50. Therapeutic drug monitoring (TDM)

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= measurement of drug concentration or activity in plasma

Methods
- High performance liquid chromatography
- Immunoassay
Indications
- Non-linear kinetics of drug
- When there is poor compliance
- If the therapeutic effect can’t be assessed clinically
- If the therapeutic index is low
  - Warfarin
  - Aminoglycosides
  - Antipsychotics
  - Digoxin
  - Lithium
- When there are signs of overdose
- To determine pharmacokinetic interactions