Monitoring markers of kidney function such as creatinine, electrolyte, fluid, weight, and acid-base status, careful attention to type and amount of intake, and addressing medication needs with choosing kidney friendly alternatives where possible, as well as monitoring drug levels of renally excreted drugs and reducing prescribed amounts adequately are commonly employed strategies (Table 2).
The potential value of monitoring drug levels or coagulation tests is yet unclear.
Monitoring drug levels in plasma cannot be indicated for routine use unless future studies provide us with more data.
By properly conducting immunosuppressive regimens, maintaining immunosuppression, and carefully monitoring drug levels, acute rejection can be successfully prevented or treated.
In addition to the strategies described in this review (Table 1), clinicians must insure that antibiotic administration satisfies minimal requirements, such as proper dosing, drug interval administration, monitoring drug levels, and avoiding harmful drug interactions.
The risk of nephrotoxicity can be reduced by monitoring drug levels to guide dose adjustments to maintain levels within a therapeutic range; however, AKI can still occur within therapeutic levels.
Often, the monitored drug levels are judged against historical "norms" and not necessarily viewed in the context of specific factors which may suggest a different scale by which they should be judged.
On the clinical side, studies involving HDACis should demonstrate on target activity in tumor tissue in addition to simply monitoring drug levels and histone acetylation in PBMCs as a surrogate), and possibly develop novel dosing and/or application schedules, such as oral vs. intravenous application, extended release or infusion over several hours, multiple dosing with lower doses etc.
Dried blood spot (DBS) analysis provides an ideal tool to monitor circulating drug levels and is also feasible to obtain drug pharmacokinetics (PK studies) [ 6, 7].
The online monitoring of drug levels in body fluids represents a visionary solution for personalized medicine that could facilitate the patient treatment.
