Therapeutic Drug Monitoring

Chapter 1: Introduction to therapeutic drug monitoring: Frequently and less frequently monitored drugs

• • 1. Introduction
• • 2. Drugs that require therapeutic drug monitoring
• • 3. Benefits of therapeutic drug monitoring
• • 4. Pathophysiological conditions and other factors that affect drug concentrations
• • 5. Therapeutic drug monitoring of various drug class
• • 6. Conclusions
• • References

Chapter 2: Effects of preanalytical variables in therapeutic drug monitoring

• • 1. Introduction
• • 2. Lab-related variables
• • 3. Patient-specific variables
• • 4. Conclusions
• • References
• • Further reading

Chapter 3: Analytical techniques used in therapeutic drug monitoring

• • 1. Introduction
• • 2. A general classification of analytical methods
• • 3. Understanding and minimizing measurement uncertainty in the clinical laboratory
• • 4. Immunoassays
• • 5. Gas and liquid chromatography
• • 6. Mass spectrometry and LC-MS/MS application to TDM
• • 7. Conclusions
• • References

Chapter 4: Therapeutic drug monitoring using alternative specimens: Saliva and dried blood spot

• • 1. Introduction
• • 2. Free drug hypothesis
• • 3. Remote sampling for TDM
• • 4. Oral fluid (saliva)
• • 5. Saliva for TDM
• • 6. Saliva collection
• • 7. Factors affecting the distribution of the analytes in DBS
• • 8. DBS with the precise volume deposition
• • 9. Dried plasma spot
• • 10. DBS for TDM
• • 11. Specimen collection for DBS (and VAMS)
• • 12. Laboratory analysis of saliva and dried blood spot
• • 13. Conclusions
• • References

Chapter 5: Clinical utility of free-drug monitoring

• • 1. Introduction
• • 2. Free concentrations versus total concentrations
• • 3. Applications and methods for monitoring free drug concentrations
• • 4. Alternative methods
• • 5. Conclusions
• • References

Chapter 6: Therapeutic drug monitoring of classical and newer anticonvulsants

• • 1. Introduction
• • 2. Pathophysiology of epilepsy
• • 3. Antiepileptic drug monitoring
• • 4. Indications for measuring a drug level
• • 5. Therapeutic drug monitoring of classical AEDs
• • 6. Newer anticonvulsants
• • 7. Therapeutic monitoring of brivaracetam
• • 8. Therapeutic monitoring of cannabidiol
• • 9. Therapeutic monitoring of cenobamate
• • 10. Therapeutic monitoring of clobazam
• • 11. Therapeutic drug monitoring of eslicarbazepine acetate
• • 12. Therapeutic drug monitoring of felbamate
• • 13. Monitoring of fenfluramine
• • 14. Monitoring of gabapentin
• • 15. Therapeutic drug monitoring of lacosamide
• • 16. Therapeutic drug monitoring of lamotrigine
• • 17. Therapeutic drug monitoring of levetiracetam
• • 18. Therapeutic drug monitoring of oxcarbazepine
• • 19. Therapeutic drug monitoring of perampanel
• • 20. Therapeutic drug monitoring of pregabalin
• • 21. Therapeutic drug monitoring of rufinamide
• • 22. Therapeutic drug monitoring of stiripentol
• • 23. Therapeutic drug monitoring of tiagabine
• • 24. Therapeutic drug monitoring of topiramate
• • 25. Therapeutic drug monitoring of vigabatrin
• • 26. Therapeutic drug monitoring of zonisamide
• • 27. Analytical methods for monitoring of AEDs
• • 28. Conclusion
• • References

Chapter 7: Challenges in therapeutic drug monitoring of digoxin and other antiarrhythmic drugs

• • 1. Introduction
• • 2. Challenges in therapeutic drug monitoring of digoxin
• • 3. Therapeutic drug monitoring of other antiarrhythmic drugs
• • 4. Chromatographic methods for determining multiple antiarrhythmic drugs simultaneously
• • 5. Conclusions
• • References

Chapter 8: Guidelines for monitoring vancomycin, aminoglycosides, and other antibiotics

• • 1. Introduction
• • 2. Vancomycin
• • 3. Aminoglycosides
• • 4. Therapeutic drug monitoring of beta-lactam antibiotics
• • 5. Therapeutic drug monitoring sulfonamides and trimethoprim
• • 6. Therapeutic drug monitoring of chloramphenicol and tetracycline
• • 7. Therapeutic drug monitoring of quinolones
• • 8. Therapeutic drug monitoring of macrolides
• • 9. Therapeutic drug monitoring of antimycobacterial agents
• • 10. Conclusions
• • References

Chapter 9: Challenges in therapeutic drug monitoring of classical tricyclic and newer antidepressants: analytical and pharmacogenetics considerations

• • 1. Introduction
• • 2. Tricyclic antidepressants
• • 3. Newer antidepressants
• • 4. Pharmacogenetic considerations in TDM of antidepressants
• • 5. Conclusions
• • References

Chapter 10: Antiretroviral drug therapeutic drug monitoring for the management of human immunodeficiency infection

• • Abbreviations
• • 1. Introduction
• • 2. Role of therapeutic drug monitoring
• • 3. TDM instrumentation and matrices of antiretroviral drugs
• • 4. TDM of antiretroviral drugs by classes
• • 5. Challenges in practical application of TDM in managing patients with HIV
• • 6. Conclusion
• • References

