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Related Concept Videos

Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

210
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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Therapeutic Drug Monitoring: Drug Analysis Methods01:26

Therapeutic Drug Monitoring: Drug Analysis Methods

190
Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood or body tissues to tailor drug therapy effectively. This monitoring is critical for managing drugs with narrow therapeutic indices like digoxin and phenytoin, ensuring they are both safe and effective. For instance, monitoring theophylline levels in asthma patients involves precision and sensitivity to adjust doses according to individual responses to therapy, ensuring efficacy and...
190
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...
335
Antipsychotic Drugs: Therapeutic Uses and Side Effects01:21

Antipsychotic Drugs: Therapeutic Uses and Side Effects

817
Antipsychotic drugs primarily block dopamine and serotonin receptors and cholinergic, adrenergic, and histaminergic receptors, thereby reducing hallucinations and delusions in conditions like schizophrenia. However, they can trigger unwanted extrapyramidal effects such as dystonias, Parkinson-like symptoms, and tardive dyskinesia.
Despite these side effects, antipsychotics are used therapeutically for various purposes, including managing schizophrenia, preventing nausea and vomiting, curbing...
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Therapeutic Index01:13

Therapeutic Index

6.7K
The therapeutic index of a drug is a key parameter in pharmacology that quantifies the relative safety of a drug by calculating the ratio between the dose that causes toxicity in half the population (50%) to the dose that proves to be effective for half the population (50%). It provides a spectrum of doses for a particular drug ranging from effective to potentially toxic. To illustrate, consider an anticoagulant agent like warfarin. It possesses a narrow window within its therapeutic index to...
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Cardiovascular Drugs: Classification based on Therapeutic Indications01:18

Cardiovascular Drugs: Classification based on Therapeutic Indications

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Cardiovascular diseases, encompassing a range of conditions, can significantly affect the heart's operations and the overall circulatory system. These conditions impair the heart's ability to pump blood, leading to a deficit in oxygen supply to crucial organs. Anomalies in the heart's electrical system, known as arrhythmias, can cause heartbeats to accelerate or slow down. Usually, heart rates increase during physical activity and decrease while resting or sleeping. However,...
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Related Experiment Video

Updated: Jan 29, 2026

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
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Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS

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Decreasing Tacrolimus Concentrations in Routine Therapeutic Drug Monitoring Data Indicate Adherence to Updated

Anders Larsson1, Johan Saldeen1, Jonathan Cedernaes1

  • 1Department of Medical Sciences, Clinical Chemistry and Pharmacology, Uppsala University, SE-751 85 Uppsala, Sweden.

Biomedicines
|January 28, 2026
PubMed
Summary

Tacrolimus drug levels have steadily declined over 18 years, likely due to safer dosing strategies. Patient medians are a reliable tool for monitoring laboratory quality in therapeutic drug monitoring.

Keywords:
immunosuppressivepatient mediantacrolimustherapeutic drug monitoringtransplantation

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Area of Science:

  • Pharmacology
  • Clinical Chemistry
  • Transplantation Medicine

Background:

  • Tacrolimus is a vital immunosuppressant for preventing organ transplant rejection.
  • Its narrow therapeutic index necessitates precise therapeutic drug monitoring (TDM).
  • High interindividual variability in tacrolimus pharmacokinetics complicates dosing.

Purpose of the Study:

  • To analyze long-term tacrolimus concentration trends.
  • To investigate potential seasonal influences on drug levels.
  • To assess the utility of patient medians for laboratory quality control.

Main Methods:

  • Retrospective analysis of 113,735 tacrolimus whole-blood samples (2006-2024).
  • Immunoassay methods from Hitachi, Abbott, and Roche were used.
  • Calculation of annual patient medians and percentiles; assessment of monthly variations.

Main Results:

  • Tacrolimus concentrations showed a consistent 20-30% decrease over the study period.
  • No significant seasonal variation in tacrolimus concentrations was detected.
  • Monthly drug level distributions remained stable throughout the year.

Conclusions:

  • Population tacrolimus levels have declined significantly over two decades.
  • This trend suggests evolving clinical practices, possibly dose minimization.
  • Patient medians offer a robust method for quality assurance in TDM.