What is Therapeutic Drug Monitoring (TDM)

What is Therapeutic Drug Monitoring (TDM)

·         Therapeutic drug monitoring (TDM) is defined as the use of drug concentration measurements in plasma as an aid to the management of drug therapy for the cure, alleviation or prevention of disease.


·         TDM enables the assessment of the efficacy and safety of a particular medication in a variety of clinical settings.


·         Therapeutic Drug Monitoring aims to individualize therapeutic regimens for optimal patient benefit and avoid both subtherapeutic and toxic plasma drug concentrations.

o   Specifi cally, TDM is a practice applied to a small group of drugs in which there is a direct relation between plasma drug concentration and pharmacological response

o   Therefore, close relationship between the plasma level of the drug and its clinical effect is essential.

o   If such a relationship does not exit TDM is of little value.

o   The measurement of plasma level is justified only when the information provided is of potential therapeutic benefit.


·         In summary, TDM process involves the following;

o   Administration of a predetermined dose of drug

o   Collection of blood samples

o   Determination/measurements of blood samples using analytical procedures

o   Evaluation of Clinical effect of drug

o   Developmen/Adjustment of dosage regimen

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References

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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