Therapeutic Drug Monitoring Programme

The goal of TDM is to use appropriate concentrations of difficult-to-manage medications to optimise clinical outcomes in patients in various clinical situations. The Therapeutic Drug Monitoring (TDM) programme was launched in June 2013 as a Pilot programme to evaluate the performance of our “in-house” liquid material as compared with commercially available lyophilised material. This programme is now accredited for 14 different therapeutic drugs, the benefits of registering in this programme include:

Stable liquid samples
Linear series for calculations of recovery
Covers therapeutic and analytical ranges
Traceability to gravimetric “weighed in” concentration
Standard Weqas report interpretation and scoring

A Whole Blood Immunosuppressants programme is available for Ciclosporin, Sirolimus and Tacrolimus.

Therapeutic Drug Monitoring
The base material is “off the clot” sterile human serum, tested negative forHIV, Hep B and C at donor level. Each therapeutic drug is gravimetrically added, the “weighed-in” value and its known linear dilution is used to calculate the target concentration. A linear series of pools are prepared using calibrated and certified equipment allowing full gravimetric traceability.

Frequency: Monthly

Samples per set: 3 x 1mL samples

Therapeutic Drug Monitoring Programme
Analyte	Approx. Range Covered
Amikacin	0 - 35	mg/L
Carbamazapine	0 - 20	mg/L
Digoxin	0 - 6	µg/L
Gentamicin	0 - 5	mg/L
*Lamotrigine	0 - 30	mg/L
Lithium	0 - 2.5	mmol/L
Methotrexate	0 - 1.5	µmol/L
Phenobarbital	0 - 65	mg/L
Phenytoin	0 - 30	mg/L
*Teicoplanin	0 - 70	mg/L
Theophylline	0 - 30	mg/L
Tobramycin	0 - 15	mg/L
Valproic acid	0 - 175	mg/L
Vancomycin	0 - 50	mg/L
Whole Blood Immunosuppressants
- Ciclosporin	0 - 600	µg/L
- Sirolimus	0 - 20	µg/L
- Tacrolimus	0 - 15	µg/L