•THERAPEUTIC DRUG MONITORING (TDM)
•Why?
•Dose optimization
•When?
•Drugs with narrow therapeutic index
•Drugs with steep dose-effect curve
•Drugs with difficult determination of overdose due to unclear clinical symptoms
•Chronic administration
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•entiepileptics, antiarythmics, cardioactive glycosides, lithium
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•When is not necessary?
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• drugs with wide TI
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• when optimal dosing can be estimated from therapeutic response
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•diuretics
•peroral antidiabetics
•anticoagulants
•antitusics
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•General rules for TDM
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•1/ suspicion of OVERDOSING AND INTOXICATION
•2/ INSUFFICIENT THERAPEUTIC RESPONSE
•3/ when we have to decide if UNWANTED EFFECTS are symptoms of disease itself or symptoms of drug
toxicity
•4/ CHRONIC ADMINISTRATION

•Clinical interpretation of drug plasmatic concetration
•Conditions of monitoring:
•1/ knowledge of real administered dose
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•2/ right time for sample withdrawn
• in steady state
• suitable time distance from last dose
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•3/ quality of analytic method
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•Task 2
•1.Create graphs using semilogaritmic plot
•2. Extrapolate a line from the elimination part of curves
•3. Read c1 and c2 in t1 and t2 from extrapolated lines
•4. Calculate ke and other parameters
•5. Compare your calculations with results obtained from Kinetica software
•6. Calculate difference in ke values (your value/Kinetica x 100%)