Volume 17, Issue 39, January - June, 2023

Therapeutic drug monitoring: Fundamentals and optimization

Ahmed S Ali^♦1,2, Mahran S Abdel-Rahman^3,4, Mohammed A Bazuhair¹

¹Dept of Pharmacology, Faculty of Medicine, King Abdulaziz University, KSA
²Dept of Pharmaceutics, Faculty of Pharmacy, Assiut University, Egypt
³Dept of Pharmacology, Faculty of Medicine, Assiut University, Egypt
⁴Dept of Pharmacology and toxicology, Faculty of Pharmacy- Sphinx University - New Assiut City, Egypt

^♦Corresponding author
Dept of Pharmacology, Faculty of Medicine, King Abdulaziz University, KSA and Dept of Pharmaceutics, Faculty of Pharmacy, Assiut University Egypt

ABSTRACT

Background: Therapeutic drug monitoring (TDM) is a clinical pharmacokinetic service aimed to optimize the pharmacotherapy of certain drugs such as those with a narrow therapeutic range and complicated pharmacokinetics. It involves the determination of serum drug concentration (SDC) in samples taken at the appropriate time from the patient. Factors to consider when interpreting SDC include pharmacokinetic and pharmacodynamic drug characteristics, patient response, specific lab results and the desired therapeutic target. To be cost-effective the service should be optimized. Area covered: This review highlights TDM fundamentals and provides suggestions for its optimization. It covers the rationale of requesting drug level, the design of the request form, optimal sampling and analytical tools. It provides guidelines for the appropriate interpretation of drug levels. Conclusion: TDM should be optimized by conducting relevant research; using PK software and integrating TDM with pharmacogenomics.

Keywords: Therapeutic drug monitoring, Clinical pharmacokinetics, optimal dosing, drugs with the narrow therapeutic range

Drug Discovery, 2023, 17(39), e15dd1015

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DOI: https://doi.org/10.54905/disssi.v17i39.e15dd1015

Published: 24 March 2023