Therapeutic drug monitoring applications

Levomepromazine Direct immersion PDMS (100) GC-NPD (LOQ 5 ng/mL) Application to therapeutic drug monitoring Kruggel and Ulrich, 2000(18)... 

Applications of High-Throughput Analysis in Therapeutic Drug Monitoring... 

Determination of risperidone and 9-hydroxyrisperi-done in human plasma by high-performance liquid chromatography Application to therapeutic drug monitoring in Japanese patients with schizophrenia. J Pharm Biomed Anal 19(3 ) 595-601. 

Therapeutic drug monitoring has four major clinical applications ... 

Aravagiri M, Marder SR, Van Putten T, et al. Determination of risperidone in plasma by high-performance liquid chromatography with electrochemical detection application to therapeutic drug monitoring in schizophrenic patients. J Pharm Sci 1993 82 447-449. 

Albers LJ, Ozdemir V. Pharmacogenomic-guided rational therapeutic drug monitoring conceptual framework and application platforms for atypical antipsychotics. Curr Med Chem 2004 11 297-312. 

Although therapeutic drug monitoring may seem an ideal application for HPLC it is not uncommon to find that an HPLC assay is developed in the first instance sinee this ean be done relatively rapidly but if the assay proves clinieally useful then an immunoassay whieh will take mueh longer to develop will be perfected. This same scenario has also been observed with other assays sueh as specifie proteins sinee immunoassays are considered preferable when high throughput is necessary. When more than one compound is required, sueh as a drug and its metabolites or all of the 20 plus amino aeids in plasma, or the three prineipal eatecholamines. 

The use of GC was first included in the United States Pharmacopoeia (USP) in the sixteenth edition in 1960, and became an official method of the British Pharmacopoeia (BP) in 1968. GC has found widespread use in pharmaceutical analysis by virtue of its applications to purity and control analysis of raw materials, content and quality assessment of dosage forms (including product stability), and in the quantitative measurement of drugs in biological fluids. The latter application is important for therapeutic drug monitoring, pharmacokinetic studies, and bioavailability assessments. In fact, in a survey on GC use, ° a major application of this technique was in the field of pharmaceuticals. 

These two optical techniques are particularly applicable to methods measuring the precipitate formation in antigen antibody reactions (see Chapter 9). Turbidimetry is used in several chemistry immunoassay systems for therapeutic drug monitoring and specific protein assays. Details of turbidimetry and nephelometry are discussed in Chapter 3. 

Alak AM. Measurement of tacrolimus (FK506) and its metabohtes A review of assay development and application in therapeutic drug monitoring and pharmacokinetic studies. Ther Drug Monit 1997 19 338-51. 

Kalian BD, Murgia MG, Slaton J, Napoli K. Potential applications of therapeutic drug monitoring of sirolimus immunosuppression in clinical renal transplantation. Ther Drug Monit 1995 17 672-5. 

A health system can own and operate a centralized therapeutic drug monitoring service (TDMS) to focus on the application of clinical pharmacokinetics to the care of patients within the system. 

Fig. 1. Overview of pharmacology. Pharmacokinetics (PK) relates to the effect of the body on the drug and principally includes bioavailability, distribution, and clearance. Pharmacodynamics (PD) relates to drug concentration and receptor availability. The response to drug concentrations may be therapeutic, subtherapeutic, or toxic, depending on considerations involving both PK and PD principles. From Linder MW, Valdes R Jr. Pharmacogenetics fundamentals and applications. Therapeutic drug monitoring and toxicology. AACC 1999 20(l) 10 with permission.)...

Fig. 5. Nomenclature system for designating enzymes and alleles of cytochrome P450. From Linder MW, Valdes R Jr. Pharmacogenetics fundamentals and applications. Therapeutic drug monitoring and toxicology. AACC 1999 20(l) 11 with permission.)...

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