Therapeutic Drug Monitoring (TDM): An Aspect of Clinical Pharmacology and Pharmacy Practice

Abstract

Therapeutic drug monitoring or TDM is the clinical pharmacology of measuring specific drugs at designated intervals to uphold a constant level of drug in a patient’s blood circulation, thereby optimizing individual dosage regimens. TDM becomes necessary only for the categories of drug 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. On the basis of drug dose and plasma drug concentration or between concentration and therapeutic effects the assumption of TDM is done. TDM initiates when the drug is first prescribed, and involves determining an initial dosage regimen appropriate for the clinical condition and such patient individuality such as age, weight, organ function, and concomitant drug therapy. Certain factors need to be considered while interpretation of concentration measurement which include sampling time in relation to drug dose, dosage history, patient response, and the desired medicinal targets. Use of appropriate concentrations of drug to manage medications to optimize clinical outcomes in patients in various clinical conditions is the primary goal of TDM.

Keywords: Therapeutic drug monitoring, pharmacokinetics, toxicity, analytical methodology

Cite this Article

Iswar Hazarika. Therapeutic drug monitoring (TDM): an aspect of clinical pharmacology and pharmacy practice. Research & Reviews: Journal of Pharmacology. 2015; 5(3): 27–34p.