Individual skill
therapeutic-drug-monitoring
Therapeutic drug monitoring — when to measure levels, sampling timing, and dose adjustment.
skills/therapeutic-drug-monitoring/SKILL.md
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## Overview
therapeutic-drug-monitoring (TDM) covers the clinical use of drug concentration measurements to
guide dosing: which drugs justify monitoring, when to draw levels (troughs, peaks, AUC), how to
interpret results in context, and how to adjust doses. TDM is worthwhile only when the drug has
a narrow therapeutic window, large PK variability, and a measurable concentration-effect
relationship — most drugs fail at least one criterion.
## When to use
- Deciding whether TDM is indicated for a drug/patient.
- Sampling strategy: trough vs peak vs AUC-guided (vancomycin, aminoglycosides).
- Interpreting levels: timing relative to dose, steady state, assay issues.
- Dose adjustment: proportional, Bayesian forecasting.