Towards Personalized Medication

The paper describes some aspects of precision medicine and shows the importance of pharmacokinetics and pharmacodynamics for the therapeutic drug monitoring and model-informed precision dosing. A key element in the design of the pharmacokinetics and pharmacodynamics (PKPD) models is relevant literature search that represents an essential step in the procurement and validation of a new drug. Available search engine resources do not offer specific functionalities that are required for efficient and relevant search in reliable literature sources. We present a prototype of such an intelligent search engine and show its results on real project data.

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Therapeutic Drug Monitoring Is a Feasible Tool to Personalize Drug Administration in Neonates Using New Techniques: An Overview on the Pharmacokinetics and Pharmacodynamics in Neonatal Age

International Journal of Molecular Sciences ◽

10.3390/ijms21165898 ◽

2020 ◽

Vol 21 (16) ◽

pp. 5898

Author(s):

Domenico Umberto De Rose ◽

Sara Cairoli ◽

Marco Dionisi ◽

Alessandra Santisi ◽

Luca Massenzi ◽

...

Keyword(s):

Therapeutic Drug Monitoring ◽

Drug Monitoring ◽

Neonatal Intensive Care ◽

Life Support ◽

Extracorporeal Life Support ◽

Neonatal Intensive Care Units ◽

Therapeutic Drug ◽

Pharmacokinetics And Pharmacodynamics ◽

Crucial Point ◽

New Techniques

Therapeutic drug monitoring (TDM) should be adopted in all neonatal intensive care units (NICUs), where the most preterm and fragile babies are hospitalized and treated with many drugs, considering that organs and metabolic pathways undergo deep and progressive maturation processes after birth. Different developmental changes are involved in interindividual variability in response to drugs. A crucial point of TDM is the choice of the bioanalytical method and of the sample to use. TDM in neonates is primarily used for antibiotics, antifungals, and antiepileptic drugs in clinical practice. TDM appears to be particularly promising in specific populations: neonates who undergo therapeutic hypothermia or extracorporeal life support, preterm infants, infants who need a tailored dose of anticancer drugs. This review provides an overview of the latest advances in this field, showing options for a personalized therapy in newborns and infants.

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New Insights Into the Pharmacokinetics and Pharmacodynamics of the Calcineurin Inhibitors and Mycophenolic Acid: Possible Consequences for Therapeutic Drug Monitoring in Solid Organ Transplantation

Therapeutic Drug Monitoring ◽

10.1097/ftd.0b013e3181aa36cd ◽

2009 ◽

Vol 31 (4) ◽

pp. 416-435 ◽

Cited By ~ 109

Author(s):

Hylke de Jonge ◽

Maarten Naesens ◽

Dirk R J Kuypers

Keyword(s):

Therapeutic Drug Monitoring ◽

Organ Transplantation ◽

Mycophenolic Acid ◽

Drug Monitoring ◽

Solid Organ Transplantation ◽

Calcineurin Inhibitors ◽

Therapeutic Drug ◽

Solid Organ ◽

Pharmacokinetics And Pharmacodynamics

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Higher teicoplanin blood level needed in elderly critically ill patients

Current Drug Metabolism ◽

10.2174/1389200222666211122124420 ◽

2021 ◽

Vol 22 ◽

Author(s):

Ling Wang ◽

Mingguang Chen ◽

Hong Ye ◽

Xiaolan Lin ◽

Yixuan Li ◽

...

Keyword(s):

Therapeutic Drug Monitoring ◽

Critically Ill ◽

Blood Level ◽

Drug Monitoring ◽

Critically Ill Patients ◽

Patient Population ◽

Therapeutic Drug ◽

Pharmacokinetics And Pharmacodynamics ◽

Blood Concentrations ◽

Individualized Dosing

Background: Significant changes in the pathophysiology of older critically ill patients may affect the pharmacokinetics and pharmacodynamics of teicoplanin. This study aimed to determine the optimal teicoplanin blood level in this patient population. Materials & Methods: 128 older critically ill and 86 older non-critically ill patients were involved and analyzed. Results: The target thresholds of teicoplanin blood concentrations in older critically ill patients and non-critically ill patients should be 31.4mg/L and 15.3mg/L, respectively. The dose of teicoplanin in older critically ill patients should be greater than 800 mg to achieve the target blood level. Conclusion : An individualized dosing approach of teicoplanin based on therapeutic drug monitoring is necessary for older critically ill patients.

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Diagnose und Monitoring bei chronisch-entzündlicher Darmerkrankung

Therapeutische Umschau ◽

10.1024/0040-5930/a001002 ◽

2018 ◽

Vol 75 (5) ◽

pp. 316-328

Author(s):

Christian Ansprenger ◽

Emanuel Burri

Keyword(s):

Therapeutic Drug Monitoring ◽

Drug Monitoring ◽

Morbus Crohn ◽

Therapeutic Drug ◽

Körperliche Untersuchung

Zusammenfassung. Die Diagnose und auch die Überwachung von chronisch entzündlichen Darmerkrankungen ruht auf mehreren Säulen: Anamnese, körperliche Untersuchung, Laborwerte (im Blut und Stuhl), Endoskopie, Histologie und Bildgebung. Die Diagnose kann nicht anhand eines einzelnen Befundes gestellt werden. In den letzten Jahren hat sich das Therapieziel weg von klinischen Endpunkten hin zu endoskopischen und sogar histologischen Endpunkten entwickelt. Für einige dieser neuen Therapieziele existiert allerdings noch keine allgemein gültige Definition. Regelmässige Endoskopien werden von Patienten schlecht toleriert, weshalb Surrogat-Marker wie Calprotectin untersucht wurden und eine gute Korrelation mit der mukosalen Entzündungsaktivität nachgewiesen werden konnte. Entsprechend zeigte sich bei Morbus Crohn eine Algorithmus-basierte Therapiesteuerung – unter anderem basierend auf Calprotectin – einer konventionellen Therapiesteuerung überlegen. Die Überwachung der medikamentösen Therapie («Therapeutic Drug Monitoring» [TDM]) ist ein zweites Standbein des Monitoring von chronisch entzündlichen Darmerkrankungen. Mit zunehmendem Einsatz vor allem der Biologika-Therapien wurden sowohl reaktives TDM (in Patienten mit klinischem Rezidiv) als auch proaktives TDM (in Patienten in Remission / stabiler Erkrankung) untersucht und haben (teilweise) Eingang in aktuelle Richtlinien gefunden. Zukünftige Studien werden die vorgeschlagenen Therapieziele besser definieren und den Nutzen der medikamentösen Therapieüberwachung auf den Krankheitsverlauf weiter untersuchen müssen.

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