THERAPEUTIC DRUG MONITORING

Question 1

What is Therapeutic drug monitoring?

Answer 1

Therapeutic drug monitoring is generally defined as the clinical laboratory measurement of a chemical parameter that, with appropriate medical interpretation, will directly influence drug prescribing procedures.

Question 2

IMPORTANCE OF THERAPEUTIC DRUG MONITORING

Answer 2

•Drug efficacy
•Drug compliance
•Drug-drug interaction
•Avoidance of toxicity
•Therapeutic cessation indication

Question 3

Process of TDM

Answer 3

1. A diagnosis is made
2. A drug is selected
   3.

Question 4

Indications of plasma drug concentration

Answer 4

• Monitoring compliance
• Individualizing therapy (during early therapy and during dosage changes)
• Diagnosing undertreatment
• Avoiding toxicity
• Monitoring and detecting drug interactions
• Guiding withdrawal of therapy

Question 5

Pharmacokinetic variability

Answer 5

1. compliance
2. dosing or medication errors
3. Tissue and body fluid mass and volume
4. Drug interactions

Question 6

Pharmacodynamic variability

Answer 6

1. Drug receptor status
2. Genetic factors
3. Drug interactions
4. Tolerance

Question 7

Criteria that a drug should satisfy for plasma concentration measurements to be useful

Answer 7

Difficulty in interpreting clinical evidence of therapeutic or toxic
effects A good relationship between the plasma drug concentration and
the therapeutic or toxic effect, or both
A low toxic: therapeutic ratio
Dose does not metabolize to important active metabolites

Question 8

ANALYTICAL PROCEDURE IN THERAPEUTIC DRUG MONITORING

Answer 8

•Timing of blood sampling
•The type of blood sample
•The measurement technique
•The interpretation of results

Question 9

Analytical methods available are

Answer 9

•High-performance liquid chromatography (HPLC).
•Fluorescence polarization immunoassay (FPIA),
•Enzyme-linked immunosorbant assay (ELISA).