TDM Flashcards
What is therapeutic index?
Ratio between the toxic and therapeutic doses of medications.
What are sources of variability in patient drug responses?
- Pharmacokinetics (dose and plasma concentration)
- Pharmacodynamic (drug concentration at receptor and response)
What are the factors affecting TDM?
- State of Health
- Interference of other medications
- Genetic makeup
- Age
When is steady state?
After 4 half lives
What blunts fluctuations
slow absorption of drug
What cardiac drugs do you monitor? When do take levels?
Digoxin
One determination is needed within 6 - 24 hours after the previous dose.
What ABX drugs do you monitor? When do take levels?
- Aminoglycosides
- Vancomycin
What Antiepileptic drugs do you monitor? When do take levels?
- Phenobarbital
- Phenytoin
- VPA
- Carbamazepine
- Levitiracetam
What Bronchodilator drugs do you monitor? When do take levels?
- Caffeine
- Theophylline
- IV Infusion: Wait 30 minutes after loading dose and resample at 4 - 8 hour intervals
- IV Bolus: Draw 30 minutes after infusion has completed
- Oral Dose: Measurement of peak concentrations is recommended, with sample drawn 4 hours following dose for slow release preparations, or 2 hours after dose for regular forms
What Immunosuppresant drugs do you monitor? When do take levels?
- Cyclospornie
- Tacrolimus
- Sirolimus
- Mycophenolate motfetil
What Anti Cancer drugs do you monitor? When do take levels?
Methotrexate
What Psychiatric drugs do you monitor? When do take levels?
- Lithium
- VPA
What drugs do you draw just prior to next dose?
- Carbamazpeine
- Aminoglycosides (trough)
- Phenytoin
- Phenobarbitol
- Quinidine
- Vancomycin (trough)
When do you draw for amino glycoside IV peak?
Infuse over 30 minutes, wait 30 minutes after infusion is complete to collect.
When do you draw for IM therapy of Aminoglycoside?
1 hour after injection
