Monitored Drugs by Category
| Drug Category | Drugs |
|---|---|
| Cardiac drugs | Digoxin, digitoxin, amiodarone, lidocane, quinidine, procainamide, N-acetyl-procainamide (a metabolite of procainamide) |
| Antibiotics | Aminoglycosides (gentamicin, tobramycin, amikacin), vancomycin, chloramphenicol |
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Contents
- 1 What medications require blood work monitoring?
- 2 Which of the following classes of medications usually requires drug level monitoring?
- 3 What are drugs candidate for therapeutic drug monitoring?
- 4 When is therapeutic drug monitoring done?
- 5 What is the need of therapeutic drug monitoring?
- 6 What do you monitor with metformin?
- 7 Why do some drugs need to have their blood levels monitored?
- 8 Which antibiotics require therapeutic drug monitoring?
- 9 Why does digoxin require therapeutic drug monitoring?
- 10 What is a drug trough level?
- 11 Does gentamicin require lab monitoring?
- 12 How is blood concentration measured for drugs?
- 13 How do you monitor medication?
- 14 Why therapeutic monitoring of anticonvulsant medication is important?
- 15 What are therapeutic levels?
What medications require blood work monitoring?
Examples of common drugs that can require monitoring are:
- Blood thinners (warfarin )
- Diabetes medicines (insulin )
- Seizure medicines (phenytoin, carbamazepine )
- Heart medicine (digoxin )
Which of the following classes of medications usually requires drug level monitoring?
The most commonly monitored drugs are probably carbamazepine, valproate and digoxin. However, there is little evidence that monitoring concentrations of anticonvulsants improves clinical outcomes when the drugs are used to treat mood disorders. Table 1shows some of the drugs that meet these criteria.
What are drugs candidate for therapeutic drug monitoring?
Examples of drugs widely analysed for therapeutic drug monitoring: Aminoglycoside antibiotics (gentamicin) Antiepileptics (such as carbamazepine, phenytoin and valproic acid) Mood stabilisers, especially lithium citrate.
When is therapeutic drug monitoring done?
TDM is also used to identify drug-drug or food-drug interactions and to monitor patient compliance, status during decontamination or detoxification, and changes in drug concentrations related to aging, pregnancy, or clinical status. TDM should be performed once a drug has reached steady-state concentration.
What is the need of therapeutic drug monitoring?
Therapeutic drug monitoring (TDM) is testing that measures the amount of certain medicines in your blood. It is done to make sure the amount of medicine you are taking is both safe and effective. Most medicines can be dosed correctly without special testing.
What do you monitor with metformin?
Obviously, patients with abnormalities need more frequent monitoring to guide therapeutic interventions. Drug-specific monitoring is also necessary (eg, serum creatinine and vitamin B12 in patients taking metformin, serum transaminases for patients taking a TZD).
Why do some drugs need to have their blood levels monitored?
These tests are used to monitor blood levels of drugs that have a narrow range in which the drug is effective but not toxic. In addition, some drugs require monitoring because the amount of drug given does not correlate well with the amount of drug that may reach the blood.
Which antibiotics require therapeutic drug monitoring?
Therapeutic drug monitoring of aminoglycosides ( e.g. gentamicin, tobramycin and amikacin ) has become standard clinical practice. Whilst the purpose of this was initially to minimize toxicities, increasingly the dosing regimens and TDM targets are specified to maximize efficacy.
Why does digoxin require therapeutic drug monitoring?
Digoxin is a cardioactive drug with a narrow therapeutic range. Therapeutic drug monitoring is essential in clinical practice for efficacy as well as to avoid digoxin toxicity. Immunoassays are commonly used in clinical laboratories for determination of serum or plasma digoxin concentrations.
What is a drug trough level?
The trough level is the lowest concentration in the patient’s bloodstream, therefore, the specimen should be collected just prior to administration of the drug. The peak level is the highest concentration of a drug in the patient’s bloodstream.
Does gentamicin require lab monitoring?
Patients who require treatment with gentamicin often require monitoring, which includes peak and trough levels. Peak levels are typically evaluated 30 minutes after completion of the infusion. Trough levels should be drawn immediately before the dose is administered.
How is blood concentration measured for drugs?
When measuring the drug concentration in plasma, a sample of whole blood is drawn from the patient (like cylinder on the left). The sample is then centrifuged to separate the RBC and plasma (like the cylinder on the right). The plasma is withdrawn and analyzed for drug concentration and the RBC is discarded.
How do you monitor medication?
Practitioners who regularly monitor medications advise that their colleagues:
- Pursue training.
- Make a list for each patient.
- Rely on proven tools.
- Discuss each medication’s purpose.
- Talk about side effects.
- Help with adherence.
- Get outside perspectives.
- Check in regularly.
Why therapeutic monitoring of anticonvulsant medication is important?
If it is likely that one or more of the AEDs need to be increased because of interactions, TDM can be used to help guide the increases in dose so that the concentrations in the body are kept stable. Also, if the person has side effects or toxicity, TDM can show which AED is causing this.
What are therapeutic levels?
The therapeutic level of a drug in the bloodstream is the range within which that drug is expected to be effective. Your doctor can request a test to measure the amount of a specific drug in the serum portion of your blood.
