Therapeutic drug monitoring in Turkey: Experiences from Istanbul

Therapeutic drug monitoring (TDM) has assumed an important place in patient management in the last few decades. In this study, serum drug levels deter mined in 7759 specimens sent to the Department of Pharmacology and Clinical Pharmacology in 1994 and 1998 for TDM were retrospectively evaluated. Moni tored drugs were carbamazepine, valproate, phenytoin, phenobarbital, digoxi n, theophylline, and salicylate, The comparison of the results obtained for the relevant 2 years showed that there was a remarkable increase in the nu mber of requests for TDM per year and in the rate of serum drug levels that were within therapeutic range. Serum antiepileptic drug level monitoring a ccounted for a major part of the data. Overall data suggest that the use of TDM in antiepileptic drugs is improving; conversely, digoxin and theophyll ine are still not being properly monitored. In this study, the results are discussed in the light of rational TDM criteria.