Question:
Which of the following drugs requires therapeutic drug monitoring?
Which of the following drugs requires therapeutic drug monitoring?
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Therapeutic drug monitoring (TDM) means measuring blood levels of a drug to keep them within a safe and effective range.
Updated On: Jun 24, 2026
- Acetaminophen
- Amoxicillin
- Lithium
- Prodrug activated in the liver
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The Correct Option is C
Solution and Explanation
Concept:
Therapeutic drug monitoring (TDM) means measuring blood levels of a drug to keep them within a safe and effective range. TDM is reserved for drugs with a narrow therapeutic index, where the toxic dose is close to the effective dose.
Step 1: Lithium has a very narrow therapeutic window — levels just above the therapeutic range can cause serious toxicity (tremor, confusion, renal and cardiac effects). Therefore its plasma concentration must be monitored regularly.
Why the other choices are wrong: Acetaminophen and Amoxicillin have wide safety margins and are not routinely monitored by blood levels. The "prodrug activated in the liver" option is not a specific drug requiring routine TDM.
Answer: Option (3) — Lithium requires therapeutic drug monitoring because of its narrow therapeutic index. (3)
Therapeutic drug monitoring (TDM) means measuring blood levels of a drug to keep them within a safe and effective range. TDM is reserved for drugs with a narrow therapeutic index, where the toxic dose is close to the effective dose.
Step 1: Lithium has a very narrow therapeutic window — levels just above the therapeutic range can cause serious toxicity (tremor, confusion, renal and cardiac effects). Therefore its plasma concentration must be monitored regularly.
Why the other choices are wrong: Acetaminophen and Amoxicillin have wide safety margins and are not routinely monitored by blood levels. The "prodrug activated in the liver" option is not a specific drug requiring routine TDM.
Answer: Option (3) — Lithium requires therapeutic drug monitoring because of its narrow therapeutic index. (3)
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