Dr Shaw expressed his conviction that through meetings like this one in regions throughout the world it is hoped that we can define best practices in TDM and Clinical Toxicology worldwide and further develop these disciplines. The opening lecture was presented by Professor Zenon Jakubowski on Therapeutic drug monitoring in Poland. He provided data describing the number of TDM tests and laboratories performing these tests. According to analysis of this data there is an underutilization of TDM tests and the need for greater collaboration between clinicians and the laboratory in Poland. Systematic implementation of best standards of practice in TDM and clinical toxicology will lead to improved patient care and reduced costs of therapy.
Mass spectrometry is indispensable for identification of drugs and metabolites.
Dr Skopp reviewed the principles of several forms of HPLC-MS analysis and focused attention on the analysis of amphetamines, cocaine, opiates, especially morphine and its glucuronides, and cannabinoids with examples from forensic and clinical cases. Following this Professor Philip Walson, University of Cincinnatti, discussed Pediatric anticonvulsant TDM with case discussions. A careful systematic review of AED TDM data demonstrates the wide inter-individual differences in AED clearance and show why TDM is required to effectively individualize AED dosing to treat pediatric seizure patients. Not only is pharmacokinetic variability of AED important but pharmacodynamic inter-individual variability has to be taken into account by the clinician when interpreting drug concentration data. Professor Michael Oellerich of the George August University Medical Center, Gottingen, described Therapeutic drug monitoring of cyclosporine and tacrolimus in transplant patients, progress and pitfalls.