Therapeutic Drug Monitoring

Junaid, Toluwalope; Wu, Xuemei; Thanukrishnan, Harisudhan; Venkataramanan, Raman

doi:10.1016/b978-0-12-814276-9.00030-1

Cited by 7 publications

(7 citation statements)

References 12 publications

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“…TDM biological matrix choice is based on the studied and proven relationship between drug concentration in the sample matrix and its concentration at the site of action or toxicity (33). Plasma is the most employed biological matrix as plasma exposure to a given drug usually correlates with the efficacy and toxicity of that drug; however, TDM based on blood sampling requires the set-up of an outpatient clinic where nursing and technical support from blood drawn to plasma separation can be provided (33). These issues, combined with the need for accurate temperature-controlled sample C o p y r i g h t E d r a S .…”

Section: Methodological Advances In Tdm: Dried Blood Spotsmentioning

confidence: 99%

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Therapeutic drug monitoring for the cancer patient: challenges and opportunities

et al. 2021

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Therapeutic Drug Monitoring (TDM) is a valuable option to improve the efficacy and safety of cancer drugs. Here, members of the Cancer Pharmacology Working Group of the Italian Society of Pharmacology describe and discuss some paradigms of TDM, moving from best known examples (TDM for fluoropyrimidines) to new opportunities as applied to last generation targeted drugs (TDM for tyrosine kinase inhibitors and monoclonal antibodies). Advances in sampling and TDM-oriented genotyping are also discussed. Based on these paradigms, this Working Group concludes that TDM should be widely exploited in both investigational and real world settings, contributing to the optimal usage of drugs.

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Section: Methodological Advances In Tdm: Dried Blood Spotsmentioning

confidence: 99%

“…p . A storage, make plasma sampling time-consuming and expensive (33). In recent years alternative matrices and sampling techniques have gained attention because of their wider applicability and convenience in certain therapeutic contexts.…”

Section: Methodological Advances In Tdm: Dried Blood Spotsmentioning

confidence: 99%

Therapeutic drug monitoring for the cancer patient: challenges and opportunities

et al. 2021

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“…[1,2] Reliance on repetitive doses of one-size-fits-all pills not only results in low patient compliance, but even when taken as prescribed, results in fluctuations of drug concentration around a target zone, resulting in poor clinical outcomes for the patients. [3][4][5] Controlled release drug delivery systems provide a platform to maintain blood plasma levels of drugs without the need for repeating dosing. [6] Polymer-based controlled release systems have already entered the market and are being used to treat a wide range of diseases, from cancers to infections, with a controlled systemic or local drug dosage.…”

Section: Introductionmentioning

confidence: 99%

Mechanistic Computational Modeling of Implantable, Bioresorbable Drug Release Systems

et al. 2023

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Implantable, bioresorbable drug delivery systems offer an alternative to current drug administration techniques; allowing for patient‐tailored drug dosage, while also increasing patient compliance. Mechanistic mathematical modeling allows for the acceleration of the design of the release systems, and for prediction of physical anomalies that are not intuitive and might otherwise elude discovery. This study investigates short‐term drug release as a function of water‐mediated polymer phase inversion into a solid depot within hours to days, as well as long‐term hydrolysis‐mediated degradation and erosion of the implant over the next few weeks. Finite difference methods were used to model spatial and temporal changes in polymer phase inversion, solidification, and hydrolysis. Modeling revealed the impact of non‐uniform drug distribution, production and transport of H+ ions, and localized polymer degradation on the diffusion of water, drug, and hydrolyzed polymer byproducts. Compared to experimental data, the computational model accurately predicted the drug release during the solidification of implants over days and drug release profiles over weeks from microspheres and implants. This work offers new insight into the impact of various parameters on drug release profiles, and is a new tool to accelerate the design process for release systems to meet a patient specific clinical need.This article is protected by copyright. All rights reserved

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“…The measurement of drug concentrations allows the dose to be adjusted to an adequate therapeutic range [ 6 ]. There are several indications to perform TDM, such as drugs with a narrow therapeutic index (NTI), high variability or unpredictability between drug dose and plasma concentration, situations where there is knowledge of the clinical effect and/or toxicity related to concentration, adverse effects defined by overdose or insufficient dose, and availability of equipment and personnel for the processing and interpretation of the results of TDM [ 1 , 7 , 8 ]. NTI is used to identify those drugs where small differences in dose or blood concentration may lead to dependence, therapeutic failure, or side effects.…”

Section: Introductionmentioning

confidence: 99%

Carbapenem Therapeutic Drug Monitoring in Critically Ill Adult Patients and Clinical Outcomes: A Systematic Review with Meta-Analysis

et al. 2021

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Drug monitoring is one strategy of antibiotic stewardship to face antimicrobial resistance. This strategy could have a determinant role in critically ill patients treated with carbapenems to overcome pharmacokinetic variability, reduce the risk of subtherapeutic dosage or toxicity, and reduce the risks inherent to treatment. However, the effectiveness of therapeutic drug monitoring (TDM) is unknown. This paper aims to identify TDM effectiveness in critically ill patients treated with carbapenems. English and ClinicalTrials.gov databases were searched to identify relevant studies evaluating carbapenem TDM. Randomized controlled trials (RCTs) and comparative cohort studies were selected for inclusion if they compared carbapenem TDM to standard care in adult critically ill or sepsis/septic shock patients. The primary outcome was mortality. Secondary outcomes included morbidity, clinical cure, microbiological eradication, antimicrobial resistance, drug-related side effects, and achievement of target plasma concentrations. Overall, performing carbapenem TDM was not associated with a decrease in mortality. However, it could be evidence for a relationship with clinical cure as well as target attainment. Some studies found favorable outcomes related to clinical and microbiological responses, such as lower procalcitonin levels at the end of the monitored therapy compared to standard care. For the primary and secondary outcomes analyzed, strong evidence was not identified, which could be due to the size, risk of bias, and design of selected studies.

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Therapeutic Drug Monitoring

Cited by 7 publications

References 12 publications

Therapeutic drug monitoring for the cancer patient: challenges and opportunities

Therapeutic drug monitoring for the cancer patient: challenges and opportunities

Mechanistic Computational Modeling of Implantable, Bioresorbable Drug Release Systems

Carbapenem Therapeutic Drug Monitoring in Critically Ill Adult Patients and Clinical Outcomes: A Systematic Review with Meta-Analysis

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