Therapeutic drug monitoring in developing nations: Assessing the current state of affairs in South America

Abstract

Therapeutic drug monitoring (TDM) aims to offer assistance to clinicians to improve drug dosing and clinical outcomes, while minimizing the probability of serious adverse effects in routine clinical practice. Disease conditions, drug-drug and drug-herbal interactions, noncompliance, and genetic features affect the relationship between drug concentrations in the body and clinical effects. They contribute to the pharmacokinetic inter-patient variability which ultimately impactsdrug response, resulting in some patients showing lack of therapeutic effects while others experience toxicity. Thus, the identification of the sources of pharmacokinetic variability contributes to the adequacy of the dosing regimen [1]. However, performing TDM in Developing Nations as South American Countries is particularly challenging, mainly due to the lack of structure and economic aspects.