Therapeutic drug monitoring of mexiletine at a large academic medical center:

摘要

Introduction:The therapeutic trough range for mexiletine (0.8–2?mcg/mL) was largely established in the setting of arrhythmia prophylaxis following myocardial infarction.Objective:Describe the usage patterns of serum mexiletine concentrations and the impact of these concentrations on mexiletine dosing in modern practice for ventricular arrhythmia treatment.Methods:A single-center, retrospective analysis was conducted using the electronic medical record to identify serum mexiletine concentrations drawn between December 2004 and December 2014. The primary endpoint was the incidence of mexiletine concentrations drawn as troughs. Secondary outcomes included the incidence of mexiletine concentrations that prompted a dose change, association between adverse events and elevated concentrations, and association between baseline characteristics and mexiletine concentrations.Results:A total of 237 individual concentrations were included for analysis with 109 (46.0%) drawn appropriately as trough concentrations. Only ...