Assessment and comparison of therapeutic drug monitoring cases in Hospital Putrajaya from 2015 to 2016

Therapeutic Drug Monitoring (TDM) has been proposed as a mean to optimize response and also to prevent toxicity cases that may harm the patients. This study focuses on statistics of how many cases of TDM occur throughout the year 2015 and 2016. The research was done in Hospital Putrajaya, Clinical Pharmacy Department whereby the data is collected from the department's database. The database consists of the past record of patients who were referred as TDM sampling as they were prescribed with medications that have the narrow therapeutic index that may cause severe toxicity to the patients and also the dosage of prescribed drugs that is required to be monitored in order to be effective for an individual. The drugs identified are the drugs that are widely and commonly used in Malaysia to assess their therapeutic range in the clinical unit; Amikacin, Gentamicin, V ancomycin, Phenytoin, Valproate, Phenobarbitone, Carbamazepine, Theophylline, Digoxin, Paracetamol, Salicylate, Lithium, Cyclosporin, and Benzodiazepine. There were increases in TDM cases from the year 2015 to 2016 with Gentamicin as the most drug taken for the sample. This is because Gentamicin is used as antibiotics to treat neonatal sepsis in HPj. All Paracetamol and Salicylates cases are considered as toxicity cases, and from the result, there is a reduction of cases from the year 2015 and 2016, however, toxicity cases among pediatrics increases. This is due lack of knowledge on handling the medication among the public, easy access to the medication and also an error in dosing prescribing. Hopefully, from this research, the awareness of how important TDM assessment to the patients can be introduced amongst prescriber to ensure that the therapeutic concentration is suitable for the individualized patients and can help to reduce toxicity cases on Paracetamol and Salicylates. This can be done by having a talk on its importance, discussing on the dosage of the TDM medications. Besides, providing easy and fast access to the doctors and pharmacist to interact with each other when related to TDM drugs especially during night shifts.