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DEVELOPMENT OF COMPUTER-AIDED PRESCRIPTION SYSTEM FOR PERSONALIZED PHARMACOTHERAPY BASED ON THE PHAEMACOKINETICS AND PHARMACODYNAMICS

基于药代动力学和药效学的个体化药物治疗计算机辅助处方系统的开发

基本信息

批准号：
16390043
负责人：
SAWADA Yasufumi
金额：
$ 7.87万
依托单位：
The University of Tokyo
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2004
资助国家：
日本
起止时间：
2004 至 2006
项目状态：
已结题

项目摘要

The aim of this study was to develop the computer-aided system that assists dosage regiment optimization, prescription checking, proper use of drugs and distribution of drug information based on the pharmacokinetics and pharmacodynamics. We developed algorithms for personalized pharmacotherapy with regard to 1) dosage adjustment of quinolone antibiotics and angiotensin converting enzyme inhibitors in patients with renal dysfunction, 2) quantitative estimation of time-dependent effects of St.John's wort on the drug metabolism and excretion, 3) receptor occupancy-estimation of antipsychotics-induced adverse reactions, 4) dose regime recommendations to avoid drug interaction between new-quinolones and metal cations, 5) estimation of dosing interval dependency of the interaction between itraconazole and triazolam, 6) assessment of the effects of α1-adorenoceptor antagonists in benign prostatic hyperplasia based on the receptor occupancy theory, 7) avoiding piloerection associated with antidepressants, and 8) optimization of the dosage regimen of TS-1 (a combination preparation of tegafur, gimeracil and oteracil potassium). We also developed prototype systems for some of the above algorithms on a personal computer. For example, with regard to the above 1), we developed a computer-aided system that helps to optimize the dosage and dosing time in patients with arbitrary grade of renal function by adjusting the patient's plasma concentration profile to that of subjects with normal renal function.Moreover, we inquired, by pharmacists' questionnaire, the needs for the computer-aided systems for dosage optimization after patients' poor compliance or alteration of the dosage form, and developed the prototypes. We also inquired into the standardization of drug information with regard to the dosage formulation to develop a computer-aided prescription checking system. (260 words)

本研究的目的是开发基于药代动力学和药效学的计算机辅助系统，以辅助剂量团优化、处方审核、正确用药和药物信息分发。我们开发了个性化药物治疗算法，包括：1)肾功能不全患者喹诺酮类抗生素和血管紧张素转换酶抑制剂的剂量调整，2)圣约翰草对药物代谢和排泄的时间依赖性定量评估，3)抗精神病药物引起的不良反应受体占用率评估，4)建议剂量方案以避免新喹诺酮类药物与金属阳离子之间的药物相互作用，5)估计伊曲康唑与三唑仑相互作用的剂量间隔依赖性；6)基于受体占用理论评价α -肾上腺素受体拮抗剂对良性前列腺增生的作用；7)抗抑郁药物避免头勃起；8)优化TS-1（替加富、吉美拉西和奥他拉西钾联合制剂）给药方案。我们还在个人电脑上为上述一些算法开发了原型系统。例如，针对上述1)，我们开发了一个计算机辅助系统，通过调整患者的血药浓度曲线与肾功能正常受试者的血药浓度曲线，帮助任意肾功能等级患者优化给药剂量和给药时间。通过药师问卷调查，了解患者服药依从性差或剂型变更后对计算机辅助剂量优化系统的需求，并开发原型。探讨药品信息在剂型方面的标准化问题，开发计算机辅助处方审核系统。(260字)