Therapeutic Drug Monitoring and Its Analytical Methods - An Educational Review
Ravinandan AP*, Sanatkumar Nyamagoud, Vinayak Ragi and Mohammed Mustafa G
Published: December 19, 2022
DOI: 10.55162/MCMS.04.089
Abstract
“Concept of Therapeutic Drug Monitoring: Need of the Hour in Indian Healthcare System”.
Therapeutic drug monitoring (TDM) is defined as “the clinical laboratory measurement of a chemical parameter that, with appropriate medical interpretation, will directly influence drug prescribing procedures”.It is the clinical practice of measuring specific drugs/medicines at selected intervals to maintain a constant concentration in a patient's bloodstream, thereby optimizing individualized dosage regimens. Generally, in TDM amount of drug concentration will be measured by using a suitable analytical method and the dose and therapeutic range adjusted accordingly [1].
TDM aims to improve pharmacotherapy by maximizing therapeutic efficacy and minimizing adverse events. In these instances, the blood concentration of the drug is a better predictor of the required/ desired effect(s) than the dose [2]. TDM is grounded on the principle that, for some drugs, there is a close relationship between the plasma/serum level of the drug and its clinical effect. Where such a relationship does not occur. Presently, TDM is of little value, where a clinical endpoint is either easier to measure or more reliable than the serum drug concentration assessment [3]. The fundamental procedures necessary for the quantification of the drug in the body through measuring the drug concentrations in the body fluids such as plasma and urine including recovery from body fluids, tissues, and organs, separation from the biological components, identification of the species concerned, and finally quantification [4].