Therapeutic Drug Monitoring Flashcards
What is Therapeutic Drug Monitoring (TDM)?
Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drugs at selected intervals to maintain a constant blood concentration within the desired therapeutic range by adjusting the dose.
What is the goal of Therapeutic Drug Monitoring?
The goal of TDM is to monitor blood concentration, balancing clinical benefits with fewer side effects by adjusting the dose for positive treatment outcomes.
What does TDM help individualize?
TDM helps individualize drug dosage through plasma or blood concentrations within the targeted therapeutic window for maximum efficacy and safety.
How does TDM assist in patient compliance?
TDM helps monitor patient compliance by identifying non-compliant patients, which could lead to treatment failure.
Why is TDM important for drug safety?
TDM is used to avoid adverse drug effects, increase efficacy, and decrease side effects by monitoring the safety of drug doses.
What does TDM help prevent in patients?
TDM helps prevent hospitalization, organ damage, and death by monitoring narrow therapeutic range drugs, toxicity, and inter-patient variability.
What is the therapeutic index (TI)?
The therapeutic index (TI) is an indicator used to achieve the safety-efficacy balance of a drug, and it varies widely among different drugs.
What characterizes drugs with a wide therapeutic index?
Drugs with a wide therapeutic index are considered very safe, requiring very high doses to reach a toxic level.
What is the risk with drugs that have a narrow therapeutic index?
Drugs with a narrow therapeutic index have a small difference between toxic and therapeutic doses, meaning small changes in dose or concentration can lead to serious therapeutic failure or adverse effects.
Can small changes in dose or concentration be dangerous for drugs with a narrow therapeutic index?
Yes, small changes in dose or concentration for drugs with a narrow therapeutic index can lead to serious therapeutic failure or adverse effects.
Which conditions can result from drugs with a narrow therapeutic index?
Serious therapeutic failure or adverse effects such as epilepsy, anticoagulant issues, immunosuppression, and aminoglycosides antibiotics can result from drugs with a narrow therapeutic index.
What is the first step when initiating Therapeutic Drug Monitoring for a patient?
The first step is to determine an initial dosage regimen based on the patient’s clinical condition, characteristics such as age, weight, organ function, and other medications they may be taking.
How is a steady state achieved in Therapeutic Drug Monitoring?
A steady state is typically reached after five half-lives of the drug, assuming it follows a first-order reaction.
What needs to be measured to monitor Therapeutic Drug Concentration?
The drug concentration circulating in the blood should be measured at specific intervals during treatment.
When should drug concentration be measured in relation to dosing?
Drug concentration should be measured before redosing and during the treatment to ensure the desired therapeutic effect is achieved.
What role do pharmacokinetics and pharmacodynamics play in TDM?
Pharmacokinetics and pharmacodynamics help clinicians decide whether dose adjustments are needed to maintain or achieve the desired therapeutic effect.
What is Area Under the Curve (AUC) guided monitoring?
AUC-guided monitoring requires the collection of multiple blood samples over the dosing interval (12-18 samples) and is considered the most accurate strategy, though expensive and time-consuming for patients.
What is Abbreviated Area Under the Curve (AUC) guided monitoring?
Abbreviated AUC-guided monitoring involves limited sampling (2-4 hours over the dosing interval), which is more convenient and less expensive than full AUC monitoring.
What is Trough Concentration Guided Monitoring (C0)?
Trough concentration guided monitoring involves collecting a sample immediately before the next dose, at the time when the concentration is expected to be lowest within the therapeutic range, and is commonly used to assess efficacy.
When is Peak Concentration Guided Monitoring (Cmax) used?
Peak concentration guided monitoring involves collecting a sample when the peak concentration is expected, and it is used to assess the drug’s efficacy.
