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Therapeutic drug monitoring (TDM) is useful in individualized therapy of immunosuppressants, antibiotics, and drugs used for anti-epileptic, anti-tumor, antiasthma. The drug concentration in blood or other biological samples is used to reflect therapeutic efficacy and toxicity. TDM is also termed as clinical pharmacokinetic (PK) monitoring and the individualized PK parameters are used for individualized therapy. Genetic polymorphisms of drug-metabolizing enzyme, transporters, and targets have substantial effects on the PKs and pharmacodynamics (PD). Pharmacogenomics is also an important tool in personalized therapy. There is difference and relationship between TDM and pharmacogenomics in the time of monitoring, samples of monitoring, results interpretation and application. Population pharmacokinetics (PPK) is developed on the basis of classical PK and statistics, which describe the disposition of drugs in vivo, including the population mean value and individual variation. The influence of various factors including pharmaogenomics on the PK can be estimated. Population pharmacogenomic–pharmacokinetic models are established to determine the impact of genetic polymorphism on the PK parameters quantitatively. Through Bayesian assay, the individualized regimen could be designed before drug administration and adjusted with TDM results after drug administration. The models are widely studied in the immunosuppressants, anti-tumor drugs, and anti-epileptic drugs. |
