Open-loop-feedback control of serum drug concentrations: pharmacokinetic approaches to drug therapy.
Recent developments to optimize open-loop-feedback control of drug dosage regimens, generally applicable to pharmacokinetically oriented therapy with many drugs, involve computation of patient-individualized strategies for obtaining desired serum drug concentrations. Analyses of past therapy are performed by least squares, extended least squares, and maximum a posteriori probability Bayesian methods of fitting pharmacokinetic models to serum level data. Future possibilities for truly optimal open-loop-feedback therapy with full Bayesian methods, and conceivably for optimal closed-loop therapy in such data-poor clinical situations, are also discussed. Implementation of these various therapeutic strategies, using automated, locally controlled infusion devices, has also been achieved in prototype form.
D000368:Aged; D000617:Aminoglycosides / Q000008:administration & dosage; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003201:Computers; D004071:Digitalis Glycosides / Q000008:administration & dosage; D005246:Feedback; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D007263:Infusions, Parenteral / Q000295:instrumentation*; D007700:Kinetics; D008297:Male; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*
D000617:Aminoglycosides; D000889:Anti-Arrhythmia Agents; D000900:Anti-Bacterial Agents; D004071:Digitalis Glycosides; D005839:Gentamicins; D004364:Pharmaceutical Preparations