Improving drug dosing in hospitalized patients: automated modeling of pharmacokinetics for individualization of drug dosage regimens.
Improving drug dosing in hospitalized patients: automated modeling of pharmacokinetics for individualization of drug dosage regimens.
复制标题
改善住院患者的药物剂量：药物剂量方案个体化的药代动力学自动建模。
DOI：
10.1016/0169-2607(89)90069-2
复制
发表时间：
1989
影响因子：
6.1
通讯作者：
Blaschke,T
中科院分区：
文献类型：
--
作者：
Lenert,L;Sheiner,L;Blaschke,T
许多临床上有用的药物都有一个既安全又有效的窄血药浓度范围。个体间和个体内药物处置的差异是导致血药浓度超出治疗范围的重要因素。个体药代动力学的建模为解决药物处置变化问题提供了一种有效的方法。以前的个体药代动力学建模方法需要大量的计算或在临床环境中使用计算机软件和硬件，并需要特殊的专业知识来解释结果。本文描述了一个原型计算机程序。PK监视器，当与适当的接口连接时，它可以自动监测药物剂量并建议可能需要的变化，以获得治疗范围内的血药浓度。该软件还可以检测药物处置变化的发生，这将导致浓度超出治疗范围，识别潜在的错误血药浓度测量，并评估进一步血药浓度测量的需要。该项目将成为MENTOR治疗监测系统项目的一个组成部分。PK Monitor有待与MENTOR系统的其余部分进行完整的评估，但初步模拟表明，在监测意外数据和变化方面具有合理的敏感性和特异性。
Many clinically useful drugs have a narrow range of blood concentrations which are both safe and efficacious. Inter-individual and intra-individual variations in drug disposition are important factors causing blood concentrations of drug to fall outside of the therapeutic range. Modeling of the pharmacokinetics of the individual offers an effective approach to the problem of variation in drug disposition. Previous approaches for the modeling of individual pharmacokinetics have required either extensive computations or access to computer software and hardware in the clinical environment, and special expertise to interpret the results. This paper describes a prototype computer program. PK Monitor, which can, when connected with an appropriate interface, automatically monitor drug dosing and recommend changes that may be required to obtain blood concentrations in the therapeutic range. The software can also detect the occurrence of change in drug disposition which will lead to concentrations outside of the therapeutic range, identify potentially erroneous blood concentration measurements, and assess the need for further blood concentration measurements. This program will be an integral part of the MENTOR therapeutic monitoring system of programs. PK Monitor awaits a complete evaluation with the rest of the MENTOR system, but preliminary simulations suggest reasonable sensitivity and specificity in monitoring for unexpected data and change.