Which of the following drug require therapeutic dose monitoring?
(Ref: Katzung, 14th ed. pg. 432; KDT, 6th ed. pg. 34-35)Therapeutic dose monitoring (TDM) is used to monitor the effect of drug through plasma concentration.Criteria to do TDMWhen response of drug can't be measured.Note:#Response of warfarin measured by INR.#Response of metformin measured by blood glucose level.#Response of propanolol measured by BP measurement.If any drug having narrow therapeutic index (unsafe drugs).If a drug is showing wide variation in pharmacokinetics.Drugs in which TDM done (Remembered as: DAAALI)DigitalisAminoglycosides (Gentamicin)Anti-epilepticsAnti-CancerLithiumImmuno suppressant (Cyclosporine, Tacrolimus, Sirolimus)Therapeutic drug range for some anti-seizure drugDrugReference rangeCarbamazepine4-12Clobazam0.03-0.30Ethosuximide40-100Phenytoin10-20Phenobarbital15-40Valproate40-100Lamotrigine3-15Levetiracetam12-46Oxcarbazepine5-35Topiramate5-20
Phenytoin
Warfarin
Metformin
Propanolol
General Pharmacology