Lec.5 Definitions

Question 1

The process of ensuring optimum medication
therapy aiming at maximizing therapeutic
benefits and minimizing/eliminating noxious
side effects.

Answer 1

Clinical Drug Monitoring

Question 2

A systematic process of collecting patientspecific information, assessing medication therapies to identify medicationrelated problems, developing a prioritized list of medication-related problems,
and creating a plan to resolve them.

Answer 2

Medication Therapy Review

Question 3

A comprehensive record of the patient’s
medications (prescription and nonprescription medications, herbal products,
and other dietary supplements).

Answer 3

Personal Medication record

Question 4

A patient-centric document containing a

list of actions for the patient to use in tracking progress for self-management.

Answer 4

Medication-related action plan

Question 5

Consultative services and pharmacist
interventions to address medication-related problems. When necessary, the
pharmacist refers the patient to a physician or other health care professional.

Answer 5

Intervention and/or referral

Question 6

MTM services are documented and
communicated to the prescriber and patient in a consistent manner, and a
follow-up MTM visit is scheduled based on the patient’s medication-related
needs, or the patient is transitioned from one care setting to another.

Answer 6

Documentation & Follow up

Question 7

Drug-related problems (DRPs) to be

monitored

Answer 7

Medication adherence/compliance problems
 Lack of therapeutic effectiveness
 Adverse drug reactions
 Medication errors
 Drug interactions
Appropriateness of medication therapy ( 5 rights)

Question 8

Drug monitoring approaches for

optimizing medication therapy

Answer 8

• Monitoring clinical response
  (e. g. antihypertensive drugs, analgesics)
• Monitoring clinical laboratory tests
  (e. g. anticoagulants, hypoglycemic agents, lipid-lowering drugs)
• Monitoring therapeutic biomarkers
  (e. g. immunosuppressive therapy and cancer chemotherapy)
• Monitoring genetic variations ( & monitor TDM)
  (e. g. rapid and slow metabolizers

Question 9

The use of drug concentration measurements in body fluids
(mostly serum, plasma, blood) as an aid to the management of
drug therapy for the cure, alleviation, or prevention of disease

Answer 9

Therapeutic drug monitoring

Question 10

Drug selection criteria for TDM?

Answer 10

-Low therapeutic index (narrow therapeutic window) or steep dose-response curve (e.g. theophylline)
-Wide inter-individual pharmacokinetic variability (poor
correlation between dose and clinical effect) (e.g. phenytoin)
-No good clinical markers of effect (e.g. prophylaxis of seizure
(phenytoin) or mania (lithium)) or toxic effects cannot be
detected until irreversible (e.g. Aminoglycoside antibiotics)
-Good plasma drug concentration-clinical effects correlation
-Well-established therapeutic range
-Availability of cost-effective drug assay

Question 11

Drugs whose biological half-life is longer

than their plasma half-life.

Answer 11

Hit & Run Drugs

Question 12

Define a steady-state?

Answer 12

Rate of drug input = Rate of drug elimination

Question 13

is the pre-dose or trough concentration

Answer 13

optimum sampling time

Question 14

Fluctuations in plasma concentration between doses depend on

the ______

Answer 14

dosage interval (dosing frequency)

Question 15

Optimum Drug Therapy?

Answer 15

TDM + Clinical Observation

Question 16

Plasma drug concentration should be interpreted in

light of:

Answer 16

• Dose regimen
• Clinical response
• Individual patient factors