Pharmacology in the Clinical Lab: Therapeutic Drug Monitoring and Pharmacogenomics (Online Course)

(based on 282 customer ratings)

Author: Kevin F. Foley, PhD, DABCC, MT, SC
Reviewer: Robert E. Moore, MLS(ASCP)CM, SCCM, TC(NRCC)

Therapeutic drug monitoring and pharmacogenomics are both pharmacy-related areas within the clinical laboratory. Although each is considered a sub-discipline within laboratory medicine, the two fields overlap significantly. This course provides an overview of each of these laboratory sub-disciplines and discusses the utility, rationale, and practice of each one. The course is intended for clinical laboratory technologists and technicians and other health care personnel who are responsible for prescribing and administering therapeutic medications.

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Continuing Education Credits

  • P.A.C.E.® Contact Hours: 1.5 hour(s)
  • Florida Board of Clinical Laboratory Science CE - General (Clinical Chemistry/UA/Toxicology): 1.5 hour(s)

Objectives

  • Define therapeutic drug monitoring (TDM) and explain the rationale for this testing.
  • Explain the concept of elimination half-life.
  • List the criteria and attributes of commonly monitored drugs.
  • Discuss three methods that are used for the measurement of therapeutic drugs in serum.
  • Define pharmacogenomics, polymorphism and CYP450; explain what is meant by "individualized medicine" or "personalized medicine."
  • Explain the usefulness of CYP450 testing as well as its shortcomings.
  • List the four classifications of metabolizers and explain the clinical relevance of each.

Customer Ratings

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Course Outline

  • TDM
      • Introduction
      • Therapeutic Drug Monitoring Definition
      • Pharmacogenomics Definition
      • Basic Pharmacokinetics
      • Drug Concentration Over Time
      • Drug Metabolism
      • Drug Elimination
      • Half-Life
      • Bioavailability
      • Protein Binding
      • Protein Availability and Drug Dosing
      • Other Factors Affecting Drug Absorption and Distribution
      • Given what you have learned thus far, which of the following statements below do you think is true?
      • Steady State
      • Steady State Example
      • Sampling
      • Peak and Trough Sampling Times
      • Why TDM?
      • Why TDM?
      • Unexpected Concentrations
      • A physician needs to prescribe a drug to a patient but the drug has a narrow therapeutic window. He is concerned about possible toxic effects. To asse...
      • TDM For All Drugs?
      • When is TDM Not Useful?
      • Alternative to TDM
      • Examples of Drugs That are Monitored by TDM
      • TDM for Antibiotics
      • TDM for Anticonvulsants
      • TDM for Immunosuppressants
      • TDM for Cardiac Medications
      • TDM for Theophylline
      • Albuterol is a fast-acting bronchodilator used acutely during asthma attacks. Which of the reasons below explains why TDM for albuterol is not availab...
      • Laboratory Methods
      • PETINIA
      • FPIA
      • Chemiluminescence
  • Pharmacogenomics
      • Individualized Medicine
      • Polymorphism and CYP450
      • CYP450s
      • CYP2D6
      • Metabolizers
      • Enzyme Abnormalities and Drugs
      • Clinical Utility
      • Warfarin Metabolism
      • Warfarin Metabolism, continued
      • A person who is classified as an ultrarapid metabolizer (UM) would need __________ of a drug metabolized by that enzyme.
      • CYP450 Induction and Inhibition
      • CYP450 Induction and Inhibition, continued
      • A patient is taking cimetidine for a stomach ulcer. This drug inhibits CYP2D6. The patient is now prescribed amphetamine for narcolepsy. Amphetamine i...
      • Genotype versus Phenotype
      • Genotype versus Phenotype, continued
      • TDM and PGx
      • The Bottom Line
      • The Bottom Line, continued
  • References
      • References

Additional Information

Level of instruction: Intermediate

Intended Audience: Clinical laboratory technologists and technicians as well as other health care personnel who are responsible for prescribing and administering therapeutic medications.

Author Credentials: Kevin F. Foley, PhD, DABCC, MT, SC is the director of clinical pathology for the Kaiser Permanente Northwest region. He also teaches clinical chemistry at Oregon Health Sciences University. Dr. Foley earned his PhD in clinical pharmacology and toxicology at East Carolina School of Medicine in North Carolina. He received a PhD in clinical pharmacology and toxicology from Brody School of Medicine, Greenville, NC. He has been working in laboratory medicine for over 15 years, starting his career as a medical technologist.
Reviewer Credentials: Robert E. Moore, MLS(ASCP)CM, SCCM, TC(NRCC) is the lead technologist in the toxicology laboratory at Kaiser Permanente in Portland, Oregon where his responsibilities include methods development and validation, review of QC data, instrument troubleshooting, and employee training/competency assessment. In his career as a medical laboratory scientist, he has been a chemistry supervisor, toxicology supervisor, and laboratory director. He holds a Bachelors degree in Biology from Marshall University.

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