Top Journals In Therapeutic Drugs
Therapeutic drug monitoring of concentrations of
drugs in body fluids, usually plasma, can be used during treatment and for diagnostic purposes. The selection of
drugs for therapeutic drug monitoring is important as the concentrations of many
drugs are not clearly related to their effects. For selected
drugs therapeutic drug monitoring aims to enhance drug efficacy, reduce toxicity or assist with diagnosis. Despite its apparent advantages, it has inherent limitations. Some large hospitals have services which provide support with drug monitoring and interpretation of results. Therapeutic drug monitoring (TDM) is a branch of clinical chemistry and clinical pharmacology that specializes in the measurement of medication levels in blood. Its main focus is on
drugs with a narrow therapeutic range, i.e.
drugs that can easily be under or overdosed. TDM aimed at improving patient care by individually adjusting the dose of
drugs for which clinical experience or clinical trials have shown it improved outcome in the general or special populations. It can be based on a priori pharmacogenetic, demographic and clinical information, and/or on the a posteriori measurement of blood concentrations of
drugs (pharmacokinetic monitoring) or biological surrogate or end-point markers of effect (pharmacodynamic monitoring). There are numerous variables that influence the interpretation of drug concentration data: time, route and dose of drug given, time of blood sampling, handling and storage conditions, precision and accuracy of the analytical method, validity of
pharmacokinetic models and assumptions, co-medications and, last but not least, clinical status of the patient.
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