Unit 1- Therapeutic Drug Monitoring

Question 1

Therapeutic Drug Monitoring

Answer 1

Clinical practice of measuring plasma levels to optimize individual dose regimens

Question 2

Use of TDM

Answer 2

Drug has a narrow therapeutic range, therapeutic effect cannot be measured by clinical observation, direct relationship between plasma drug concentration and toxicity, availability of cost effective assay

Question 3

Populations Needing TDM

Answer 3

Extremes of age, dosing problems, multiple medications, unusual PK

Question 4

TDM Advantages

Answer 4

Maximize drug efficacy, avoid toxicity, identify therapeutic failure, cost effective

Question 5

TDM Information Required

Answer 5

History of drug administration, plasma drug concentrations, clinical status, time of sampling, physiological data, concurrent drug therapy

Question 6

Pharmacokinetic Variables

Answer 6

Absorption, clearance, and volume of distribution

Question 7

Pharmacodynamic Variables

Answer 7

Maximum efficacy in target tissue and potency

Question 8

Absorption and TDM

Answer 8

Over or under dosage can be detected by drug measurements

Question 9

Most important factor of drug fate

Answer 9

Clearance

Question 10

Efficacy and TDM

Answer 10

Avoid further administration of a drug when concentrations are greater than EC50 because all pharmacological responses are saturated

Question 11

Potency and TDM

Answer 11

Measure drug in a patient that is receiving normal dosage but not improving

Question 12

Target Concentration Strategy

Answer 12

Optimizing dosage in an individual based on pharmacokinetics and pharmacodynamics

Question 13

Target Concentration Strategy Steps

Answer 13

Choose target concentration, predict volume of distribution and clearance, measure patient’s response and drug concentration, revise volume of distribution or clearance, adjust dose

Question 14

Dosage Adjustment

Answer 14

New dose = old dose x target plasma drug concentration/observed plasma drug concentraiton