Therapeutic drug monitoring

Question 1

why do we need to monitor serum drug levels

Answer 1

• the usual dose can affect people differently
• changes in patient pysicology such as in pregnanqcy
• toxicity
• bioavailability
• complaiance?

Question 2

what kind of drugs need to be monitored?

Answer 2

• those with large interindivual variations
• those with loe therpetuci indexes
• where clinical benefit related to serum conc

Question 3

why do drugs need to be monitored

Answer 3

the same dose wont work the same in everyone

Question 4

critera for effective drug monitoring

Answer 4

• accurate patient info
• appropriate sample
• accurate analysis
• correct interpresntation
• appropriate response

Question 5

patient info required for dose management

Answer 5

age, sex, weight, renal funtion, pathology, drug being used, dosage used, time scale

Question 6

pharmacogenetics

Answer 6

links differences n genes to drug metabolism

Question 7

pharmacogenomics

Answer 7

study of all genes determining drug behaviour

Question 8

how can genetis affect drugs

Answer 8

poylmorhism of many genes coding for drug metabolise enzyme systes can lead to different indivuuals respondes to drugs

Question 9

deevelopments into Thiopurines

Answer 9

immunosupressant for transplants
certain people cant metabolise this as they dont have the enzyme TPMP and the drug acucmulates becoming toxic
knowing the enzyme phenotype allows dosage tailoring to give therpeutic dose without toxic effects