Abstract
Therapeutic drug monitoring (TDM) is a tool used to integrate pharmacokinetic and pharmacodynamics knowledge to optimize and personalize various drug therapies. The optimization of drug dosing may improve treatment outcomes, reduce toxicity, and reduce the risk of developing drug resistance. To adequately implement TDM, accurate and precise analytical procedures are required. In clinical practice, blood is the most commonly used matrix for TDM; however, less invasive samples, such as dried blood spots or non-invasive saliva samples, are increasingly being used. The choice of sample preparation method, type of column packing, mobile phase composition, and detection method is important to ensure accurate drug measurement and to avoid interference from matrix effects and drug metabolites. Most of the reported procedures used liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) techniques due to its high selectivity and sensitivity. High-performance chromatography with ultraviolet detection (HPLC-UV) methods are also used when a simpler and more cost-effective methodology is desired for clinical monitoring. The application of high-performance chromatography with fluorescence detection (HPLC-FLD) with and without derivatization processes and high-performance chromatography with electrochemical detection (HPLC-ED) techniques for the analysis of various drugs in biological samples for TDM have been described less often. Before chromatographic analysis, samples were pretreated by various procedures—most often by protein precipitation, liquid–liquid extraction, and solid-phase extraction, rarely by microextraction by packed sorbent, dispersive liquid–liquid microextraction. The aim of this article is to review the recent literature (2010–2020) regarding the use of liquid chromatography with various detection techniques for TDM.
Highlights
The health of the human population is largely determined by the effectiveness of the therapies used as well as the side effects of pharmaceuticals that can threaten the safety of people
Therapeutic drug monitoring (TDM) is a multidisciplinary clinical practice used for the optimization and individualization of drug therapy in the general and special populations that has been predominantly used to prevent or minimize adverse events produced by drugs, especially
We described the application of different chromatographic techniques in combination with the various types of detection used for TDM of drugs belonging to more than one drug classes
Summary
The health of the human population is largely determined by the effectiveness of the therapies used as well as the side effects of pharmaceuticals that can threaten the safety of people. Therapeutic drug monitoring (TDM) is a multidisciplinary clinical practice used for the optimization and individualization of drug therapy in the general and special populations that has been predominantly used to prevent or minimize adverse events produced by drugs, especially. TDM represents a strategy to personalize the therapy by tailoring the dose for the patient, which is fundamental with many drugs, especially drugs with a narrow therapeutic window. The TDM results can be used to assist in the determination of whether the patient has developed viral resistance to the prescribed drugs or whether the patient has stopped taking the drugs. The TDM results can be applied to assist in the determination of whether the patient treated by drugs such as antibiotics, antiviral, or antifungal acquired resistance to the prescribed drugs or whether the patient has stopped taking the drugs
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