Brad Schaeffer has served as the President of MedComp Sciences since 2012. Located in Zachary, Louisiana, MedComp Sciences focuses on healthcare innovation and medication monitoring. In the following article, Brad Schaeffer and MedComp Sciences explain the importance of medication and dosage monitoring for patients.
As Paracelsus said centuries ago, “the dosage makes the poison.” That means that one person’s medicine could potentially kill another if they take the wrong quantity. The modern combinations of drugs and a heavily medicated American population means that many medications require further scrutiny before being given to a patient.
Enter therapeutic medication monitoring (or therapeutic drug monitoring). Brad Schaeffer and MedComp Sciences say that the purpose of TMM is to make sure the patient gets the right dosage of medicine. Brad Schaeffer and MedComp Sciences explain what TMM/TDM is, what drugs usually require it, and when someone should start looking into TMM services.
Therapeutic Medication Monitoring (TMM)
Therapeutic drug monitoring is a testing procedure meant to optimize the dosage for any given patient. Brad Schaeffer and MedComp Sciences explain that some drugs are so strong that they can have adverse side effects, possibly even being lethal if prescribed in the wrong amount. At the same time, these drugs must also be effective enough to get therapeutic results. This sweet spot is called the “therapeutic window.”
Brad Schaeffer and MedComp Sciences say that to find the proper dosage for a patient, therapeutic medication monitoring requires a sample of blood, urine, or saliva. This is usually done before writing a prescription.
Much of TDM also depends on pharmacogenetics—that is, making prescriptions based on someone’s genetic predispositions. In some cases, a riskier-than-average prescription may be considered if the patient has genetic factors that make common options ineffective.
Why Would Someone Need TMM
Brad Schaeffer and MedComp Sciences say that someone may need TMM right before they start a new medication (see chart below for examples). The medications in question often have a high degree of pharmacokinetic variability, meaning they react differently in different individuals, especially over time. Brad Schaeffer and MedComp Sciences say that the effectiveness of these drugs can even vary by gender, genetics, or interactions with other drugs.
Since these drugs can be toxic when given in the wrong dosage, personalized testing is required. They may also interact with current medications or other factors.
Some of these factors include:
- The dose of the drug
- The frequency/route of administration (i.e., how and how often the drug is taken)
- Body type
- Chemistry of the drug
- Any other drugs the patient is taking
Why Genetics Matter
Brad Schaeffer and MedComp Sciences have mentioned genetics a few times, but why do they matter for TMM? The simple answer is that some genes have adverse (or preventative) reactions to certain drugs. The wind can blow either way—some people may have stronger or weaker reactions to drugs. Entire medication groups can be rendered useless by a tweak of one allele.
The Drugs That Warrant TMM
Some drugs are very likely to warrant drug monitoring. Here is a table of some examples:
There are many, many more drugs that warrant TMM. This list only covers some of the most common.
This chart neglects to mention that many cancer drugs also have a narrow therapeutic window. Any cancer treatment will almost certainly require TMM.
Brad Schaeffer and MedComp Sciences say that drug interactions are complex. But if someone thinks they might need drug monitoring, the only way to know for sure is to ask their doctor. A wise personal care provider will provide TMM before prescribing any drugs with potentially hazardous side effects.
Brad Schaeffer and MedComp Sciences say that the biggest risk of TMM is only bruising and lightheadedness after a blood test. Even so, many TMM tests opt to use saliva samples instead. There is almost no risk with getting TMM if someone’s physician asks for it. Overall, if a patient has had bad interactions with medications in the past, it is almost certainly worth getting TMM before a prescription.
Therapeutic medication monitoring is effective on a case-by-case basis. Many people only consider it after standard medications prove ineffective. Some diseases like cancer require TMM regardless of the situation. People with severe reactions to certain medications or genetic diseases may also require TMM.
Therapeutic medication drug and dosage monitoring ensures that a patient gets the proper amount of potent medication, and checks for possible drug interactions. If a drug has potentially deadly or otherwise worrisome side effects, it may be a candidate for TMM. Finally, people with adverse reactions to medications may require TMM before starting a potentially dangerous prescription.