Drug Monitoring and Analysis

Therapeutic drug monitoring (TDM) is the clinical practice of measuring specific drugs at designated intervals to maintain a constant concentration in a patient's bloodstream, thereby optimizing individual dosage regimens.

It is used mainly for monitoring drugs with narrow therapeutic ranges, drugs with marked pharmacokinetic variability, medications for which target concentrations are difficult to monitor, and drugs known to cause therapeutic and adverse effects. The process of TDM is predicated on the assumption that there is a definable relationship between dose and plasma or blood drug concentration, and between concentration and therapeutic effects.

Therapeutic drug monitoring (TDM) is generally defined as the clinical laboratory measurement of a chemical parameter that, with appropriate medical interpretation, will directly influence drug prescribing procedures.

Figure: Process for reaching dosage decisions with therapeutic drug monitoring.

Therapeutic Drug Monitoring. The basic assumptions underlying therapeutic drug monitoring are that drug metabolism varies from patient to patient and that the plasma level of a drug is more closely related to the drug's therapeutic effect or toxicity than is the dosage.

Drug therapy, also called pharmacotherapy, is a general term for using medication to treat disease. Drugs interact with receptors or enzymes in cells to promote healthy functioning and reduce or cure illness. Health professionals in this focus area work directly with patients: they may provide care, treatment, counseling and health education information. Sample careers: Registered Nurse, Physician, Respiratory Therapist, Surgical Technician, Physical Therapist, Dental Hygienist, Paramedic, Pharmacist.

The benefits of medicines are the helpful effects you get when you use them, such as lowering blood pressure, curing infection, or relieving pain. The risks of medicines are the chances that something unwanted or unexpected could happen to you when you use them.

Types of drug therapies:

• Antimetabolites.
• Antimitotics.
• Antitumor Antibiotics.
• Asparagine-Specific Enzymes.
• Biosimilars.
• Bisphosphonates.
• Chemotherapy.
• DNA-Damaging Agents (Antineoplastics) and Alkylating Agents.

The practice of therapeutic drug monitoring is based on several disciplines, including pharmacokinetics, pharmacodynamics, and chemical analysis. The impact of the analysis on the determination of pharmacokinetic parameters is not well appreciated. Analytical goals in therapeutic drug monitoring should be established by determining the nature of the problem to be solved, selecting the appropriate matrix and methodology to solve the problem, and developing valid analytical schemes that are performed competently with appropriate quality and interpreted within the framework of the problem.

The availability of new immunoassay and chromatographic methods has led to the revolution in therapeutic drug monitoring. The immunochemical and chromatographic methods both meet the analytical requirements of sensitivity, precision, and accuracy needed for most TDM applications. The technique chosen for any laboratory will depend upon numerous factors such as the availability of personnel and equipment, the time required to perform the assay, the speed with which the clinician needs the results, and the cost and medical benefit to the patient. It is reasonable to assume that the rapid development of new equipment and methodologies will continue to keep therapeutic drug monitoring one of the most interesting and fastest growing areas in clinical medicine.

Media Contact:
Allison Grey
Journal Manager
Journal of Clinical Chemistry and Laboratory Medicine
Whatsapp no.-  +1(504)608-2390
Email: jcclm@molecularbiol.com
Online submission: https://www.scholarscentral.org/submissions/clinical-chemistry-laboratory-medicine.html