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Theurapeutic Drug MonitoringHealthLink Lab

 

THERAPEUTIC DRUG MONITORING

Therapeutic drug monitoring allows clinicians to more accurately titrate drug dosages, thus enhancing individualization of therapy.
With the development of improved analytical techniques, the clinician is able to predict the therapeutic or toxic effects by monitoring the relationship between serum concentrations and response of the patient.
Therapeutic drug monitoring can be a useful adjunct to patient therapy by facilitating drug dosage 
adjustments and reducing the risk of adverse effects associated with higher serum concentrations. Examples of drugs 
for which therapeutic drug monitoring may be indicated are shown below.
Testing for many therapeutic drugs is performed at HealthLink Lab. What is not available here, we send to Quest Laboratories in Atlanta.
IMPORTANT: Do not use serum separator tubes for the therapeutic drug monitoring or toxicological
analyses. The gel barrier material will bind to lipophilic substances, resulting in a falsely low drug
concentration report. Collect the specimen in a tube with no anticoagulants or preservatives. Use a pipet
to transfer serum to a plastic vial.

                                                                                                              Half­Life

Therapeutic Range

Generic Name

Trade Name

(Hours)

At Steady State*

ANTIEPILEPTICS

Primidone

Mysoline®

6-20

5-12 mg/L

 

Phenobarbital

Luminal®

4 days

1540 mg/L

 

Phenytoin

Dilantin®

8-60

10-20 mg/L

 

Carbamazepine

Tegretol®

20-30

4-10 mg/L

 

Clonazepam

Clonopin®

19-60

10-80 mg/L

 

Ethosuximide

Zarontin®

30-60

40-100 ug/L

 

Valproic Acid

Depakene®

6-15

50-100 mg/L

CARDIAC DRUGS

Digoxin

Lanoxin®

30-40

0.5-2.0 ng/mL

 

Digitoxin

Digitoxin

4-10 days

10-30 mg/L

 

Procainamide

Pronestyl®

2.5-5

4-10 mg/mL

 

Quinidine

Quinidine Sulfate

5-12

2-5 mg/L

 

Lidocaine

Xylocaine®

5-5

1.5-5.0 mg/L

 

Disopyramide

Norpace®

3-11

5 mg/L

 

Tocainide

Tonocard®

11-17

4-10 mg/L

ANTIBIOTICS

Chloramphenicol

Chloromycetin®

1-4

10-25 mg/L (peak)

 

Gentamicin

Garamycin®

2

5-10 mg/L (peak)

 

Tobramycin

Nebcin®

2-4

5-10 mg/L (peak)

 

Amikacin

Amikin®

2-3

20-25 mg/mL (peak)

 

Vancomycin

Vancocin®

6

30-40 mg/mL (peak)

PSYCHOTHERAPEUTIC

Lithium

Lithane®

8-15

0.8-1.2 mEq/L

AGENTS

Amitriptyline

Elavil®

17-40

120-250 ng/mL**

 

Nortriptyline

Aventyl®

15-93

50-140 ng/mL

 

Imipramine

Tofranil®

6-24

150-250 ng/mL**

 

Desipramine

Norpramin®

12-76

50-300 ng/mL

MISCELLANEOUS 

Theophylline

Aminophylline®

4-6

10-20 mg/mL

DRUGS

Salicylate

Aspirin

3-6

50-100 mg/L (analgesic)

 

 

 

 

100-300 mg/L

 

 

 

 

(anti­inflammatory)

*REPRESENTATIVE DRUGS FOR WHICH THERAPEUTIC DRUG MONITORING MAY BE BENEFICIAL.
Half­life values are listed to guide in setting sample collection time for steady­state concentration and pertain to adult dosages only. For pediatric values call the laboratory.

 

 

 

 

 

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