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Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood at designated intervals to ensure the drug concentration stays within a therapeutic range. This monitoring is crucial for optimizing individual dosage regimens, enhancing therapeutic efficacy, and minimizing drug-related toxicity. TDM is vital for drugs with narrow therapeutic windows, significant variability in pharmacokinetics, and a clear correlation between plasma levels and...
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How to define the therapeutic limits.

Alberto Cester1, Monica Maselli, Francesco Bolzetta

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Physicians must balance scientific knowledge with conscience to determine therapeutic limits in aging patients, especially in cardiology. Advanced assessment tools and patient resilience are crucial for personalized treatment decisions, moving beyond age-based restrictions.

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Area of Science:

  • Geriatrics
  • Cardiology
  • Medical Ethics

Background:

  • Increased life expectancy necessitates re-evaluating therapeutic limits.
  • Physicians face daily decisions balancing science, conscience, and patient limits.
  • Aging populations, particularly in cardiology, require comprehensive risk and multidimensional assessments.

Purpose of the Study:

  • To define the therapeutic limit in the context of advanced age and technological progress.
  • To emphasize the need for individualized, multidimensional patient assessment.
  • To explore the evolving approaches in geriatric cardiology and cardiac surgery.

Main Methods:

  • Utilizing advanced tools for multidimensional patient assessment.
  • Evaluating patient resilience and ability to overcome critical phases.
  • Fostering interdisciplinary collaboration and respecting individual professionalism.

Main Results:

  • Chronological age is no longer an insurmountable barrier in cardiology/cardiac surgery.
  • Less or minimally invasive techniques have expanded treatment possibilities for older adults.
  • Individualized assessment, including resilience, is key to determining appropriate therapy.

Conclusions:

  • Therapeutic limits must be determined individually, considering risk, resilience, and advanced assessment.
  • Modern cardiology and cardiac surgery have overcome many age-related limitations.
  • A humble, competent, and collaborative approach is essential for optimal geriatric care.