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Chapter-32 Drug-level Monitoring

BOOK TITLE: Monitoring in Anesthesia and Critical Care

Author
1. Tyagi Asha
2. Arora Vandna
ISBN
9789352700431
DOI
10.5005/jp/books/18044_33
Edition
1/e
Publishing Year
2018
Pages
8
Author Affiliations
1. UCMS & GTB Hospital, New Delhi, India
2. University College of Medical Sciences, Guru Teg Bahadur Hospital, New Delhi, India, Pt. BD Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
Chapter keywords
Drug-level monitoring, therapeutic drug monitoring, TDM, prophylactic antibiotic therapy, total intravenous anesthesia, TIVA, target controlled infusions, TCI

Abstract

This chapter starts by dwelling upon the current status of monitoring of drug levels in clinical practice. It then discusses the practice of therapeutic drug monitoring (TDM), which involves drug-level monitoring at predetermined times. The role of TDM is well-established in certain specializations of medical practice but not in routine anesthetic practice. The upcoming role of TDM for antibiotic therapy in critically ill septic patients is highlighted. Drug-level monitoring at predetermined times is indicated and carried out for certain specific indications. Drug-level monitoring is, however, not routinely practiced in anesthetic and related settings at present. It holds great potential for optimizing and individualizing drug therapy to maximize benefits and minimize adverse effects. The future of drug-level monitoring may change with the advent of currently investigational biosensors into routine practice.

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