A 78-year-old man with prostate cancer needed intravenous treatment with amikacin for a suspected gramnegative bacillary respiratory infection. He had a body surface area of 1.97 m, weight of 78 kg, and body mass index of 29 kg/m. Laboratory test results are shown in Table 1. Because the initial renal function was judged to be normal and the patient was considered overweight, the antibiotic was...

The practice of therapeutic drug monitoring is based on several disciplines, including pharmacokinetics, pharmacodynamics, and chemical analysis. The impact of the analysis on the determination of pharmacokinetic parameters is not well appreciated. Analytical goals in therapeutic drug monitoring should be established by determining the nature of the problem to be solved, selecting the appropria...

Therapeutic drug monitoring (TDM) is one of the most complex laboratory testing processes in modern laboratory medicine practice. Based on the simple engineering principle of feedback control, TDM strives to regulate an individual’s exposure to a drug by measuring the drug’s concentrations, usually at steady state and at distributional equilibrium, and then use these concentrations to determine...

Prodrugs are analogs of active drugs that have been developed to improve the bioavailability and/or tolerability of the latter. Fosphenytoin (1 ) and mycophenolate mofetil (MMF) (2 ) are two examples of prodrugs where monitoring of the active drug, the anticonvulsant phenytoin and the immunosuppressant mycophenolic acid (MPA), respectively, is used to guide therapy. The successful application o...

The World Health Organization, WHO, reported in 2010 that there were approximately 490 million (7%) of people suffering from mental disorders, such as abuse of alcohol and other substances, major depression, bipolar disorder, schizophrenia and dementia, recommending research the pathophysiology of these disorders in order to improve their understanding and to develop more efficient and cost-eff...

Posaconazole is a second-generation triazole agent with a potent and broad antifungal activity. In addition to the oral suspension, a delayed-release tablet and intravenous formulation with improved pharmacokinetic properties have been introduced recently. Due to the large interindividual and intraindividual variation in bioavailability and drug-drug interactions, therapeutic drug monitoring (T...

Commonly used conventional antiepileptic drugs for pharmacotherapy in epilepsy are phenytoin, carbamazepine and valproic acid. These drugs have complex pharmacokinetic properties leading to fluctuation in their plasma level at given same therapeutic dose. The present study was done to monitor their plasma levels. A prospective observational study was conducted at National Public Health Laborato...