MONITORINGDRUGTHERAPY-UniversityofPeradeniya：监测药物疗法-Peradeniya大学.pptVIP

MONITORING DRUG THERAPY LAKSHMAN KARALLIEDDE OCTOBER 2011 Drug Therapy Monitoring Definition Drug therapy monitoring, also known as Therapeutic Drug Monitoring (TDM), is a means of monitoring drug levels in the blood. Purpose TDM is employed to measure blood drug levels so that the most effective dosage can be determined, with toxicity prevented. TDM is also utilized to identify noncompliant patients (those patients who, for whatever reason, either cannot or will not comply with drug dosages as prescribed by the physician). Precautions Because so many different factors influence blood drug levels, the following points should be taken into consideration during TDM: the age and weight of the patient; the route of administration of the drug; the drugs absorption rate, excretion rate, delivery rate, and dosage; other medications the patient is taking; other diseases the patient has; the patients compliance regarding the drug treatment regimen; and the laboratory methods used to test for the drug. REASONS FOR MONITORING DRUG TREATMENT TO SEE WHETHER THERE IS A THERAPEUTIC RESPONSE TO ASSESS DRUG TOXICITY TO ASSESS COMPLIANCE Examples of easily measurable therapeutic responses Urine output in patients treated with desmopressin for diabetes insipidus Intraocular Pressure in patients treated with timolol eye drops for glaucoma Muscle fatigue in patients treated with pyridostigmine for myasthenia gravis Monitoring drug treatment Want our treatments to work Do not wish treatments to cause harm. Monitoring drug treatment is one way of seeing that a treatment works, while protecting the patient from adverse drug effects. For many patients and many treatments clinical evaluation is sufficient (e.g. Measuring blood pressure in a patient on antihypertensive treatment). When therapeutic goals cannot always be directly observed, monitoring may require blood tests to determine whether therapeutic levels have been reached.e.g the measurement of the international normalise