Question:
Which of the following drug does NOT require therapeutic drug monitoring:
Which of the following drug does NOT require therapeutic drug monitoring:
Updated On: Jul 14, 2026
- Digitoxin
- Phenytoin
- Gentamicin
- Acetaminophen
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The Correct Option is D
Approach Solution - 1
The correct option is (D): Acetaminophen.
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Approach Solution -2
The question asks which drug does NOT need therapeutic drug monitoring (TDM), meaning regular blood level checks to keep dosing safe and effective. Let's look at each drug's risk profile.
- Digitoxin: This cardiac glycoside has a narrow gap between the dose that helps the heart and the dose that causes dangerous arrhythmias, so its blood levels are routinely monitored.
- Phenytoin: This antiepileptic drug also has a narrow therapeutic range, and its clearance from the body changes unpredictably as the dose increases, which means small dose changes can cause large swings in blood level, making monitoring necessary.
- Gentamicin: This aminoglycoside antibiotic can damage the kidneys and the ears if blood levels climb too high, so peak and trough levels are checked regularly during treatment.
- Acetaminophen: At normal recommended doses, acetaminophen has a wide margin between an effective dose and a harmful one, and its levels in the blood behave predictably. Because of this, routine blood level monitoring is not standard practice for typical dosing, unlike the other three drugs listed.
Digitoxin, phenytoin, and gentamicin all carry narrow safety margins that require regular blood level checks, while acetaminophen at normal doses does not need this kind of routine monitoring.
Therefore, the correct answer is Acetaminophen.
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