio Psichiatrico del Comprensorio Sanitario di Bolzano,Bolzano,Italy [6]Department of Psychiatry,Psychotherapy and Psychosomatics,University Hospital of Würzburg,Germany [7]Department of Psychiatry and Psychotherapy,Medical Center-University of Freiburg,Faculty of Medicine,University of Freiburg,Freiburg,Germany [8]Psychiatric Hospital,Kaufbeuren,Germany [9]Department of Child and Adolescent Psychiatry,Psychosomatics and Psychotherapy,Center of Mental Health,University Hospital of Würzburg,Germany [10]Federal Institute for Drugs and Medical Devices(BfArM),Bonn,Germany [11]Department of Psychiatry,Psychotherapy and Psychosomatics,RWTH Aachen University,Aachen,and JARA–Translational Brain Medicine,Aachen,Germany [12]Clinical Pharmacology,Department of Psychiatry and Psychotherapy and Department of Pharmacology and Toxicology,University of Regensburg,Regensburg,Germany [13]Department of Psychiatry and Psychosomatics,University of G ttingen,G ttingen,Germany [14]Psychiatric Hospital,Vitos Klinik,Eichberg,Eltville,Germany [15]Center of Epilepsy,Bielefeld,Germany [16]Medical Laboratory Stein,Limbach Group,M nchengladbach,Germany [17]Psychiatric Hospital,K nigsfelden,Brugg,Aargau,Switzerland [18]Institute of Psychological Medicine,Haag in Oberbayern,Germany [19]Danuviuskliniken,Psychiatric Hospital,Pfaffenhofen,Germany [20]Department of Psychiatry and Psychotherapy,University of Tübingen,Tübingen,Germany [21]Psychiatric Hospitals Oberberggruppe,Berlin,Germany [22]Psychiatric Hospital Weisser Hirsch,Dresden,Germany [23]Experimental Psychiatry Unit,Department of Psychiatry1,Medical University of Innsbruck,Innsbruck,Austria [2

出　　处：《实用药物与临床》2022年第1期1-20,共20页Practical Pharmacy and Clinical Remedies

基　　金：首都临床特色应用研究与成果推广项目(Z171100001017075);北京市属医院科研培训计划项目(PZ2020031)。

摘　　要：治疗药物监测(Therapeutic Drug Monitoring,TDM)通过定量测定和解释血药浓度以优化药物治疗。TDM着眼于药代动力学的个体差异,使个体化药物治疗成为可能。在精神病学和神经病学领域中,有可能明显获益于TDM的主要患者群体包括少年儿童、孕妇、老年患者、智障患者、药物滥用者、涉法精神病患者、已知或怀疑药代动力学异常的患者以及合并躯体疾病影响药代动力学的患者。常规剂量下治疗无效,用药依从性难以判断,药物耐受性不佳,以及可能存在药代动力学方面的药物-药物相互作用等情况都是治疗药物监测的典型指征。然而,只有将TDM充分整合到临床治疗过程中,才能发挥其优化药物治疗的潜在优势。为了向临床医生和实验室提供有效的TDM信息,神经精神药理学与药物精神病学协会(Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie,AGNP)的TDM专家组在2004年发表了第一版《精神科治疗药物监测指南》。2011年进行了更新之后,现在再次更新。遵循新版指南,可能会改善神经精神药物治疗的效果,加快很多患者的康复,并降低医疗费用。

关 键 词：抗凝药物 妊娠期 静脉血栓栓塞疾病抗抑郁药 抗癫痫药 抗帕金森病药 抗精神病药 血药浓度 共识指南 药物分析 基因型分析 神经药物 遗传药理学 药代动力学 表型分析 血浆药物浓度 精神药物 参考范围 血清药物浓度 治疗药物监测 治疗窗 

分 类 号：R969[医药卫生—药理学]