Criteria for Therapeutic Drug Monitoring

·         The drug in question has a narrow therapeutic range, eg: Lithium, phenytoin, and digoxin

·         A direct relationship exists between the drug or drug metabolite levels in plasma and the pharmacological or toxic effects,

·         The therapeutic effect can not be readily assessed by the clinical observation,

·         Large individual variability in steady state plasma concentration exits at any given dose

·         Appropriate analytic techniques are available to determine the drug and metabolite levels

·         Drugs for which relationship between dose and plasma concentration is unpredictable, e.g Phenytoin

·         Non compliance

·         Therapeutic failure

·         Major organ failure

·         Prevention of adverse drug effects


Wells BG, DiPiro J, Schwinghammer T (2013), Pharmacotherapy Handbook (6th Ed). New York, NY: McGraw-Hill.

DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey ML, (2008): Pharmacotherapy: A Pathophysiologic Approach (7th ed): New York, NY: McGraw-Hill.

Katz M D., Matthias KR., Chisholm-Burns M A., Pharmacotherapy(2011) Principles & Practice Study Guide: A Case-Based Care Plan Approach: New York, NY: McGraw-Hill.

Schwinghammer TL, Koehler JM (2009) Pharmacotherapy Casebook: A Patient-Focused Approach (7th ed): New York, NY: McGraw-Hill.

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