Pharmacokinetic & Pharmacodynamic Drug Information and Dosage Adjustment System



TypeHSR Project
SummaryNot only every patient is different, but also every drug. Drug dosage must be individualised, and adjusted to the patient's organ func- tion (e.g. age, kidney) and severity of disease (e.g. intensive care, outpa- tient office). Within an European project, we are on the way to built up a drug information and dosage adjustment system. The essential compo- nents are available: the pharmacokinetic /-dynamic database NEPharm, calculation algorithms, a consensus on general pharmacokinetic concept, on dose adjustment rules, and on standard nomenclature (ATC code). A graphical user interface must be designed. The required components must be made interoperable, namely patient record, drug dictionary, phar- macokinetic /-dynamic database, calculation algorithms, graphical user interface. The dosage proposals made by the system must be clinically certified, and be compared to standard practice in an external environ- ment to evaluate clinical applicability and reliability. Special versions of the system will be designed for the needs of our software partners. The integrated system will be implemented to establish an internet-based centre of excellence for individualised drug therapy. Results: -At present information is recorded for 2,496 generic drugs (acyclovir, zidovudine) as extracted from 4,318 primary scientific citations (NEJM, Drugs ). NEPharm provides 37 slots for pharmacokinetic and pharmacodynamic parameters as well as different clinical categories (e.g. T½, CE50, Neonatal). Based on 29,945 extracted values a statistically synthesised estimate is calculated for 13,824 pharmacokinetic and pharmacodynamic parameters. In addition, categories are provided for drug interactions (e.g. cyclosporin-rifampicin), and fast/slow metabolism, or other polymorphism's (P-glycoprotein transporter). Conclusion: -PharmacoKinetic, PharmacoDynamic and PharmacoGenetic knowledge may be recorded in discrete or dichotomous categories. Where such functions are known, as for example in renal impairment, individual parameters can be estimated by rule-based interpolation. Innovative aspects: We have developed two components that are interoperable to derive individualized drug dose adjustment. First, we have a pharmacokinetic database with 3500 parameters for 1800 most frequently used drugs. Secondly, we have calculated algorithms for individual parameter estimates, and dosage adjustments according to patient related data.
SectorsPrimary, Hospital
TopicsEffectiveness, E-Health
Last update date09-20-2011 11:25


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