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Gilbert’s syndrome is a hereditary (usually autosomal recessive) condition caused by impaired hepatic bilirubin clearance. Gilbert’s syndrome is present in 5–10% of Western European populations, with one in three of those affected unaware that they are affected. Gilbert’s syndrome is characterised by mild unconjugated non-haemolytic hyperbilirubinaemia.

Diagnosis of the disorder is often made after an incidental finding of isolated hyperbilirubinaemia on routine liver biochemistry testing.

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A joint initiative of the Patient Services Section and the Drug and Therapeutics Information Service of the Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia. The RGH Pharmacy E-Bulletin is distributed in electronic format on a weekly basis, and aims to present concise, factual information on issues of current interest in therapeutics, drug safety and cost-effective use of medications.
Editor: Assoc. Prof. Chris Alderman, University of South Australia – Director of Pharmacy, RGH © Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia 5041.

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Therapeutic drug monitoring (TDM) refers to the measurement of drug concentrations in biological fluids with the goal of optimising a patient’s drug therapy and clinical outcomes. Drugs where TDM is used include those with a narrow therapeutic index, concentration-dependent pharmacokinetics, or where the desired therapeutic effect is difficult to monitor or there are large pharmacokinetic variations between individuals.

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