Toxicology & TDM
Therapeutic drug monitoring and toxicology screening reports
Rajan Mehta, 75M — critical drug level. Immediate prescribing physician notification required.
Rajan Mehta, 75M
TOX-2026-0441 · Dr. R. Iyer (Cardiology) — Therapeutic Drug Monitoring
Specimen: Blood (EDTA + Lithium Heparin) · 23 Jun 2026, 06:15
Critical
| Drug / Analyte | Result | Therapeutic Range | Flag | Clinical Note |
|---|---|---|---|---|
| Digoxin (TDM) | 2.8 ng/mL | 0.5–2.0 ng/mL | Supratherapeutic | Risk of digoxin toxicity — dose review required |
| Vancomycin Trough (TDM) | 22 mcg/mL | 10–20 mcg/mL | Supratherapeutic | Reduce dose frequency. Monitor renal function. |
| Phenytoin (Total) | 14 mcg/mL | 10–20 mcg/mL | Therapeutic | — |
Supratherapeutic digoxin and vancomycin levels. Recommend clinical review for potential toxicity. Reduce digoxin dose and lengthen vancomycin dosing interval.
Arjun Sharma, 22M — critical drug level. Immediate prescribing physician notification required.
Arjun Sharma, 22M
TOX-2026-0440 · Dr. S. Iyer (Emergency) — Overdose workup
Specimen: Blood + Urine · 22 Jun 2026, 23:40
Critical
| Drug / Analyte | Result | Therapeutic Range | Flag | Clinical Note |
|---|---|---|---|---|
| Paracetamol (Acetaminophen) | 182 mcg/mL | 10–20 mcg/mL (therapeutic) | Toxic | Above Rumack-Matthew line — N-acetylcysteine urgently indicated |
| Salicylates | < 30 mg/L | < 30 mg/L (non-toxic) | Not Detected | — |
| Urine Drug Screen | Benzodiazepines: Detected | — | Detected | Poly-substance overdose |
Acute paracetamol poisoning with hepatotoxic level. Benzodiazepine co-ingestion. Urgent NAC protocol, LFT monitoring, and ICU transfer recommended.