Precision dosing to avoid adverse drug reactions

Thomas M. Polasek; Carl M. J. Kirkpatrick; Amin Rostami-Hodjegan

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Precision dosing to avoid adverse drug reactions

机译：精密剂量以避免不良药物反应

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Adverse drug reactions (ADRs) have traditionally been managed by trial and error, adjusting drug and dose selection reactively following patient harm. With an improved understanding of ADRs, and the patient characteristics that increase susceptibility, precision medicine technologies enable a proactive approach to ADRs and support clinicians to change prescribing accordingly. This commentary revisits the famous pharmacology–toxicology continuum first postulated by Paracelsus 500?years ago and explains why precision dosing is needed to help avoid ADRs in modern clinical practice. Strategies on how to improve precision dosing are given, including more research to establish better precision dosing targets in the cases of greatest need, easier access to dosing instructions via e-prescribing, improved monitoring of patients with novel biomarkers of drug response, and further application of model-informed precision dosing.

机译：不良药物反应（ADRS）传统上通过试验和误差来管理，调整药物和剂量选择，随后患者伤害。随着对ADR的了解，提高了易感性的患者特征，精密医学技术能够积极主动地接近ADR和支持临床医生，以相应地改变处方。该评论重新评估着名的药理学毒理学毒理学毒理学毒理学首先由Paracelsus 500发表于帕拉克斯500岁？几年前，并解释了为什么需要精确给药来帮助避免现代临床实践中的ADR。给出了如何提高精密剂量的策略，包括更多研究，在最大的需求中建立更好的精确剂量目标，更容易通过电子处方能够进行给药指令，改善了对药物反应的新型生物标志物的患者的监测，以及进一步的应用模型明智的精密剂量。

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《Therapeutic advances in drug safety.》 |2019年第12期|共6页
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Thomas M. Polasek; Carl M. J. Kirkpatrick; Amin Rostami-Hodjegan;
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adverse drug reactionsmedication safetymodelinformed precision dosing,precision dosingprecision medicine;

机译：不良药物反应隐藏ymodelinformed精密剂量;精密剂量选择;

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1. Avoidability of adverse drug reactions spontaneously reported to a French regional drug monitoring centre. [J] . Jonville Bera AP, Saissi H, Bensouda Grimaldi L, Drug safety: An international journal of medical toxicology and drug experience . 2009,第5期

机译：自发向法国区域毒品监测中心报告了药物不良反应的可避免性。
2. ISMP Adverse Drug Reactions: Pheochromocytoma Crisis Induced by Metoclopramide Baclofen Dependence Following High-Dose Therapy Fatal Cardiotoxicity Following High-Dose Cyclophosphamide Acute Anterograde Amnestic Syndrome Induced by Fentanyl Ivermectin-lnduced Toxic Epidermal Necrolysis Pembrolizumab-lnduced Type I Diabetes [J] . Michael A. Mancano, Jonathan Lapin, Andrew Paik Hospital pharmacy. . 2019,第4期

机译：ISMP不良药物反应：由高剂量治疗致病性致病性致病性致病症患者致病患者致病症患者急性甲基磷酰胺急性蒽酮诱导的胎儿蛋白蛋白诱导的脂肪蛋白诱导的毒性表皮毒性染色症染蛋白-1ND-LNDED型I型糖尿病
3. Quantitative Evaluation of Initial Symptoms as Predictors to Detect Adverse Drug Reactions Using Bayes' Theory: Expansion and Evaluation of Drug-Adverse Drug Reaction-Initial Symptom Combinations Using Adverse Event Reporting System Database [J] . Daisuke Kobayashi, Shigeru Hosaka, Emiko Inoue, Biological & pharmaceutical bulletin . 2013,第12期

机译：使用贝叶斯理论对作为评估不良药物反应预测指标的初始症状进行定量评估：使用不良事件报告系统数据库扩展和评估药物不良反应-初始症状的组合
4. Identifying Adverse Drug Reactions of Hypolipidemic Drugs from Chinese Adverse Event Reports [C] . Yu Zhang, Xuwen Wang, Liu Shen, 2018 IEEE International Conference on Healthcare Informatics Workshops . 2018

机译：从中国不良事件报告中识别降血脂药物的不良药物反应
5. Involvement of Th17 Pathway in Adverse Drug Reactions: Mechanistic Investigation of Drug-Induced Autoimmunity and Drug-induced Liver Injury. [D] . Zhu, Ervin Xu. 2012

机译：Th17途径参与药物不良反应：药物诱发的自身免疫和药物诱发的肝损伤的机制研究。
6. Precision dosing to avoid adverse drug reactions [O] . Thomas M. Polasek, Carl M. J. Kirkpatrick, Amin Rostami-Hodjegan 2019

机译：精确加药以避免药物不良反应
7. Avoiding adverse drug reactions in children - development of the Liverpool Adverse Drug Reaction Avoidability Assessment Tool [O] . Bracken L 2000

机译：避免儿童发生药物不良反应-利物浦药物不良反应可避免性评估工具的开发

Precision dosing to avoid adverse drug reactions

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