A Novel, Rapid, and Low-Volume Assay for Therapeutic Drug Monitoring of Posaconazole and Other Long-Chain Azole-Class Antifungal Drugs

Wiedman, Gregory; Zhao, Yanan; Perlin, David S.

doi:10.1128/msphere.00623-18

Cited by 9 publications

(4 citation statements)

References 16 publications

(17 reference statements)

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“…Nonetheless, the presence of 2a is certain to improve target-receptor occupancy in the initial cycles, likely buttressing low effective concentrations of monomeric voriconazole in conformations that can elicit aptamers. The isolated aptamers do not bind fluconazole, suggesting they are not class-wide cross-reactive aptamers (17,28,29) and further confirming that stabilizing interactions occur with group III in 2 (Fig. 4A).…”

Section: Functional Group-guided Selections For Leucinesupporting

confidence: 55%

“…Similarly, voriconazole should have been a straightforward target because of its aromatic surfaces and heteroatoms. However, we could neither adapt reported aptamers cross-reactive with the azole class of antifungals ( 17 ) as sensor components ( 8 , 12 ), nor could we isolate specific aptamers. These two seemingly unrelated targets, with substantially different molecular weights, share proximate pairs of sterically crowded sp 3 carbons (Fig.…”

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confidence: 99%

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A functional group–guided approach to aptamers for small molecules

Yang

Mitchell

Banerjee

et al. 2023

Science

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Aptameric receptors are important biosensor components, yet our ability to identify them depends on the target structures. We analyzed the contributions of individual functional groups on small molecules to binding within 27 target-aptamer pairs, identifying potential hindrances to receptor isolation—for example, negative cooperativity between sterically hindered functional groups. To increase the probability of aptamer isolation for important targets, such as leucine and voriconazole, for which multiple previous selection attempts failed, we designed tailored strategies focused on overcoming individual structural barriers to successful selections. This approach enables us to move beyond standardized protocols into functional group–guided searches, relying on sequences common to receptors for targets and their analogs to serve as anchors in regions of vast oligonucleotide spaces wherein useful reagents are likely to be found.

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Section: Functional Group-guided Selections For Leucinesupporting

confidence: 55%

mentioning

confidence: 99%

A functional group–guided approach to aptamers for small molecules

Yang

Mitchell

Banerjee

et al. 2023

Science

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“…Moderate dose data for posaconazole suspension suggest that TDM is valuable for improving efficacy, assessing treatment failure due to suboptimal drug exposure and minimising possible azole‐induced toxicity 12 . Currently, the main methods for the determination of posaconazole blood concentrations are chromatography, mass spectrometry, bioassay and fluorescence assays 99–102 . Bioassays and fluorometric assays are less commonly used in clinical practice because of their low selectivity and susceptibility to ambient temperature, pH and other conditions.…”

Section: Discussionmentioning

confidence: 99%

“…12 Currently, the main methods for the determination of posaconazole blood concentrations are chromatography, mass spectrometry, bioassay and fluorescence assays. [99][100][101][102] Bioassays and fluorometric assays are less commonly used in clinical practice because of their low selectivity and susceptibility to ambient temperature, pH and other conditions.…”

Section: Discussionmentioning

confidence: 99%

Progress of triazole antifungal agent posaconazole in individualized therapy

Shu

Shi

Yang

et al. 2022

Clinical Pharmacy Therapeu

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What is known and objective: Posaconazole is the second-generation triazole antifungal agent with widespread clinical application. Posaconazole exposure is influenced by various factors such as drug interactions, disease state and diet, resulting in a high interindividual variability in many patients and failure to ensure therapeutic efficacy. Therefore, it is necessary to conduct individualized therapy on posaconazole to ensure the efficacy and safety of treatment.Methods: Articles were identified through PubMed using the keywords such as "posaconazole," "therapeutic drug monitoring" and "Population pharmacokinetics" from 1 January 2001 to 30 April 2022. Results and discussion: In this paper, we review the individualized treatment studies of posaconazole from the three aspects of therapeutic drug monitoring, population pharmacokinetic study and Monte Carlo simulation to provide reference for in-depth individualized posaconazole dosing studies. What is new and conclusion: This review suggests that therapeutic drug monitoring should be performed in patients taking posaconazole to adjust the dosage and assess the efficacy and cost-effectiveness of posaconazole under different clinical conditions and different dosing regimens through Monte Carlo simulations. In the future, a more detailed delineation and comprehensive examination of posaconazole PPK for specific populations requires further study.

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Therapeutic Drug Monitoring

2020

Fundamentals of Analytical Toxicology

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To study the appropriateness of phlebotomy for digoxin therapeutic drug monitoring (TDM) in outpatients, we conducted a retrospective chart review, a computer search of all previous TDM testing, and a questionnaire of all outpatients (n = 86) who had serum digoxin determinations between April 10 and April 28, 1992 (585 tests). In patients who took digoxin at the same time daily (40 patients, 300 tests), 52% of tests were performed on inappropriate samples drawn within 6 h of the last dose. No patient who took digoxin after 1700 had inappropriate tests. Phlebotomy for serum digoxin determinations before distribution of digoxin is complete is a common problem in outpatients, leading to clinically uninterpretable test results. Postdistribution sampling can be assured by nighttime dosing, and this recommendation has been implemented at our hospital. INDEXING TERMS: blood sampling #{149} pharmacokinetics Digoxin is one of the most widely prescribed drugs for both inpatients and outpatients /1], and digoxin serum concentration is the most commonly ordered therapeutic drug monitoring (TDM) test in the US. Digoxin serum concentrations have been shown to be useful in corroborating the clinical diagnosis of digoxin toxicity as well as correlating with therapeutic effects of digoxin [2, 3]. Digoxin pharmacokinetics are complex hut well characterized (for a review see [4]). For oral dosing of digoxin, rapid absorption occurs in the intestine /4/; reaching distributional equilibrium after a digoxin dose requires at least 8 h, the time at which the semilog plots of plasma and tissue concentrations vs time reach terminal linear and parallel slopes [4, 5]. Samples obtained within 8 h after a digoxin dose can be very misleading as an index of digoxin response /4/.

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A Novel, Rapid, and Low-Volume Assay for Therapeutic Drug Monitoring of Posaconazole and Other Long-Chain Azole-Class Antifungal Drugs

Cited by 9 publications

References 16 publications

A functional group–guided approach to aptamers for small molecules

A functional group–guided approach to aptamers for small molecules

Progress of triazole antifungal agent posaconazole in individualized therapy

Therapeutic Drug Monitoring

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