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The page below is a sample from the LabCE course Pharmacology in the Clinical Lab: Therapeutic Drug Monitoring and Pharmacogenomics. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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When is TDM Not Useful?

TDM is not useful in these specific situations:
  • For drugs which act intracellularly, or that need to be converted to active forms (like AZT)
  • For drugs in which the effects last much longer than the serum concentrations of the drugs; examples include antineoplastics (cancer chemotherapies) and warfarin.
  • Narcotic pain medications where continued use can lead to tolerance such that the levels needed for pain relief in one person would be toxic to another person