TUCUXI

Many drugs are traditionally prescribed at standard dosage despite a high variability of their absorption and disposition between patients. For critical drugs (anticancer, anti-HIV, antifungals, anti-epileptics, psychotropic agents etc.), too low concentrations may lead to inefficacy and sometimes selection of drug-resistant cells or viruses. Conversely, too high concentrations increase the risks of adverse effects and toxicity. Such drugs are said to have a “narrow therapeutic margin”. Mon... itoring of circulating drug concentrations in the patients, also called “therapeutic drug monitoring” (TDM), represents the best way to optimize drug dosage and prevent toxicity or lack of effectiveness, when no accurate efficacy markers are measurable. Still TDM has slowly developed until recently, because both the drug measurement and the interpretation of concentration results were demanding. During the last decade, laboratory technologies have markedly progressed and no longer represent a limiting factor. At present, dozens of drugs can be easily analyzed. A prerequisite for the wide accessibility of TDM to all patients that require it is that physicians, pharmacists, nurses and even patients can easily interpret drug concentration results and adjust therapies accordingly.More