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Encyclopedia of Health and Medicine

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162 Drugs<br />

substitution maintains therapeutically acceptable<br />

consistency for potency <strong>and</strong> EFFICACY.<br />

The current st<strong>and</strong>ard <strong>of</strong> practice calls for close<br />

monitoring <strong>of</strong> blood concentrations until the drug<br />

reaches the desired therapeutic level, with routine<br />

blood tests to monitor blood concentration over<br />

time, when the person begins taking a new drug,<br />

<strong>and</strong> when there is a change in the person’s health<br />

status (including significant change in body<br />

weight). Once the blood concentration <strong>of</strong> the drug<br />

reaches a steady state with the drug at a therapeutic<br />

level the NTI becomes less <strong>of</strong> a concern.<br />

COMMONLY PRESCRIBED<br />

NARROW THERAPEUTIC INDEX (NTI) DRUGS<br />

aminophylline carbamazepine clindamycin<br />

clozapine cyclosporin digoxin<br />

disopyramide isoproterenol levothyroxine<br />

lithium metaproterenol phenytoin<br />

prazosin primidone procainamide<br />

quinidine valproic acid warfarin<br />

See also BIOAVAILABILITY; BIOEQUIVALENCE; ORANGE<br />

BOOK, THE; PEAK LEVEL; THERAPEUTIC LEVEL; THERAPEU-<br />

TIC WINDOW; TROUGH LEVEL.

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