Therapeutic drug monitoring

Framing

Therapeutic drug monitoring applies to agents with a narrow therapeutic index or significant pharmacokinetic variability (digoxin, lithium, aminoglycosides, vancomycin, and anticonvulsants among the classic examples) - measuring plasma concentration to keep dosing within an evidence-based target range that balances efficacy against toxicity, with correct sample timing relative to the dose being essential to valid interpretation
Monitoring extends beyond the drug level itself to organ function relevant to clearance (renal/hepatic) and to specific adverse effects known to occur with each monitored agent

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