Rajesh Kumar, Brijesh Kumar*, Ashutosh Kumar
Department of Pharmacology, Institute of Medical Sciences, Banaras Hindu University Varanasi, India – 221005
*Address for Corresponding Author
Brijesh Kumar
Department of Pharmacology, Institute of Medical Sciences,
Banaras Hindu University, Varanasi 221005, India.
Abstract
Concomitant food, drug and disease states play a dramatic role on the pharmacokinetics of first-line anti-tuberculosis drugs. Food has enormous effect on physico-chemical properties, site, rate, and extent of absorption and first pass metabolism of the drugs. Concomitant drugs may sometimes produce sub-therapeutic level while illicit toxicity on the other hand like hepatotoxicity. Drugs with antacids in empty stomach or with food also alter pharmacokinetics. Different types of drugs in HIV and diabetes have huge alteration in pharmacokinetic parameters like Cmax, Tmax, AUC and clearance. In tuberculosis treatment with HIV, the decrease in CD4 cell count and compromised immunity directly alter therapeutics. The applications of Therapeutic drug monitoring (TDM) is based on the measurement of drug concentrations in blood samples collected at appropriate times and subsequent dose adjustment according to the target concentration. Appropriate dosing through individualization by TDM may lower the treatment costs and optimize the dosage regimen to achieve the optimal response with minimal toxicity. This review aims to consider the effect of food, concomitant drugs and co-morbidities in patients of tuberculosis by monitoring therapeutic drug concentration in the patient’s blood plasma.
Keywords: Tuberculosis, pharmacokinetics, Therapeutic drug monitoring
