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Doody's Review ServiceReviewer: Valerie L. Ng, PhD MD(Alameda County Medical Center/Highland Hospital)
Description: This is the third edition of a comprehensive yet truly concise (as the title states) guide to therapeutic drug monitoring.
Purpose: The purpose is to provide a concise guide to therapeutic drug monitoring (TDM). The purpose of this edition is to update information and include new methodologies now commonly used for TDM. These are obviously worthy objectives, given the significant volume of laboratory testing devoted to TDM. This book nicely meets the authors' objectives.
Audience: This book is written for laboratorians (clinical laboratory scientists, clinical chemists, laboratory directors) for everyday use and for use as an educational aid. In my opinion, this book will also be useful to anyone interested in current TDM practice and technology, including physicians and allied health practitioners (especially pharmacists), poison control centers, toxicologists, and others whose daily practice involves therapeutic drugs.
Features: This 240-page book contains a wealth of information on TDM. The first few chapters review basic material: pharmacokinetics, pre- and post-analytical phases, clinical usefulness of free drug monitoring, effects of various serum/plasma interferents and effects of herbs or food. The remaining 13 chapters focus on specific clinical areas where TDM is used, e.g., antimicrobials, antiepileptics, antidepressants, cardioactive drugs, immunosuppressives, analgesics, antineoplastics, etc. Each of these clinically focused chapters begins with a brief introduction to the drug (including its structure) and the role of TDM in appropriate disease management, followed by brief discussions of each of the drugs used in these disease-focused areas. The drug-specific information includes "at a glance" tables specifying properties related to the individual drug — pharmacokinetic, dosing, monitoring, and excretion. Very quickly you can see what drugs are used to treat which disease, and zero in on a particular drug for key information. Some of the introductory sections include assay-specific information when more than one assay is commercially available — very useful for laboratorians considering which assay to develop in house. The one thing I could not find was clear indications for when to use what drug. For example, I was looking for recommendations of when to monitor the effects of newer anticonvulsants (specifically, lamitrogine). While I could find lots of information about the drug itself, there was no recommendation as to when TDM should be instituted after starting the patient on this drug. But maybe this type of disease management information belongs in a different type of book, such as clinical management of diseases.
Assessment: This is a useful reference. It should be kept within easy reach in any clinical toxicology laboratory or any laboratory performing TDM.