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1. Work: Elgilani Zaher
- Monitoring of serum drug concentration to optimize drug therapy (Warfarin therapy )
-Can also monitoring drug effect rather than concentration
(Warfarin therapy monitoring with INR (see blood) )
Flowmeter test
INR : international neutral rescue
1.2 in normal person but some
patient need more amount

2. Clinical significant
Avoid toxicity
- Narrow therapeutic index (lithium , digoxin , warfarin )
(Digoxin 1-2 ngml > arrhythmia > toxicity )
-Presence of disease state (liver or renal dysfunction ) can
change of pharmacokinetics (Administration > excretion)
 To improve efficacy (Response of ligand on cell )
-Drug with non-liner kinetics (zero elimination ) (phenytoin)
 Drug resistance or patient non-compliance(Psychopath)

3. Q) What is affinity of the drug ?
It is the empathy of receptors to ligand or drug .