Value Tag's Archives

Medical LabThe idea that drug concentrations could be measured and used to guide therapeutic deci­sions was first applied to quinidine when it was used to convert the cardiac rhythm of patients with atrial fibrillation to sinus rhythm (Sokolow & Ball 1956).

Although quinidine is rarely used for this purpose today, because of the advent of DC cardioversion, this study is still almost unique because it defined a target concentration based upon both the probability of therapeutic success and of toxicity.

Therapeutic drugTherapeutic drug monitoring is based upon the collaboration between a health care provider (clinician, pharmacist, nurse) responsible for making quantitative and qualitative decisions about drug treatment and the clinical labora­tory providing analytical services for the measurement of drug concentrations. The in­formation provided by a drug concentration measurement is generally greater than for other substances measured by the laboratory.

This is because, unlike say sodium or glucose, the in­take of a drug is quite well known and the pro­cesses of distribution and elimination are usu­ally very simple and not under the control of a multitude of homeostatic controlling reflexes.