Summary
Routine use of therapeutic drug monitoring in children is helpful in individualising the dosage during long term treatment (e.g. theophylline and antiepileptic drugs) and in checking against toxic accumulation of drug in neonates (e.g. digoxin, theophylline/caffeine and aminoglycoside antibiotics). In individual patients, measurements of drug concentrations in plasma may be the only way to elucidate clinically unexpected drug effects or to handle interaction phenomena.
Knowledge of the pharmacokinetic and pharmacodynamic changes during development is a prerequisite for a correct interpretation of the concentration values. Unfortunately, the quantitative relation between kinetics and clinical effect is still relatively poorly known for many drugs in the paediatric age groups.
Apart from the pharmacokinetic informative value, therapeutic drug monitoring also has some merit as an aid to the physician in explaining to the patient and the parents why the drug should be taken as instructed. This may improve compliance.
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References
Boréus LO. Principles of pediatric pharmacology. Churchill Livingstone, New York, 1982
Buchanan N. Therapeutic drug monitoring in childhood. Australian Paediatric Journal 22: 19–26, 1986
Collins-Nakai RL, Ng PK, Beaudry MA, Ocejo-Moreno R, Schiff D, et al. Total body digoxin clearance and steady-state concentrations in low birth weight infants. Developmental Pharmacology and Therapeutics 4: 61–70, 1982
Evans WE, Schentag JJ, Jusko WJ. Applied pharmacokinetics. Principles of therapeutic drug monitoring, 2nd ed., Applied Therapeutics Inc., Spokane, 1986
Hastreiter AR, van der Horst RL, Voda C, Chow-Tung E. Maintenance digoxin dosage and steady-state plasma concentration in infants and children. Journal of Pediatrics 107: 140–146, 1985
Hendeles L, Weinberger M, Bighley L. Absolute bioavailability of oral theophylline. American Journal of Hospital Pharmacy 34: 525–527, 1977
Nyberg L, Wettrell G. Pharmacokinetics and dosage of digoxin in neonates and infants. European Journal of Clinical Pharmacology 18: 69–74, 1980
Rylance GW, Moreland TA. Drug level monitoring in paediatric practice. Archives of Diseases in Childhood 55: 89–98, 1980
Sawchuk RJ, Zaske DE, Cipolle RJ, Wargin WA, Strate RG. Kinetic model for gentamicin dosing with the use of individual patient parameters. Clinical Pharmacology and Therapeutics 21: 362–369, 1977
Sjöqvist F, Borgå O, L’Orme EM. The role of the clinical pharmacological laboratory in improving drug therapy. In Avery GS (Ed.) Drug treatment, 3rd ed., ADIS Press, Auckland, 1987
Vozeh S. Cost-effectiveness of therapeutic drug monitoring. Clinical Pharmacokinetics 13: 131–140, 1987
Zaske DE. Aminoglycosides. In Evans WE, et al. (Eds) Applied pharmacokinetics, 2nd ed., p. 332, Applied Therapeutics Inc., Spokane, 1986
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Boréus, L.O. The Role of Therapeutic Drug Monitoring in Children. Clin-Pharmacokinet 17 (Suppl 1), 4–12 (1989). https://doi.org/10.2165/00003088-198900171-00003
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DOI: https://doi.org/10.2165/00003088-198900171-00003