Choosing optimal sampling times for therapeutic drug monitoring. 1985

G E Schumacher

Recent advances linking pharmacokinetic theory with the selection of optimal sampling times and the influence of sampling times on the interpretation of serum drug concentrations are discussed. For serum drug assay results to be interpreted easily, samples should be obtained during the postdistributive phase (for loading and maintenance doses) or at steady state (for maintenance doses). Beyond this, the choice of sampling times depends on whether peak, trough, or intermediate concentrations are being monitored. When intrapatient and interpatient variation in pharmacokinetic values are considered to be the principal components of variability, the best time for taking a single sample after a test dose in order to predict the average concentration during the steady-state dosage interval is when sample time equals 1.4 times the population half-life of the drug. Optimal sampling times to predict maximum or minimum steady-state concentrations may differ from those used to estimate the average concentration. Efforts to decrease the number of samples needed to estimate accurately steady-state drug concentrations have led investigators to test "single-point" prediction methods following a test dose. However, for drugs administered by continuous infusion, it seems prudent to assay more than one serum sample obtained before steady state is achieved; a single sample obtained too early could contribute to inaccurate predictions. Recommendations are presented for optimal sampling times for commonly monitored drugs.

UI MeSH Term Description Entries
D008657 Metabolic Clearance Rate Volume of biological fluid completely cleared of drug metabolites as measured in unit time. Elimination occurs as a result of metabolic processes in the kidney, liver, saliva, sweat, intestine, heart, brain, or other site. Total Body Clearance Rate,Clearance Rate, Metabolic,Clearance Rates, Metabolic,Metabolic Clearance Rates,Rate, Metabolic Clearance,Rates, Metabolic Clearance
D008991 Monitoring, Physiologic The continuous measurement of physiological processes, blood pressure, heart rate, renal output, reflexes, respiration, etc., in a patient or experimental animal; includes pharmacologic monitoring, the measurement of administered drugs or their metabolites in the blood, tissues, or urine. Patient Monitoring,Monitoring, Physiological,Physiologic Monitoring,Monitoring, Patient,Physiological Monitoring
D001800 Blood Specimen Collection The taking of a blood sample to determine its character as a whole, to identify levels of its component cells, chemicals, gases, or other constituents, to perform pathological examination, etc. Blood Specimen Collections,Collection, Blood Specimen,Collections, Blood Specimen,Specimen Collection, Blood,Specimen Collections, Blood
D004334 Drug Administration Schedule Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience. Administration Schedule, Drug,Administration Schedules, Drug,Drug Administration Schedules,Schedule, Drug Administration,Schedules, Drug Administration
D004364 Pharmaceutical Preparations Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. Drug,Drugs,Pharmaceutical,Pharmaceutical Preparation,Pharmaceutical Product,Pharmaceutic Preparations,Pharmaceutical Products,Pharmaceuticals,Preparations, Pharmaceutical,Preparation, Pharmaceutical,Preparations, Pharmaceutic,Product, Pharmaceutical,Products, Pharmaceutical
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor

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