1 Introduc

Apuntes

1 Introduction to Therapeutic Drug Monitoring Amitava Dasgupta, PH D CONTENTS 1. Introduction 2. Implications of Therapeutic Drug Monitoring 3. Characteristics of Drugs Require Monitoring 4. Factors Affecting Serum Drug Concentrations 5. Effect of Disease on Serum Drug Concentrations 6. Drug Metabolism and Clearance in Neonates, Children, and Elderly 7. Therapeutic Drug Monitoring of Individual Drugs 8. Conclusions Summary Therapeutic drug monitoring is defined as measuring serum concentrations of a drug in a single or multiple time points in a biological matrix after a dosage. The purpose of therapeutic drug monitoring is to individualize the dosage to achieve maximum efficacy of a drug and at the same time minimize adverse drug reactions. Therapeutic drug monitoring has clinical importance for drugs with a narrow therapeutic window, such as various anticonvulsants, cardioactive drugs, theophylline, immunosuppressants, tricyclic antidepressants, antiretroviral drugs, certain antibiotics, and neoplastic drugs. Altered pharmacokinetic parameters are observed for many drugs in disease states including hepatic and renal impairment, cardiovascular disease, thyroid dysfunction, and cyst...