Ueda W
Department of Anesthesiology and Resuscitology, Kochi Medical School, Nankoku.
Masui. 1991 Oct;40(10):1536-41.
In order to maximize the effectiveness and safety of drug therapy, it is important to individualize the dosage of potent drugs. Some drugs can not be titrated against the intensity of the therapeutic or toxic actions. Determination of the blood concentration of such drugs can be a helpful guide in adjusting the dosage during their therapeutic use. The drug dosing guided by pharmacokinetics is called TDM or therapeutic drug monitoring. In conventional pharmacokinetics, a large number of blood samples are collected from one patient to determine the individual pharmacokinetic parameters. In TDM, the pharmacokinetic parameters obtained from a group of patients who belong to a certain category are used to guide estimation of the individual pharmacokinetic parameters and only a few blood samples from one patient are sufficient to determine the individual parameters. The blood concentration of a drug and the intensity of its pharmacodynamic action, however, is not necessarily correlated. Therapeutic decisions should never be based solely on the blood concentration of a drug.
为了使药物治疗的有效性和安全性最大化，使强效药物的剂量个体化很重要。有些药物无法根据治疗或毒性作用的强度进行滴定。测定这类药物的血药浓度有助于在其治疗使用期间调整剂量。由药代动力学指导的给药称为治疗药物监测（TDM）。在传统药代动力学中，要从一名患者身上采集大量血样以确定个体药代动力学参数。在治疗药物监测中，从属于某一特定类别的一组患者获得的药代动力学参数用于指导个体药代动力学参数的估算，并且仅需从一名患者采集少量血样就足以确定个体参数。然而，药物的血药浓度与其药效学作用强度不一定相关。治疗决策绝不应仅基于药物的血药浓度。
