Horrevorts A M, Mouton J W
Bronovo Ziekenhuis, Den Haag, The Netherlands.
Eur J Clin Microbiol Infect Dis. 1993;12 Suppl 1:S58-60. doi: 10.1007/BF02389880.
Optimal use of a drug depends on rational dosing and subsequent therapeutic drug monitoring for effectiveness and toxicity. Drug monitoring is not relevant for all drugs, but is indicated in the case of drugs which have a narrow therapeutic range or show a large inter-individual variation. If the response is not satisfactory or toxic side effects are observed, the regimen has to be adjusted or another drug used. Methods have been developed to establish rational dosing schedules for the individual patient. In previous methods, the patient's specific data such as age, length, weight and serum creatinine are integrated with population pharmacokinetic parameters for a drug. This approach is subject to an appreciable margin of error, particularly in patients whose physiology is far from normal. Therapeutic drug monitoring via blood level determination makes it possible to evaluate the patient's individual pharmacokinetic parameters on which a rational dosage regimen can be based.
药物的最佳使用取决于合理给药以及随后针对有效性和毒性的治疗药物监测。并非所有药物都需要进行药物监测，但对于治疗窗窄或个体间差异大的药物则需要进行监测。如果疗效不理想或观察到有毒副作用，则必须调整用药方案或换用其他药物。已经开发出一些方法来为个体患者制定合理的给药方案。在以前的方法中，患者的特定数据（如年龄、身高、体重和血清肌酐）与某种药物的群体药代动力学参数相结合。这种方法存在相当大的误差幅度，尤其是在生理状况与正常情况相差甚远的患者中。通过测定血药浓度进行治疗药物监测能够评估患者的个体药代动力学参数，进而据此制定合理的给药方案。
