Unit 6 Therapeutic Drug Monitoring Flashcards
Define TDM
Measures the amount of a drug in a patient’s blood, serum, or other bodily fluids. This helps determine if the drug is reaching therapeutic levels
- helps adjust dosages based on individual factors like metabolism, age, and health conditions
Drug characteristics analyzed by TDM
Pharmacokinetic Properties
- analyze how a drug moves through the body like absorption, distribution, metabolism and elimination
- Helps determine the best dosage, route of administration and potential drug interactions
Therapeutic range
- find the right drug level for each patient, balancing effectiveness with safety
Individual variability
- process drugs differently based on age, genetics and health
TDM indication
- patients who are at high risk for drug-related problems
- underlying health conditions
- used to monitor drug levels in patients who are not responding to treatment or experiencing adverse effects
Drug characteristics analyzed in TDM
- concentration ( amount of drug present in the blood )
- half of life ( time it takes for the
drug’s concentration to decrease by half ) - time to peak ( parameter reflects how quickly a drug reaches its maximum concentration )
- volume of distribution ( drug distributes throughout the body, affecting its concentration in target
tissues )
TDM sample collection and analysis
- patient preparation ( Patients should fast before sample collection as instructed )
- sample medication ( Blood samples are drawn from a vein following
standard procedures. The time of sample collection and the last dose of medication ) - sample transportation ( Samples
may require refrigeration or freezing during transport ) - analysis in laboratory ( specialized techniques such as chromatography or immunoassays, to determine the drug concentration in the blood )
- results interpretation ( interpreted by a healthcare professional )
TDM analytical methodology
- Chromatic technique
- high-performance liquid chromatography (HPLC) and gas
chromatography (GC) separate and quantify drugs in biological samples - Immunoassays
- immunosorbent assays (ELISA) and
radioimmunoassays (RIA) to detect and measure specific drugs using antibodies - Mass spectrometry
- identify and quantify drugs by measuring their mass-to-charge ratio - Combination Method
- ensure accuracy and reliability in drug analysis
Factors affect TDM result
Patient-Specific Factors
Age
- Gender
- Weight
- Kidney and Liver
- Function
- Genetic Factors
Drug-Related Factors
- Pharmacokinetic
- Properties
- Dosage Form
- Route of Administration
- Drug Interactions
Analytical Factors
- Method Used
- Sample Collection
- Laboratory Quality
Control
Environmental Factors
- Diet
- Stress
- Smoking
- Alcohol Consumption
Pharmacy assistant’s role in TDM
- collecting patient information, scheduling appointments, and coordinating sample collection
- ensure accurate labeling and storage of TDM samples
Pharmacokinetic and pharmacodynamic in TDM
Pharmacokinetic
- how the body absorbs, distributes, metabolizes, and eliminates drugs
Pharmacodynamic
- explores how drugs affect the body
Interpretation of TDM result
THERAPEUTIC RANGE
- TDM results are compared to a therapeutic range
- effective and safe
- Drug concentration too low > not effective
Concentration high > toxic / side effects
INDIVIDUAL VARIABILITY
- individual patient’s medical history, medications, and clinical presentation
Optimize drug therapy with TDM
- Personalized drug dosage
- Tailored medication regimens based on individual needs - Effective treatment
- Ensuring therapeutic drug levels for optimal outcomes - Reduce adverse effects
- Minimizing potential risks and side effects - Improve patient compliance
- Enhancing patient understanding and adherence to medication plans
Challenges and limitations
- variability in drug metabolism
- patient compliance and factors
- limited availability of TDM services
- cost and time considerations
