Cristina Mihaela Ghiciuc *, Sava Dumitrescu **
* Asist. Dr. Cristina Mihaela Ghiciuc, Catedra de Farmacologie, UMF “Gr. T. Popa” Iași
** Prof. Dr. Sava Dumitrescu, Catedra de Farmacologie, UMF “Gr. T. Popa” Iași
Abstract
Therapeutic drug monitoring refers to the individualization of dosage by maintaining plasma or blood drug concentrations within therapeutic window, in order to determine an optimum benefit for the patient. Therapeutic drug monitoring is useful in the following situat ions: investigation of a inadequate therapeutic response, prevention or confirmation of toxic effects , evaluation of a chronic therapy, severe drug intoxications, understand of pharmacokinetics and pharmacodinamic of new drugs. Therapeutic drug monitoring is necessary for drugs with: reversible effect on receptors, total blood concentration directly related to the target drug concentraiotn, narrow therapeutic index, high interindividual variability, therapeutic effect difficult to monitorise, a sensitive and easy analytical method for the drugs: Phenobarbital, Amitriptiline , lmipramine , Nortriptiline , Lithium, Digoxin, Amiodarone, Lidocaine, Quinidine, Flec ainide, Mexiletin, Propranolol, Teophylline, Methotrexate, Ciclosporine, Gentamicin, Tobramicin, Netilmicin, Amikacin, Vancomicine. Therapeutic drug for monitoring for antiretrovirals is still controversial. Usually, therapeutic blood monitoring may be realized from total blood or plasma samples, but may be used also other type of biological samples (urine, saliva, hair etc). The data must be correlated with the general state of the patient; a special attention must be given to associate diseases. Importance has the decision of the necesity to use or not the therapeutic drug monitoring for a certain patient, in order to obtain a maximum benefit for him and a favorable cost-efficiency rapport. In conclusion, the treatment efficacy may be considerably improved using therapeutic drug monitoring and individualizationof a therapy based on pharmacokinetic data.