Clinical Pharmacokinetics

, Volume 17, Supplement 1, pp 4–12 | Cite as

The Role of Therapeutic Drug Monitoring in Children

  • Lars O. Boréus


Routine use of therapeutic drug monitoring in children is helpful in individualising the dosage during long term treatment (e.g. theophylline and antiepileptic drugs) and in checking against toxic accumulation of drug in neonates (e.g. digoxin, theophylline/caffeine and aminoglycoside antibiotics). In individual patients, measurements of drug concentrations in plasma may be the only way to elucidate clinically unexpected drug effects or to handle interaction phenomena.

Knowledge of the pharmacokinetic and pharmacodynamic changes during development is a prerequisite for a correct interpretation of the concentration values. Unfortunately, the quantitative relation between kinetics and clinical effect is still relatively poorly known for many drugs in the paediatric age groups.

Apart from the pharmacokinetic informative value, therapeutic drug monitoring also has some merit as an aid to the physician in explaining to the patient and the parents why the drug should be taken as instructed. This may improve compliance.


High Performance Liquid Chromatography Digoxin Theophylline Carbamazepine Valproate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Boréus LO. Principles of pediatric pharmacology. Churchill Livingstone, New York, 1982Google Scholar
  2. Buchanan N. Therapeutic drug monitoring in childhood. Australian Paediatric Journal 22: 19–26, 1986PubMedGoogle Scholar
  3. Collins-Nakai RL, Ng PK, Beaudry MA, Ocejo-Moreno R, Schiff D, et al. Total body digoxin clearance and steady-state concentrations in low birth weight infants. Developmental Pharmacology and Therapeutics 4: 61–70, 1982PubMedGoogle Scholar
  4. Evans WE, Schentag JJ, Jusko WJ. Applied pharmacokinetics. Principles of therapeutic drug monitoring, 2nd ed., Applied Therapeutics Inc., Spokane, 1986Google Scholar
  5. Hastreiter AR, van der Horst RL, Voda C, Chow-Tung E. Maintenance digoxin dosage and steady-state plasma concentration in infants and children. Journal of Pediatrics 107: 140–146, 1985PubMedCrossRefGoogle Scholar
  6. Hendeles L, Weinberger M, Bighley L. Absolute bioavailability of oral theophylline. American Journal of Hospital Pharmacy 34: 525–527, 1977PubMedGoogle Scholar
  7. Nyberg L, Wettrell G. Pharmacokinetics and dosage of digoxin in neonates and infants. European Journal of Clinical Pharmacology 18: 69–74, 1980PubMedCrossRefGoogle Scholar
  8. Rylance GW, Moreland TA. Drug level monitoring in paediatric practice. Archives of Diseases in Childhood 55: 89–98, 1980CrossRefGoogle Scholar
  9. Sawchuk RJ, Zaske DE, Cipolle RJ, Wargin WA, Strate RG. Kinetic model for gentamicin dosing with the use of individual patient parameters. Clinical Pharmacology and Therapeutics 21: 362–369, 1977PubMedGoogle Scholar
  10. Sjöqvist F, Borgå O, L’Orme EM. The role of the clinical pharmacological laboratory in improving drug therapy. In Avery GS (Ed.) Drug treatment, 3rd ed., ADIS Press, Auckland, 1987Google Scholar
  11. Vozeh S. Cost-effectiveness of therapeutic drug monitoring. Clinical Pharmacokinetics 13: 131–140, 1987PubMedCrossRefGoogle Scholar
  12. Zaske DE. Aminoglycosides. In Evans WE, et al. (Eds) Applied pharmacokinetics, 2nd ed., p. 332, Applied Therapeutics Inc., Spokane, 1986Google Scholar

Copyright information

© ADIS Press Limited 1989

Authors and Affiliations

  • Lars O. Boréus
    • 1
  1. 1.Department of Clinical PharmacologyKarolinska HospitalStockholmSweden

Personalised recommendations