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TDM
Is the application of
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Minimum information should be
available for successful
interpretation of a conc .
measurement
1.Time of sample collection
2.An accurate dosage regimen (drug dose,
frequency, route of administration
and formulation used)
3.Total duration of therapy (if steady
state has been achieved)
4.Patient details (age, sex, weight,
creatinine clearance..........
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How to determine a dosage
regimen?
From published recommended
dosages:
ØPharmacopoeia
ØNational formulary
ØPhysician’s desk reference
ØManufacturer’s data sheets
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Dose-response relationship in
clinical practice is not the
same as in experimental
Effect studies:
%
Dose
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A drug could be given as
Continuous I.V.
Repetitively (by
infusion mouth)
• Steady state conc. Of • Cpss will fluctuate
drug in plasma between peaks and
(Cpss) is reached troughs (within
and stay constant dosing interval)
Plasma Plasma
conc . conc .
Number of
Number of t1 / 2
t1 / 2 Sampling for drugs with short t1/2
Sampling once Immediately before next
reach steady
Pharmasri dose (trough conc)
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Is the amount of time
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Time required for the drug conc. in
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Volume of blood (plasma)
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Proportion of drug which
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Is the amount of drug
administered to maintain a
steady state concentration
MAINTENANCE DOSE
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Is the amount of drug
L o a d in g d o se = V X d e sire d
co n ce n tra tio n
apparently distributes
1.Pka of drug
2.Partition coefficient of drug in fatty
tissue
3.Regional blood flow
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Why TDM is not widely
used?
• For some drugs other parameters are
available
• It is very costly
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