Towards evidence-based dosing regimens in children on the basis of population pharmacokinetic pharmacodynamic modelling
Towards evidence-based dosing regimens in children on the basis of population pharmacokinetic pharmacodynamic modelling
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DOI：
10.1136/archdischild-2013-303721
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发表时间：
2014-03-01
影响因子：
5.2
通讯作者：
Knibbe, Catherijne A. J.
中科院分区：
文献类型：
--
作者：
Admiraal, Rick;van Kesteren, Charlotte;Knibbe, Catherijne A. J.
随着年龄的增长，药物的药代动力学（PK）和药效学（PD）特征发生变化，这可能会改变药物的效果。为了确保儿科护理中的最佳药物疗效和安全性，需要在儿童中探索药物的PK和PD关系。本文概述了开展群体PK/PD研究并将其结果转化为合理的给药方案的概况，并讨论了PK/PD循证给药方案的开发和前瞻性评价。阿米卡星，吗啡和白消安的例子，显示如何PK（/PD）建模不仅导致优化和个性化的儿科临床护理的特定药物，但也洞察器官系统的成熟。它表明，后者的结果可以随后被用作通过相同的途径消除的其他药物的剂量的基础。最终，这些努力应该导致所有年龄组的可预测的药物疗效和安全性。
When growing up, the pharmacokinetic (PK) and pharmacodynamic (PD) profiles of drugs change, which may alter the effect of drugs. To ensure optimal drug efficacy and safety in paediatric care, PK and PD relationships of drugs need to be explored in children. This article presents an outline on performing a population PK/PD study and translating these results into rational dosing regimens, with the development and prospective evaluation of PK/PD derived evidence-based dosing regimen being discussed. Examples on amikacin, morphine and busulfan are provided, showing how PK (/PD) modelling not only led to optimization and individualization in paediatric clinical care for the specific drugs but also to insight in maturation of organ systems involved. It is shown that the latter results can subsequently be used as a basis for dosing of other drugs eliminated through the same pathway. Ultimately, these efforts should lead to predictable drug efficacy and safety across all age groups.