Chapter 11: Therapeutic drug monitoring of selected antifungal agents

• • 1. Introduction
• • 2. Overview of therapeutic drug monitoring of antifungal drugs
• • 3. Analytical methods to support TDM of antifungal drugs
• • 4. Specific antifungal drugs
• • 5. Conclusions
• • References

Chapter 12: Therapeutic drug monitoring of selected direct oral anticoagulants

• • 1. Introduction
• • 2. DOAC: Pharmacokinetic, pharmacodynamics, clinical indications, and dosing
• • 3. DOAC measurementsdoverview
• • 4. Conclusion
• • References

Chapter 13: Drug testing in pain management

• • 1. Introduction
• • 2. Utility and cost of drug testing in pain management
• • 3. Substance abuse and addiction medicine
• • 4. Drug testing approaches
• • 5. Drug testing menu
• • 6. Results reporting
• • 7. Testing frequency
• • 8. Specimen types and alternative specimens
• • 9. Specimen collection and testing workflow
• • 10. Analytical approaches
• • 11. Specific analytes and interpretation
• • 12. Stimulants
• • 13. Novel psychoactive substances
• • 14. Pharmacogenomics
• • 15. Conclusions
• • References
• • Further reading

Chapter 14: An introduction to personalized medicine

• • 1. Introduction
• • 2. Overview of classical sequence variation profiling techniques
• • 3. Recent molecular profiling technologies
• • 4. Select example biomarkers in pharmacogenomics
• • 5. Translational approaches associated with pharmacogenomics and personalized medicine
• • 6. Conclusions
• • References
• • Further reading

Chapter 15: Genomic technology advances and the promise for precision medicine

• • 1. Introduction
• • 2. DNA microarrays
• • 3. Sequencing technologies
• • 4. Pharmacogenetic testing and healthcare
• • 5. Systems medicine
• • 6. Disease diagnosis
• • 7. Drug discovery
• • 8. Precision medicine
• • 9. Challenges in machine learning for systems medicine
• • 10. Conclusion
• • 11. Future prospects
• • References

Chapter 16: Pharmacogenomics and warfarin therapy

• • 1. Introduction
• • 2. The potential of pharmacogenetics for warfarin
• • 3. Pharmacology
• • 4. Nongenetic factors affecting warfarin dosing
• • 5. Clinical relevance
• • 6. Cost-effectiveness of pharmacogenomics testing in warfarin therapy
• • 7. Conclusion
• • References

Chapter 17: Drug hypersensitivity linked to genetic variations of human leukocyte antigen

• • 1. Introduction
• • 2. HLA: Molecular structure, genomic organization, polymorphism, and nomenclature
• • 3. Repositories related to HLA alleles and associated ADRs
• • 4. HLA alleles and their association with drug-induced ADRs
• • 5. Steven Johns syndrome/toxic epidermal necrolysis (SJS/TEN)
• • 6. Morbilliform drug eruption
• • 7. Drug reaction with eosinophilia and systemic symptoms DRESS
• • 8. Drug-induced liver injury
• • 9. Clinical recommendations for HLA genotyping
• • 10. Conclusions
• • Acknowledgment
• • References

Chapter 18: Therapeutic drug monitoring of selected anticancer drugs: pharmacogenomics issues

• • 1. Introduction
• • 2. Traditional therapeutic drug monitoring for anticancer drugs
• • 3. Newer approaches to personalized dosing and treatment with anticancer agents: pharmacogenetics
• • 4. Pharmacogenetic considerations for specific anti-cancer agents
• • 5. Conclusions
• • References

Chapter 19: Consequences of differences in bio-analytical assays for the precision monitoring of immunosuppressive drugs

• • 1. Introduction
• • 2. Immunosuppressive drugs and their metabolites
• • 3. Sample matrix
• • 4. Various analytical techniques for measuring immunosuppressants
• • 5. Stability
• • 6. Proficiency testing and comparison studies
• • 7. Interassay differencesdare they relevant?
• • 8. Conclusions
• • References

Chapter 20: Donor-derived cell-free DNA as a marker of graft injury after solid organ transplantation

• • 1. Introduction
• • 2. Causes of chronic allograft dysfunction
• • 3. Need for biomarkers
• • 4. Value of conventional TDM
• • 5. Biomarkers for immune monitoring as supplement to TDM
• • 6. Molecular methods: Biopsy and cellular approaches
• • 7. Conclusions
• • References

Chapter 21: Pharmacodynamic monitoring as an integral part of therapeutic drug monitoring

• • 1. Introduction
• • 2. Drug concentrations
• • 3. Pharmacodynamic monitoring
• • 4. Physiological biomarkers
• • 5. Laboratory biomarkers
• • 6. Drug-specific and nonspecific PD biomarkers
• • 7. Summary
• • References

Chapter 22: Role of therapeutic drug monitoring to identify clinically significant drug-herbal supplement interaction

• • 1. Introduction
• • 2. Herbedrug interaction mechanisms
• • 3. Impact of herb supplements and herbedrug interactions in clinical practice
• • 4. Contamination of herbal supplements
• • 5. Analytical interferences caused by some herbal supplements
• • 6. Conclusions
• • References