Therapeutic drug monitoring program

ABSTRACT

A therapeutic drug monitoring [TDM] program was initiated usimg clinical pharnacokinetic principles TDM was established in one patient -care clinical pharm acokinetic laboratory [LAB] which serves 350 medical / surgical beds and outpatient departments. Clinical pharmacokinetic guidelines regarding when and how to draw levels for TDM were made available and posted in each ward directives for LAB personnel were developed and rationale for each of the directive is explained. A clinical pharmacokineticist was actively involved in processing, interpreting, recommending and interacting with the clinician in 1996,5181 levels were received by the LAP from various wards. Those levels that would not yield any useful information towards bettei patient -care were not analyzed and termed as canceled. Toxic levels were those whose values were greater than the therapeutic range. Canceled and toxic levels were approximately 10% and 8% respectively. Antiepileptics represents 48% and gentamicin 21.5% of the total levels received by the LAB. Using basic pharmacokinetic concepts and abundance of clinical pharmacokinetic knowledge of various agents, allows the pharmacists to taks an active role in predicting proper dosage regimens and effectively using resources for better patient-care. TDM provides hospital pharmacists with an opportunity to use clinical pharmacokinetics in everyday practice