Naslov predavanja

A NEW CLINICAL SOFTWARE PACKAGE for
MULTIPLE MODEL (MM) DESIGN of DRUG DOSAGE REGIMENS
for PLANNING, MONITORING, and ADJUSTING OPTIMALLY INDIVIDUALIZED DRUG THERAPY for PATIENT

Kratka vsebina

Dosage regimens based on parametric population models use single values to describe each parameter distribution. When a target goal is selected, the regimen is assumed to achieve it exactly. In contrast, MM dosage design is based on nonparametric (NP) population models. These have up to one set of parameter values for each subject studied in the population, each with an estimated probability. With this more likely population model, multiple predictions are possible. Using these NP models, one can compute the MM dosage regimen which specifically minimizes the predicted weighted squared error with which a target goal can be achieved.
When feedback from serum concentrations becomes available, each set of parameter values in the NP prior has its probability recomputed. Using that revised model, the new regimen to achieve the target with maximum precision is again computed. In addition, a new Interacting Multiple Model (IMM) sequential Bayesian method now estimates posterior densities when parameter values have been changing during the analysis, as occurs with acutely ill and unstable patients. These approaches have now been combined into a new Windows software package, the MM-USC*PACK programs, for clinical use. A three compartment linear model is used.
The library of population models currently includes Gentamicin, Tobramycin, Netilmicin, Amikacin, Digoxin, Vancomycin, and Trimethoprim. Carbamazepine and Carbamazepine Sustained Release are available for adults in the steady state, Carbamazepine with Phenytoin, and Carbamazepine with Phenobarbital for adults, in the steady state. There are also models for Valproate for both adults and pediatric patients, and Sustained Release Valproate for adults.

Kontaktni naslov: R. Jelliffe
University of Southern California Keck School of Medicine
2250 Alcazar St, CSC-134-B, Los Angeles CA USA
Phone: (1-323)-442-1300
email: jelliffe@usc.edu