Characteristics of Drugs Subject To Therapeutic Drug Monitoring
In pharmacotherapy, many medications are used without monitoring of blood levels, as their dosage can generally be varied according to the clinical response that a patient gets to that substance. In a small group of drugs, this is impossible, as insufficient levels will lead to undertreatment or resistance, and excessive levels can lead to toxicity and tissue damage.
Indications for therapeutic drug monitoring include:
- There is an experimentally determined relationship between plasma drug concentration and the pharmacological effect.
- Knowledge of the drug level influences management.
- There is narrow therapeutic window
- There are potential patient compliance problems.
- The drug dose cannot be optimised by clinical observation alone.
Examples of drugs analysed by therapeutic drug monitoring:
- Aminoglycoside antibiotics (gentamicin)
- Antiepileptics (such as carbamazepine, phenytoin and valproic acid)
- Mood stabilisers, especially lithium citrate
- Antipsychotics (such as pimozide and clozapine)
Therapeutic drug monitoring can also detect poisoning with above drugs, should the suspicion arise.
Read more about this topic: Therapeutic Drug Monitoring
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