1887
Volume 2(2021) Number 2
  • E-ISSN: 2708-0463

ملخص

مراقبة الأدوية العلاجية هي خدمة سريرية تهدف إلى الاستخدام الأمثل للأدوية ذات النطاق العلاجي الضيق أو لها حركية دواء معقدة، وتشمل قياس تركيز الدواء في المصل أو الدم في العينات المأخوذة في أوقات مناسبة ومعلومة. ومن خلال فهم متعمق لخصائص الأدوية التي تم قياسها، ودراسة ملف المريض، يمكن تفسير تركيز الدواء في الدم لاستنباط الجرعة المثلى وفقًا لاحتياجات المريض الفردية. يهدف هذا البحث إلى تسليط الضوء على أساسيات الخدمة وتقديم اقتراحات لتحسينها، وخاصة في الدول النامية. ويقدم إرشادات عملية تضمنت تصميم النماذج لطلب الخدمة، وأخذ العينات في الوقت الأمثل، واستخدام طرق التحليل المناسبة، ويعرض أيضًا توجيهات للتفسير المناسب للنتائج؛ وتكامل أدوار الفريق الطبي؛ والتعليم المستمر وتنمية المهارات. كما أوصى البحث بإشراك المرضى في تحسين الخدمة وإجراء البحوث ذات الصلة؛ واستخدام برنامج حاسوب لحركية الدواء والتكامل بين قياس الدواء وعلم الأدوية الجيني.

Therapeutic drug monitoring (TDM) is a teamwork clinical pharmacokinetic service that aims to optimize the pharmacotherapy of certain drugs such as those with a narrow therapeutic range, complicated pharmacokinetics. It involves the determination of drug levels in blood samples taken at the appropriate time. Interpretation of results requires the integration of pharmacokinetics, the pharmacodynamics of the drug, and the patient’s clinical profile. To be cost-effective, the service should be optimized. This review highlights the fundamentals of TDM service and provides practical suggestions for its optimization especially in developing countries. It covers the rationale of requesting drug level, design of request form, optimal sampling, and analytical tools. It provides guidelines for appropriate interpretation of drug levels, completeness of the roles of the qualified medical team, continuing education and skills development, involving the patients in improving the service, conducting relevant research, and the use of PK software and integration of TDM with pharmacogenomics.

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