Therapeutic Drug Monitoring

Assay techniques
1. Assays using antibodies
  1. FPIA, RIA, EMIT
  2. Advantages: rapid, less training, small sample size
  3. Disadvantages: less specific (cross-react)
2. chromatography techniques
  1. GC, HPLC
  2. Advantages: better specificity; good for research applications
  3. Disadvantages: equipment costly, needs bigger sample size, not as quick as antibody methods, need more training
Blood Sampling
1. correct time- usually trough level
2. correct type of tube
3. correct handling and storage
Assay requirements
1. Reproducible, accuracy and precision
Interpreting TDM result clinically
1. look at result AND patient response
2. Consider patient factors- e.g. disease, age
3. consider assay used and sample collection/handling
4. sample taken at correct time?
5. what is dosage regimen and when last dose was taken
good candidate for TDM
1. good correlation between concentration and effect
2. therapeutic range defined
3. narrow therapeutic index
4. large interindividual variability
5. effect cannot be measured by simpler method

Resource summary

	Created by jenny schneider almost 11 years ago