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Plasma Therapeutic Drug Monitoring and Clinical Toxicology

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Recent Advances in Therapeutic Drug Monitoring and Clinical Toxicology

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Abstract

Therapeutic drug monitoring (TDM) is a branch of clinical pharmacology that seeks to optimize and maintain the concentration of medications within the bloodstream. The ability to predict a drug concentration within the serum or plasma following a predetermined dose is essential in treating disease; however, a given dose of a drug may not produce identical serum concentrations between patients due to variations in drug formulation, drug interactions, environmental factors, genetic variation, and renal and hepatic function. Therein lies the risk of undertreatment or overtreatment, particularly in drugs with narrow therapeutics indices. Identifying drug concentrations at steady state using proper measurement techniques specific to the drug of interest is both practical and maximizes safety and efficacy. Of note, pharmacogenetic variation in cytochrome P-450 enzymes between individuals, as well as age-related changes in drug metabolism, further complicates medication dosing. Therapeutic drug monitoring in the context of each patient serves to address these factors and requires collaboration between pharmacy, nursing, and medical teams.

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Authors and Affiliations

  1. University of South Florida Morsani College of Medicine, MD Program, Tampa, FL, USA

    Gregory Fishberger, Nicole Natarelli, Dao Le, Deborah Liaw, Afrin Naz, Caroline Ward & Michael Young

  2. University of South Florida Morsani College of Medicine, Department of Molecular Pharmacology & Physiology, Tampa, FL, USA

    Charles Preuss

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  1. Gregory Fishberger
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Correspondence to Gregory Fishberger .

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  1. Department of Medical Pharmacology, University of Ghana Medical School, Accra, Ghana

    Seth Kwabena Amponsah

  2. USF Health Taneja College of Pharmacy, University of South Florida, Tampa, FL, USA

    Yashwant V. Pathak

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Fishberger, G. et al. (2022). Plasma Therapeutic Drug Monitoring and Clinical Toxicology. In: Amponsah, S.K., Pathak, Y.V. (eds) Recent Advances in Therapeutic Drug Monitoring and Clinical Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-031-12398-6_3

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