European Journal of Biomedical and Pharmaceutical Sciences

THERAPEUTIC DRUG MONITORING (TDM) IN CLINICAL PRACTICES: OVERVIEW

Chinmoyee Deori, Dr. Bitupan Kalita and Dr. Tonushyam Sonowal*

ABSTRACT

Therapeutic drug monitoring (TDM) is a clinical practice that involves regularly measuring specific drug levels in a patient's bloodstream to maintain a consistent concentration, ensuring optimal dosage regimens. While not necessary for most medications, TDM is primarily utilized for drugs with narrow therapeutic ranges, significant pharmacokinetic variability, challenging target concentration monitoring, and those known for causing both therapeutic and adverse effects. The underlying principle of TDM relies on establishing a clear relationship between drug dose, blood or plasma drug concentration, and therapeutic effects. The process begins at the initiation of drug prescription, determining an initial dosage regimen based on factors such as clinical condition, patient characteristics (age, weight, organ function), and concurrent drug therapy. Interpretation of concentration measurements takes into account variables like sampling time relative to drug dose, dosage history, patient response, and the intended therapeutic targets. The ultimate aim of TDM is to optimize clinical outcomes by maintaining appropriate concentrations of challenging-to-manage medications for patients in diverse clinical scenarios.

Keywords: TDM, Clinician, Human Genome Project, Pharmacokinetics.