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ASHP Statement on the Pharmacist’s Role in Clinical Pharmacokinetic Monitoring

The American Society of Health-System Pharmacists (ASHP) believes that clinical pharmacokinetic monitoring is a fundamental responsibility of all pharmacists providing pharmaceutical care. Clinical pharmacokinetic monitoring is an integral component of pharmaceutical care for selected patients based on their specific pharmacotherapy, disease states and related factors, and treatment goals. ASHP believes that clinical pharmacokinetic monitoring is essential to achieving positive outcomes for these patients across the continuum of care and in all practice settings of health systems. Examples of such outcomes include decreased mortality, decreased length of treatment, decreased length of hospital stay, decreased morbidity (either improved symptoms of disease or improved recuperation), and decreased adverse effects from drug therapy.

Background

Clinical pharmacokinetics is the process of applying pharmacokinetic principles to determine the dosage regimens of specific drug products for specific patients to maximize pharmacotherapeutic effects and minimize toxic effects. Application of these principles requires an understanding of the absorption, distribution, metabolism, and excretion characteristics of specific drug products in specific diseases and patient populations. The influence of factors such as age, sex, diet, pathophysiologic conditions, and concomitant use of other drug products must also be understood. The development of patients’ individualized dosage regimens should be based on integrated findings from monitoring both the drug concentration-versus-time profiles in biological fluids and the pharmacologic responses to these drug products.

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