Published online Mar 6. Find articles by Ju-Seop Kang. Find articles by Min-Ho Lee. Author information Copyright and License information Disclaimer. Corresponding author. Tel: , Fax: , rk. This article has been cited by other articles in PMC. Abstract Therapeutic drug monitoring TDM is the clinical practice of measuring specific drugs at designated intervals to maintain a constant concentration in a patient's bloodstream, thereby optimizing individual dosage regimens.
Keywords: Drug monitoring, therapeutic; Pharmacokinetics. Open in a separate window. Figure 1. Process for reaching dosage decisions with therapeutic drug monitoring. Table 1 Indications for requesting plasma drug concentrations. Figure 2. Figure 3.
Figure 4. Table 2 Criteria that a drug should satisfy for plasma concentration measurements to be useful. Table 3 Method validation issues. Figure 5. References 1. Cost-effectiveness of therapeutic drug monitoring: a systemic review. Ther Drug Monit. Birkett DJ. Pharmacokinetics made easy: therapeutic drug monitoring. Aust Prescr. Therapeutic drug monitoring in pediatrics: a need for improvement.
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Best practice in therapeutic drug monitoring. Lesson 1: introduction to pharmacokinetics and pharmacodynamics. In: Dipiro JT, editor. Concepts in Clinical Pharmacokinetics. Bethesda: ASPS; Bochner F, Tonkin A.
The clinician and therapeutic drug monitoring in the s. Med J Aust. ABC of monitoring drug therapy: making the most of plasma drug concentration measurements. Aronson JK, Hardman M. ABC of monitoring drug therapy: measuring plasma drug concentrations. Clinical utility of plasma digoxin measurements. Med Interne. Plasma digoxin concentration fluctuations associated with timing of plasma sampling and amiodarone administration.
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The value of therapeutic drug monitoring to the practising physician: an hypothesis in need of testing. Sjoqvist F. Interindividual differences in drug responses: an overview. Variability in Drug Therapy. New York: Raven Press; A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out.
This usually takes less than five minutes. Depending on the type of medicine you are taking, you may need to schedule your test for before or after you take your regular dose. There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly. Your results will show if medicine levels in your blood are in a range that is medically helpful but not dangerous.
This is called the therapeutic range. The range varies depending on the type of medicine and your own health needs. If your results are not in this range, your provider may need to adjust your dosages. If your dosages are changed, you may get repeated tests until your medicine levels fall into the therapeutic range.
Vancomycin is a glycopeptides antibiotic and it produces its effect by inhibiting the cell wall synthesis. It is considered a time dependent antibiotic. Vancomycin is indicated in treatment of complicated infections such as endocarditis, osteomyelitis , meningitis and hospital acquired pneumonia caused by Staphylococcus aureus. Most accurate and practical method for monitoring efficacy is by evaluating trough serum vancomycin concentration. Approximately after fourth dose the trough levels of vancomycin should be obtained at steady state prior to administration of the next dose.
TDM of vancomycin is specially required when high or aggressive dosing is being done to treat complicated infections or when the treatment is of prolonged duration. Its evaluation is also necessary when the patient is renally compromised or when vancomycin is being administered with aminoglycoside its levels are also monitored in patients with altered pharmacokinetics and in patients with burns and edema because of abnormal volume of distribution.
Antibiotic Level, Ticarcillin Rifampin and Metabolite, Serum or Plasma Ethambutol Quantitative, Serum or Plasma Gentamicin, Peak Level Gentamicin, Trough Level Optimal range: 0.
Sulfonamides, Quantitative, Serum or Plasma Vancomycin, Peak Level Vancomycin, Random Level Vancomycin, Trough Level Antibody Therapeutic Tests. Adalimumab Activity and Neutralizing Antibody Adalimumab Activity with Reflex to Antibody Infliximab or Biosimilar Activity and Neutralizing Antibody Infliximab or Biosimilar Activity with Reflex to Antibody Use to evaluate response failure to vedolizumab therapy Use to adjust dosage. Vedolizumab Quantitation with Antibodies, Serum Aids in management of individuals receiving natalizumab therapy.
Natalizumab Antibodies Anticoagulant Tests. Use to monitor treatment efficacy of low-molecular-weight heparin. Therapeutic range based on enoxaparin brand low-molecular-weight heparin. Use to monitor warfarin treatment. Warfarin Quantitative, Serum or Plasma Carbamazepine Epoxide and Total Carbamazepine,11 epoxide: Therapeutic range proposed : 0.
Carbamazepine, Free and Total, Serum or Plasma Carbamazepine, Total Clobazam and Metabolite, Quantitative, Serum or Plasma Ethosuximide, Serum or Plasma Felbamate Gabapentin Keppra Levetiracetam Lacosamide, Serum or Plasma Lamotrigine Therapeutic range: 2. Perampanel Quantitative, Serum or Plasma Phenobarbital Pregabalin, Serum or Plasma Rufinamide, Serum or Plasma Topiramate Valproic Acid Vigabatrin Quantitative, Serum or Plasma Zonisamide Phenytoin, Free and Total Valproic Acid, Free and Total Phenytoin, Free Therapeutic range: Use to optimize drug therapy and monitor patient adherence This test can be ordered when fosphenytoin is administered.
Phenytoin Use to optimize drug therapy and monitor patient adherence The active metabolite of primidone is phenobarbital. Primidone and Metabolite Antidepressant Tests. Antidepressant Panel Quantitative, Urine Tricyclic Antidepressants, Quantitative, Serum or Plasma Amitriptyline and Nortriptyline, Serum or Plasma Bupropion and Metabolite, Serum or Plasma Citalopram Quantitative, Serum or Plasma
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