THERAPEUTIC DRUG

MONITORING

Reported by: Calantas, Allyssa Nicole G.

BS Medical Technology 3YS1
  TDM: is defined as the use of drug concentrations in
body fluids as an aid to management of patients
receiving drug therapy for the cure, alleviation or
🤔 What is prevention of disease.
Therapeutic Drug
 It is a tool that can guide clinicians to provide
Monitoring effective and safe drug therapy in the individual
(TDM)? patient
 TDM ensures that a given drug produces maximal
therapeutic benefit and minimal side effects to achieve
a constant serum level of the drug that will be
therapeutic
 Most drugs have a half life independent of their
concentration

 ⚠️ MIXED FUNCTION OXIDASE (MFO) is the

biochemical pathway responsible for the greatest
portion of drug metabolism
 1. The consequences of overdosing and underdosing are
serious.
2. There is small difference between therapeutic and toxic
dose.

3. There is poor relationship between the drug and

☠️ Indications circulating concentrations and therapeutic and toxic
for Therapeutic effects.

Drug Monitoring 4. There is a change in the patient’s physiologic state that

may unpredictably affect circulating drug
concentrations
5. A drug interaction is or may be occuring
6. It helps in monitoring compliance
 TDM Routes of Administration
🏃🏼♀️ Thecirculatorysystemisaconvenientroutethatcaneffectivelydelivermostdrugstoits
siteofaction

 Parenteral Administration
INTRAMUSCULAR INJECTION

• are usually delivered into the gluteal or deltoid

muscles.
• Extreme caution should be observed with gluteal
injections to avoid injury to the sciatic nerve.
• The onset of action with IM administration is relatively
short, usually within several minutes.
 Intravenous (IV)injection
• usually restricted to use in the hospital
• IV injection offers the fastest means of drug
absorption because the drug is delivered
directly into the circulation.
• therefore, the onset of drug action is almost
immediate.
 Inhalation
• involves administration of drug through the nose or
mouth and into the lungs during respiratory inspiration.

• This route is especially useful for the local

administration of drugs into the respiratory tract.
 Oral Administration

 Safest and the most convenient method.

• Oral administration usually requires 30 to 60 minutes before
significant absorption from the GI tract occurs; therefore, the onset of
drug action is delayed.

• Some drugs are irritating to the stomach, administration of such

drugs with sufficient amounts of water or with meals minimizes
gastric irritation.

• Advantage of oral administration is that drugs given orally can be

removed (within the first few hours) by gastric lavage or induced
vomiting.
 Suppository
• These are drugs mixed with a substance that will melt at body
temperature.

• Suppositories are intended for insertion into the rectum, urethra,

or vagina
 Transcutaneous/Transdermal
• A Transcutaneous patch or skin patch is a medicated
adhesive patch that is placed on the skin to deliver a
specific dose of medication through the skin and into
the bloodstream.
❌ Slow effect (prolonged drug action)
Site: Upper arm, chest, mastoid region
📚 REFERENCE
🧠 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC
2687654/

🧠 Clinical Chemistry book by Maria Teresa Rodriguez