Therapeutic drug monitoring in a developing country: an overview

Therapeutic Drug Monitoring (TDM) was introduced in India in the mid and la te 1980s and the last 10 years have seen it grow, together with the growth of separate Clinical Pharmacology departments. The TDM service in the count ry is broadly of two types: in large teaching hospitals where the service i s available through departments of Clinical Pharmacology, and in the privat e sector, where drug estimations are done by clinical biochemistry departme nts with minimal interpretation. This article is based on literature review and our own experiences over a 10 year period in a department of Clinical Pharmacology. It focuses on the evolution of TDM, its problems such as lack of funding, special aspects such as the impact of ethnic differences, nutr itional deficiencies, quality of medicines and availability of generic prod ucts; its utility as a research tool and its future.