Therapeutic drug monitoring

Therapeutic drug monitoring measures drug concentrations in blood or other biological samples to guide dosing, especially when exposure varies widely or the safe and effective range is narrow.

Pharmacokinetics: The study of how the body absorbs, distributes, metabolizes, and eliminates drugs. These processes determine the concentration measured and how it changes after a dose.
Vancomycin: An antibiotic used to treat serious infections caused by Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus. Concentration-guided dosing helps balance antimicrobial exposure against kidney toxicity.
Therapeutic index: A measure comparing the dose or concentration that causes toxicity with that producing a desired effect. A narrow margin between benefit and harm strengthens the case for monitoring.
Pharmacogenomics: The study of how genetic variation influences drug response, metabolism, and treatment outcomes. Genotype predicts aspects of drug handling, while monitoring measures exposure after treatment begins.
Pharmacodynamics: The study of how drugs affect the body and how those effects relate to drug exposure. A blood concentration matters only through its relationship to benefit and harm.
Aminoglycoside: A class of antibiotics that inhibit bacterial protein synthesis and can damage the kidneys and inner ear. Monitoring helps adjust dosing while limiting concentration-related toxicity.
Blood plasma: The liquid component of blood in which cells and many dissolved substances are suspended. Many drug assays report concentrations measured in plasma rather than whole blood.
Dose titration: The gradual adjustment of a dose in response to clinical effects or tolerability. Titration can rely on symptoms or outcomes without measuring drug concentrations.
Steady state (pharmacology): A condition in which drug input and elimination balance, producing a repeating concentration pattern across dosing intervals. Samples near steady state often support interpretation of ongoing therapy.
Lithium (medication): A mood-stabilizing medication used mainly to treat bipolar disorder. Its narrow therapeutic range and variable clearance make serum levels central to safe dosing.

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