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Related Concept Videos

Therapeutic Drug Monitoring: Overview and Classification01:16

Therapeutic Drug Monitoring: Overview and Classification

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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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Total internal reflection fluorescence microscopy or TIRF is an advanced microscopic technique used to visualize fluorophores in samples close to a solid surface with a higher refractive index, such as a glass coverslip. TIRF only allows fluorophores in proximity to the solid surface to be excited. When light from a medium with a lower refractive index (such as air) hits the glass coverslip at a critical angle, the light undergoes total internal reflection stead of passing through the glass.
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Therapeutic Drug Monitoring: Affecting Factors01:29

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Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
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Tandem mass spectrometry is a technique that uses multiple mass analyzers in series to obtain a higher selectivity and reduce chemical noise during analyte detection. Instruments with multiple analyzers separated by an interaction cell enable secondary fragmentation and selected study of the fragment ions.Secondary fragmentations occur in the interaction cell and can be induced by various factors. Fragmentation induced by collision with inert gases, such as N2, Ar, He, etc., is called...
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Transcranial Direct Current Stimulation tDCS for Memory Enhancement
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TDM is dead. Long live TCI!

Nick Holford1, Guangda Ma1, David Metz2

  • 1Department of Pharmacology & Clinical Pharmacology, University of Auckland, Auckland, New Zealand.

British Journal of Clinical Pharmacology
|June 17, 2020
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Target Concentration Intervention (TCI) offers superior precision over traditional Therapeutic Drug Monitoring (TDM). Evidence suggests TCI should replace TDM in modern healthcare for better patient outcomes.

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Area of Science:

  • Pharmacology and Clinical Pharmacy
  • Drug Dosing Strategies
  • Evidence-Based Medicine

Background:

  • Therapeutic Drug Monitoring (TDM) has been a cornerstone of drug therapy.
  • Target Concentration Intervention (TCI) emerged two decades ago, proposing enhanced precision.
  • TCI links pharmacokinetic and pharmacodynamic principles for individualized dosing.

Purpose of the Study:

  • To evaluate the theoretical benefits of TCI compared to TDM.
  • To review clinical trial evidence supporting TCI's superiority.
  • To advocate for the adoption of TCI in contemporary clinical practice.

Main Methods:

  • Systematic review of theoretical frameworks for TCI and TDM.
  • Analysis of clinical trial data comparing TCI and TDM efficacy.
  • Examination of pharmacokinetic and pharmacodynamic principles in drug dosing.

Main Results:

  • TCI demonstrates greater precision in achieving target drug concentrations.
  • Clinical evidence supports improved patient outcomes with TCI over TDM.
  • The integration of pharmacokinetics and pharmacodynamics is more effectively utilized in TCI.

Conclusions:

  • TCI offers significant clinical advantages over traditional TDM.
  • The digital age facilitates the implementation and benefits of TCI.
  • TDM should be superseded by TCI for optimized drug therapy management.