Journal of Pharmacovigilance

Assessments of Therapeutic Drug Monitoring Test in Children

Dincer Barnes^* Department of Microbiology, University of Manchester, Manchester, UK
^*Correspondence: Dincer Barnes, Department of Microbiology, University of Manchester, Manchester, UK, Email:

Received: 11-Nov-2022, Manuscript No. JP-22-19388; Editor assigned: 14-Nov-2022, Pre QC No. JP-22-19388 (PQ); Reviewed: 02-Dec-2022, QC No. JP-22-19388; Revised: 13-Dec-2022, Manuscript No. JP-22-19388 (R); Published: 22-Dec-2022, DOI: 10.35248/2329-6887.22.10.406

Description

Treatment Drug Monitoring (TDM) is a test that measures the number of certain drugs in the blood. It is done to make sure that the amount of medicine who are taking is safe and effective. Most drugs can be administered correctly without special testing. However, with certain types of drugs, it can be difficult to find a dose that contains enough of the drug to treat the condition without causing dangerous side effects. It helps to check if they are taking it. Therapeutic drug monitoring in infants and children because it differs significantly from adults. Drug disposition is controlled by multiple processes involved in drug uptake, distribution, metabolism, and excretion, all of which differ in infants and children from adults. This makes TDM unique and challenging in this population. For example, infants have lower plasma protein concentrations and less protein binding, resulting in a higher free fraction of highly protein bound drugs compared to adults. Infants and young children generally have a higher metabolic capacity and therefore receive higher drug dosages on a weight basis than adults in this population. Individual differences in drug response are well known in both adults and children. Several factors contribute to this variability. In adults, development of the cells, tissues, and organs involved in drug metabolism is complete, whereas in neonates their functional development is still underway. Volume of distribution and clearance, two important parameters, are well-characterized for the pharmacokinetics (PK) of a particular compound. Bioavailability and absorption should also be considered when the route of administration is non-intravenous. These three parameters depend on Absorption, Distribution, Metabolism and Excretion (ADME). Rapid maturation of the neonatal liver affects many bio transformative functions. Enzyme expression varies from the fetal and postnatal period to her first year of life when she reaches near-full functional activity. A sampling technique that integrates the use of micro sampling with alternative matrix analysis is micro dialysis. It consists of a semi-permeable catheter that can separate permeable molecules within the matrix. Micro dialysis is used in neonates to continuously monitor endogenous analytes such as glucose and lactate, especially in intensive care units. However, until now it was only available for research purposes. To date, the blood/ plasma dogma in neonatal TDM is fading. This is primarily due to the clinical, ethical, and analytical shortcomings associated with this vulnerable population. Promising approaches have been developed, but simpler and more reliable sampling strategies require further research.

Both pharmacokinetic and non-pharmacokinetic factors manipulate the correlation between dose and drug exposure and limit achievement of therapeutic goals. By applying TDM with microbiological results, antibiotic drug concentration and bactericidal potency can be correlated with Minimum Inhibitory Concentration (MIC). Pharmacokinetic and pharmacodynamics behavior in the pediatric age group differs significantly from that in the normal adult population. Parental compliance in administering drugs at appropriate time intervals may further accentuate patient non-compliance in the pediatric population. The pace of dramatic change in other areas of therapy has not been reflected in the pediatric specialization, contributing to the poor development of pediatric therapeutic pharmacovigilance.

Therapeutic drug monitoring is primarily applied when the therapeutic indicator is narrow and the concentration of the drug in serum that produces the unwanted effect is quite close to the concentration required to produce a beneficial therapeutic effect. However, it should be noted that even if drug concentrations are within the therapeutic range, side effects may still occur in certain patients due to variations in individual pharmacokinetic and pharmacodynamic indices.