Pharmacy Practice (09) = Therapeutic Drug Monitoring (TDM) = थेरारापयूटिक ड्रग मोनिटरिंग क्या है

Download "Solution Pharmacy" Mobile App to Get All Uploaded Notes, Model Question Papers, Answer Papers, Online Test and other GPAT Materials - play.google.co...
THERAPEUTIC DRUG MONITORING
Therapeutic drug monitoring (TDM) is the clinical practice of measuring specific drugs at designated intervals to maintain a constant concentration in a patient’s bloodstream, thereby optimizing individual dosage regimens. It is unnecessary to employ TDM for the majority of medications, and it is used mainly for monitoring drugs 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.
NEED OF THERAPEUTIC DRUG MONITORING:
1. The drug in question has a narrow therapeutic range
2. a direct relationship exists between the drug or drug metabolite levels in plasma and the pharmacological or toxic effects
3. The therapeutic effect cannot be readily assessed by the clinical observation,
4. Large individual variability in steady state plasma concentration exits at any given dose
5. Appropriate analytic techniques are available to determine the drug and metabolite levels.
TDM IS UNNECESSARY WHEN:
1. Clinical outcome is unrelated either to dose or to plasma concentration
2. dosage need not be individualized
3. The pharmacological effects can be clinically quantified
4. When concentration effect relationship remains un-established
5. Drugs with wide therapeutic range such as beta blockers and calcium channel blockers.
FACTORS TO BE CONSIDERED DURING THE THERAPEUTIC DRUG MONITORING:
1. Patient data: Age, sex and lean body weight are particularly important for renally cleared drugs because calculation of creatinine clearance rate will depend on these factors.
2. Dosage regimen (dose, dosing frequency and route of administration) and duration of therapy:
3. Sampling time: The serum or plasma concentration of a drug depends on the time when the blood drawn for a TDM assay in relation to the last dose.
4. Indication for therapy: Some of the drugs are recommended for more than one clinical condition. In that case, the dose of the drug is important.
5. Patient adherence: If the concentration of the drug is lower than expected, the possibility of non-adherence should be investigated before a dose increases recommended.
6. Reduced protein binding: Most drugs assay measure total drug concentration (protein bound plus unbound drug) but only unbound drug interacts with p receptors and produces pharmacological action.
7. Drug Interaction: Many patients are on polypharmacy and TDM results should be interpreted considering the status of medicines. For example, patients on digoxin may have exceptional increase in serum digoxin concentration resulting in digoxin toxicity if amiodarone or verapamil are administrated without tapering of digoxin dose.
8. Pathological factors (which may affect the patient's capacity to absorb distribute, metabolize or excrete the drug): Comorbid conditions should be considered before interpreting the TDM results.
9. Medication or sampling errors: For in-patients situations where the TDM result is inconsistent with drug administration records, the possibility of a medication of sampling error should be considered.
10. Laboratory errors: If all other causes of an unexpected result have been ruled out. Laboratory error may be the factor responsible for unexpected results. The laboratory should be asked to repeat the assay or new blood sample should be taken.
Get in touch with the solution by just clicking the following links-
Facebook Group- / solutionpharamcy
Mobile App - play.google.co...
New Channel (Pharmacy Dictionary) / @pharmacydictionary
E-Mail for official and other work - [e-mail]
#solutionpharmacy #Pharmacologyclass #Pharmacognosyvideos #GPAT

[@mrcoolsenpai5791]

Narrow therapeutic index (NTI) drugs are drugs where small differences in dose or blood concentration may lead to serious therapeutic failures and/or adverse drug reactions that are life-threatening or result in persistent or significant disability or incapacity.

[@kishorjadhav5880]

Mam please send to pdf notes and important questions paper telegram

[@solutionpharmacy]

For notes, model question paper, model answer paper,online and offline MCQs Please download our app from play store and go to STORE section and join "Solution BEST ever" course - play.google.com/store/apps/details?id=co.bolton.nqilv

[@umairahmadriyazuddin3286]

Ma'am aap Install Kiya but ye Pharmacy Practice nahi hai ma'am us me subject mughe to perches karna tha but subject nahi hai 10 sub are available but excluding Pharmacy Practice .... ma'am please