Introduction

Therapeutic drug monitoring is defined as measuring serum concentrations of a drug in a single or multiple time points in a biological matrix after a dosage. The purpose of therapeutic drug monitoring is to individualize the dosage to achieve maximum efficacy of a drug and at the same time minimize adverse drug reactions. Therapeutic drug monitoring has clinical importance for drugs with a narrow therapeutic window, such as various anticonvulsants, cardioactive drugs, theophylline, immunosuppressants, tricyclic antidepressants, antiretroviral drugs, certain antibiotics, and neoplastic drugs. Altered pharmacokinetic parameters are observed for many drugs in disease states including hepatic and renal impairment, cardiovascular disease, thyroid dysfunction, and cystic fibrosis. Altered drug disposition also occurs in pregnant women. Therapeutic drug monitoring helps to identify
such altered drug disposition, and dosage adjustment can be made for proper management of the patient to avoid adverse reactions. Therefore, therapeutic drug monitoring is cost effective in heath care.

Contents

1 Introduction to Therapeutic Drug Monitoring

2 Monitoring Free Drug Concentration

3 Analytical Techniques for Measuring Concentrations of Therapeutic Drugs

in Biological Fluids

4 The Pre-Analytical Phase of Drug Testing: From Specimen Collection to Analysis

5 Effect of Hemolysis, High Bilirubin, Lipemia, Paraproteins, and System Factors

on Therapeutic Drug Monitoring

6 Digoxin: So Many Interferences and How to Eliminate Them

7 Interferences with Measurement of Anticonvulsants

8 Pitfalls in Measuring Antidepressant Drugs

9 Immunosuppressive Drugs: Pharmacokinetics, Preanalytic Variables, and Analytical Considerations

10 Therapeutic Drug Monitoring in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome

11 Pharmacogenomics and Personalized Medicine: Issues and Methodology

12 Interference of Heterophilic and Other Antibodies in Measurement of Therapeutic Drugs by Immunoassays

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