Advances in liquid chromatography and related methodologies for therapeutic drug monitoring

In this article the merits of current liquid chromatography (LC) columns and techniques are reviewed, to include the following topics: (1) a brief introduction to rational therapeutic drug monitoring (TDM) to justify drug measurements; (2) selected recent survey results from the College of American Pathologists (CAP) to establish the current utilization pattern of LC for TDM in the USA; (3) LC analyses of major classes of drugs--antiarrhythmics, antidepressants, antiepileptics, antimicrobials, cyclosporine, and others--with emphasis on analysis of these drugs in human serum or plasma, by focusing on the less usual, reversed-phase functional groups such as CN and phenyl, and by the use of "mini" columns, silica and polymeric columns, the emphasis being reduced on the well-established C-18 columns; (4) high-speed LC; (5) various approaches of direct sample analysis--solvent extraction, automated sample processing, column switching, micro-injections, micellar chromatography, electrochemical detection with photolytic derivation, and the internal surface reversed-phase column of Pinkerton; (6) microbore LC drug analysis; (7) clinical chiral separation; and (8) overall conclusions.