Therapeutic Drug Monitoring (TDM)

what is therapeutic range

• the concentration below toxic range + above minimum effective concentration

  • concentration wanted for therapeutic effects w/o toxicities

T/F: There are absolute boundaries for specific therapeutic ranges

• false

  • NO ABSOLUTE BOUNDARIES FOR ANY THERAPEUTIC RANGE

when is TDM commonly used in?

• used in with drugs that have a defined therapeutic range and a low therapeutic index

frequent, lower doses have…

a) less variability between peak and trough

b) more variability between peak and trough

a) less variability between peak and trough

when drawing 2 levels without a dose in between, you want to sample the 2 levels

a) close together

b) as far apart as possible

b) as far apart as possible

try to wait at least ___ half-lives (or longer) after initiating a regimen before obtaining a level

2

to interpret drug levels, you must know…

1. dose given (time)

2. if patient is at steady state

how would changes in gut function affect concentration vs time graph

• shifts the curves to the left or to the right

  • same peaks / troughs but at different times

how does increasing tau (dosing interval) affect peak and trough of a drug?

• decreases trough

• decreases peak