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Therapeutic Drug Monitoring in the Elderly
Jorge G. Ruiz1, Samir Array, David T. Lowenthal
1Extended Care/Geriatrics, Mountain Home Veterans Affairs Medical Center, Johnson City, TN, USA.
American Journal of Therapeutics
|December 1, 1996
Summary
Therapeutic drug monitoring (TDM) guides medication doses using plasma drug levels. Despite limited data, TDM is crucial for managing elderly patients due to complex health conditions and polypharmacy.
Area of Science:
- Pharmacology
- Geriatrics
- Clinical Pharmacy
Background:
- Therapeutic drug monitoring (TDM) involves using repeated plasma drug concentration measurements to guide patient dosing regimens.
- TDM aids in confirming drug poisoning, toxicity, diagnosing adverse drug reactions, and verifying patient compliance.
- Limited data exists on TDM specifically in the elderly population.
Purpose of the Study:
- To explore the utility and implications of therapeutic drug monitoring in the management of elderly patients.
- To infer the role of TDM in older adults based on existing pharmacokinetic and pharmacodynamic data.
Main Methods:
- Review of pharmacokinetic and pharmacodynamic studies in older populations.
- Analysis of TDM applications in younger individuals for comparative insights.
- Inference of TDM's role in the elderly based on general principles and available data.
Main Results:
- Elderly patients frequently present with chronic conditions, polypharmacy, and drug interactions.
- Adverse drug reactions in the elderly can manifest atypically.
- Despite limitations, TDM appears to be a valuable tool for optimizing drug therapy in this demographic.
Conclusions:
- Therapeutic drug monitoring is an important tool for managing drug therapy in the elderly.
- The unique physiological and clinical characteristics of the elderly necessitate careful consideration of TDM.
- Further research is warranted to establish specific guidelines for TDM in geriatric populations.