- Title
- Pharmacokinetic–pharmacodynamic modeling in overdose patients – is it worth the trouble?
- Creator
- Isbister, Geoffrey K.
- Relation
- Clinical Toxicology Vol. 48, Issue 9, p. 896-897
- Publisher Link
- http://dx.doi.org/10.3109/15563650.2010.533680
- Publisher
- Informa Healthcare
- Resource Type
- journal article
- Date
- 2010
- Description
- Pharmacokinetic–pharmacodynamic (PKPD) analyses are complex and time consuming and many would believe too far removed from clinical practice to be useful for patient management. However, the clinical application of drug dosing schedules or risk assessment strategies based on PKPD analyses is possible in routine patient management. PKPD analyses investigate the relationship between dose, drug concentration and effect, including the effect of important patient characteristics (sex, age, weight, renal function). This provides accurate quantification of the relationship between dose and effect. For therapeutic drug administration this allows for individualization of drug therapy which can significantly improve the risk–benefit of the treatment. Evans et al. showed that patients with B-linkage leukemia who received individualized chemotherapy including methotrexate, had significantly better outcomes than those receiving conventional dosing. It is more difficult to see how this may be useful in clinical toxicology where there is no control over the dose ingested and the focus is on toxic and not therapeutic effects. In overdose patients, PKPD analysis can be used to develop a meaningful risk assessment based on the reported ingested dose and the potential effect of other factors (e.g. concurrent drug ingestion). PKPD analyses themselves are not without problems such as accounting for the uncertainty in dose and uncertainty in the timing of dose. If PKPD analysis is going to be accepted as a useful tool to guide clinical practice then the outcomes of research on this need to be easily translatable into clinical practice.
- Subject
- PKPD analyses; overdose patients; patient management
- Identifier
- http://hdl.handle.net/1959.13/1048158
- Identifier
- uon:14882
- Identifier
- ISSN:1556-9519
- Language
- eng
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