Learning Journal of POCT

Therapeutic drug Monitoring (TDM) might be looked upon as the drug measurement use in body fluids to ensure supervision of patients who receive drug therapy for the treatment, mitigation and prevention of diseases. It has been a tradition to adjust of dosage drugs in accordance with traits and their therapeutic effects on a particular individual. Dosage personalization has proved to be difficult for those drugs that are not accessed in clinics, or when effects of toxins can’t be sensed without severe toxicity.  Measuring drug levels in body fluids like serum and urine is an established clinical practice assisting in optimization and individualizing the therapy, (Valdes et al, 2010).

Toxicology in the current clinical context, toxicology has been linked to the process of investigating patients who are poisoned, and identifying relevant toxins. There are many reasons that can lead to poisoning like euthanasia among others.  It has been shown that POCT is vital in hospital emergency department in assessing poisoned patients on admission. Apart from being used in clinics, it has been used as part of screening programs at workplace, or driver screening initiatives. Drug overdose and abuse testing has been performed generally on urine, and the saliva use has been only in defined conditions, while for ethanol testing, breath is preferred.

The alleged flexibility and ease of tool use, makes POCT devices, the best analytical apparatus in several conditions and by many operators. The main problem with this tool is that; unskilled operators and the potentiality inappropriate usage and the interpretation of results, might render the results unreliable. From the legal point of view, POCT drug and even ethanol outcomes are only considered to being preliminary results. The final confirmed results have to be confirmed by laboratory procedures that are accredited, for example following the Australian Standard AS 4308, (Valdes et al, 2010).

 The effects of smoking were recognized three decades ago. Due to this, Continine has been the acceptable standard for the validation of chemicals of smoking status. It has been measured in several body fluids like urine, while the traditional analysis was chromatography. The assessment of point of care for the status of smoking mainly concentrates on providing evidence that supports claims of smoking by patients or volunteers. Presently, POCT is not under use to asses’ exposure to ETS.