Therapeutic Drug Monitoring (TDM) is the measurement of specific drugs at timed intervals in order to maintain a relatively constant concentration of the medication in the bloodstream. Drugs that are monitored tend to have a narrow therapeutic index; the blood level required to be effective is close to the level that causes significant side effects and/or toxicity.
Thermo Scientific develops and produces reagents that can be easily adapted to and are optimised for a wide range of clinical chemistry analysers e.g. the Roche Hitachi series, the Beckman Coulter AU series and the Thermo Scientific Indiko system.
This means that no matter the size of the laboratory or the volume of drug testing performed, Humor Diagnostica can provide the drug-testing solution that will fit the individual laboratory’s needs and requirements.
Reagent bottles are bar-coded for positive reagent identification, lot number tracking and expiry date registration.
Contact Humor Diagnostica to receive the application protocol for your specific laboratory analyser.
TDM assays include:
- Antiepileptic – Carbamazepine, Phenobarbital, Phenotoin, Valproc Acid, Lamotrigine and Topiramate
- Antiasthmatic – Theophylline II
- Antibiotic – Amikacin, Gentamycin, Tobramycn, Vancomycin, Teicoplanin
- Antidepressant – Lithium
- Cardiac – Digoxin, Digitoxin, Procainamide, N- Acetylprocainamide (NAPA)
Following solid organ transplantation, patients receive individualised multi-drug immunosuppressive therapy, usually a combination of a Calcineurin inhibitor (Cyclosporine or Tacrolimus), a DNA synthesis inhibitor (Mycophenolic Acid) and/or an mTOR inhibitor (Everolimus or Sirolimus).
In addition to the classical assessment of the patient, one of the tools that transplant clinicians use as a guide to dose adjustment is the measurement of the drug concentrations in blood. This process is known as Immunosuppressive Drug Monitoring (ISD).
Although the current immunosuppressive drugs are effective in preventing acute rejection, most patients experience at least some adverse effects. Inadequate low therapeutic levels may lead to acute rejection, whereas very high levels are more likely to be associated with nephrotoxicity.
Routine monitoring of blood levels helps to determine the dose that maintains maximal efficacy with minimal toxicity.
Available ISD assays include:
TNFα blockers are biologic agents used for the treatment of inflammatory diseases such as ulcerative colitis, Crohn’s disease and rheumatoid arthritis. TNFα blockers include Infliximab (IFX, Remicade®, RemsimaTM, Inflectra®) and adalimumab (Humira®).