[Improving the safety of antipsychotic drugs in children and adolescents by antipsychotic drug concentration measurements using a fingerprick]
Kloosterboer et al.
The finding, in our words
The dried blood spot method via fingerprick showed greater variability than venipuncture for antipsychotic drug concentrations but was feasible in children and adolescents with behavioural problems, and higher risperidone trough concentrations correlated with both increased weight gain and greater effectiveness, enabling definition of a therapeutic window for safer dosing in this population.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
VAMS microsampling found no significant difference from venous blood for tacrolimus in paediatric patients; samples were stable for 14 days, with average difference between paired at-home samples of 0.12 ± 0.94 ng/mL.
A systematic review of dried blood spot sampling for tacrolimus monitoring across adult and paediatric organ transplant recipients demonstrated that reported analytical bias compared with venous sampling fell within acceptable limits across the majority of studies. This supports dried blood microsampling as an accurate approach for decentralised therapeutic drug monitoring.
Guardian-collected capillary dried blood spots were feasible for home monitoring of lamotrigine, and for carbamazepine and valproic acid when conversion factors were applied, with only 4 of 190 comparisons risking a conflicting dose decision and negligible risk of patient harm. Levetiracetam DBS showed high variability against plasma and is recommended only for checking nonadherence, not for dose adjustment.
The validated LC-MS/MS method showed similar pharmacokinetic profiles for albendazole and its metabolites across plasma, whole blood, dried blood spots and Mitra microsamples from hookworm-infected adolescents, supporting microsampling for paediatric pharmacokinetic studies. Mitra extraction proved more robust than dried blood spots during validation and is recommended for future albendazole pharmacokinetic work, despite higher albendazole sulfone concentrations observed in both microsampling devices compared with wet matrices.
A dried blood spot LC-MS/MS method was validated for therapeutic monitoring of carbamazepine, lamotrigine, levetiracetam and valproic acid. Concentrations from dried blood spots correlated strongly with plasma (R² 0.92) across venous and capillary samples, enabling home self-collection and reducing clinic visits for children with epilepsy.