Therapeutic drug monitoring in pediatrics: a need for improvement.
Therapeutic drug monitoring (TDM) is practiced for a number of frequently used drugs in infants and children. It is believed that monitoring drug levels will increase the probability of a therapeutic response and minimize the probability of adverse drug sequelae. Dose adjustments are based on measured drug levels interpreted relative to published therapeutic ranges which may or may not reflect the true relationship with either therapeutic or adverse effects. Potential errors derive from many sources, some amenable to solutions based on current knowledge, others awaiting improved understanding of the causes and consequences of unreliable therapeutic ranges.
Department of Biochemistry, Montreal Children's Hospital, McGill University, Quebec, Canada.
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Senécal
D002648:Child; D016503:Drug Delivery Systems; D016903:Drug Monitoring; D004358:Drug Therapy; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D010372:Pediatrics; D012016:Reference Values; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013810:Therapeutic Equivalency