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

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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)