Stochastic Programming on Optimal Drug Administration for Two Stage Cancer Treatment Problems

2012 ◽  
Vol 3 (1) ◽  
pp. 1-10
Author(s):  
P. Tirupathi Rao ◽  
D. Flora Evangil ◽  
K. Madhavi
Keyword(s):  
Drug Administration ◽  
Dosage Level ◽  
Drug Dosage ◽  
Drug Dose ◽  
Drug Usage ◽  
Optimal Decisions ◽  
Optimal Drug ◽  
Vacation Period ◽  
Lower Limits ◽  
Care Decision

Either Continuous drug administration or continuous drug vacation for long spells of cancer chemotherapy is not suggestible. Similarly the quantum of administered drug dose either above the required level or below the wanted level is also not advised. Effective drug administration has to consider the optimal threshold limits on the drug administration/drug vacation times; upper and lower limits of drug quantity; along with the suitable number of drug administration/drug vacation cycles; and the number of spells within the cycle of drug usage/stoppage. This paper develops an optimization programming problem for designing drug administration strategies for a cancer patient under chemotherapy. This study will help in exploring the decision parameters at the targeted objectives. Optimal decisions on drug dosage level, drug administration period, drug vacation period, number of drug administration cycles; number of drugs applied within a cycle, etc., can be obtained with the model. Sensitivity analysis is carried out for understanding the model behavior. This work has a scope for developing health care Decision Support Systems.

scholarly journals A drug pharmacodynamics and pharmacokinetics based approach towards stabilization of HIV infection dynamics

2015 ◽  
Vol 30 (5) ◽  
Author(s):  
Rufina M. Tretyakova ◽  
Andreas Meyerhans ◽  
Gennady A. Bocharov
Keyword(s):  
Drug Administration ◽  
Drug Efficacy ◽  
Drug Dosage ◽  
Antiretroviral Drugs ◽  
Loop Control ◽  
Infection Dynamics ◽  
Antiretroviral Drug ◽  
Optimal Drug ◽  
Drug Pharmacokinetics ◽  
Efficacy Function

AbstractIn our study we developed a computational algorithm for finding optimal dosages of antiretroviral drug administration for the stabilization of HIV load at low levels. The novelty is that the pharmacokinetics and pharmacodynamics of the antiretroviral drugs were taken into account. A standard closed-loop control of HIV dynamics was constructed that stabilizes the viral load and the optimal drug administration mode was formulated. We analyze the appropriateness of the ‘drug efficacy’ based control and its relationship to a realistic drug dosage and kinetic models in the human body. The translation of the efficacy function into drug concentration is implemented via the pharmacodynamics model of the drug effect. Optimal approximation of the idealized concentration functions is based on the orthogonal projection on linear subspace of drug pharmacokinetics functions.

Impact of Removing the Race Coefficient in Renal Function Estimate Equations on Drug Dosage Recommendations

2021 ◽  
pp. 106002802110102
Author(s):  
Janine Miller ◽  
John P. Knorr
Keyword(s):  
Filtration Rate ◽  
Drug Dosage ◽  
Drug Dose ◽  
Epidemiology Study ◽  
Black African ◽  
Drug Dosing ◽  
Disease Epidemiology ◽  
Black Patients ◽  
The Impact ◽  
Level Of Agreement

Background The appropriateness of including the race coefficient in glomerular filtration rate (GFR) equations in Black patients is debated, and the impact on drug dosing is unknown. Objective This study explored the impact of removing the race coefficient on drug dosing in Black patients in comparison to conventional methods. Methods This was a retrospective study of hospitalized patients who self-identified as Black/African American and were prescribed an antimicrobial that includes renal dosage recommendations in the product labeling. The primary end point was the discordance between drug dosing recommendations derived by body surface area deindexed GFR estimated by the CKD-EPI equation (Chronic Kidney Disease Epidemiology study) with and without race versus recommendations derived from Cockcroft-Gault (CG). Results A total of 210 Black patients were included. There was an 18% rate of discordance when GFR was estimated with the race coefficient (GFR w/Race) versus without the race coefficient (GFR w/out Race). GFR w/out Race had a higher level of agreement with dosing by creatinine clearance (CrCl; κ = 0.779) than GFR w/Race versus CrCl (κ = 0.651). GFR w/out Race had less within-patient difference than GFR w/Race in comparison to CrCl (mean difference: −6.3 vs −18.0 mL/min). Conclusions and Relevance This represents the first report to examine the removal of the race coefficient and its implication on drug dose discordance. GFR w/out Race had a higher level of agreement and less drug dose discordance than GFR w/Race, in comparison to CrCl estimates. If GFR equations are considered comparable to CrCl for the purposes of guiding drug dosing, GFR w/out Race should be considered.

15 Optimal Drug Administration Based on a Compartmental System

2015 ◽  
pp. 166-174
Author(s):  
Hideo Kusuoka ◽  
Hajime Maeda ◽  
Shinzo Kodama ◽  
Michitoshi Inoue ◽  
Hiroshi Abe ◽  
...  
Keyword(s):  
Drug Administration ◽  
Compartmental System ◽  
Optimal Drug

scholarly journals Hyperthyroidism in the personalized medicine era: the rise of mathematical optimization

2019 ◽  
Vol 16 (155) ◽  
pp. 20190083 ◽  
Author(s):  
Fanwen Meng ◽  
Enlin Li ◽  
Paul Michael Yen ◽  
Melvin Khee Shing Leow
Keyword(s):  
Personalized Medicine ◽  
Rapid Determination ◽  
Mathematical Optimization ◽  
Optimal Dose ◽  
Equation System ◽  
Drug Dosage ◽  
Dose Titration ◽  
Synthesis Rate ◽  
Efficient Treatment ◽  
Optimal Drug

Thyroid over-activity or hyperthyroidism constitutes a significant morbidity afflicting the world. The current medical practice of dose titration of anti-thyroid drug (ATD) treatment for hyperthyroidism is relatively archaic, being based on arbitrary and time-consuming trending of thyroid function that requires multiple clinic monitoring visits before an optimal dose is found. This prompts a re-examination into more deterministic and efficient treatment approaches in the present personalized medicine era. Our research project seeks to develop a personalized medicine model that facilitates optimal drug dosing via the titration regimen. We analysed 49 patients' data consisting of drug dosage, time period and serum free thyroxine (FT4). Ordinary differential equation modelling was applied to describe the dynamic behaviour of FT4 concentration. With each patient's data, an optimization model was developed to determine parameters of synthesis rate, decay rate and IC 50 . We derived the closed-form time- and dose-dependent solution which allowed explicit estimates of personalized predicted FT4. Our equation system involving time, drug dosage and FT4 can be solved for any variable provided the values of the other two are known. Compared against actual FT4 data within a tolerance, we demonstrated the feasibility of predicting the FT4 subsequent to any prescribed dose of ATD with favourable accuracy using the initial three to five patient-visits' data respectively. This proposed mathematical model may assist clinicians in rapid determination of optimal ATD doses within allowable prescription limits to achieve any desired FT4 within a specified treatment period to accelerate the attainment of euthyroid targets.

Optimal drug administration manner would rescue partial virological response in chronic hepatitis B patients with entecavir or tenofovir treatment

2020 ◽  
Vol 27 (7) ◽  
pp. 731-738 ◽  
Author(s):  
Ya‐Chao Tao ◽  
Meng‐Lan Wang ◽  
Dong‐Mei Zhang ◽  
Dong‐Bo Wu ◽  
Yong‐Hong Wang ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Drug Administration ◽  
Virological Response ◽  
Optimal Drug ◽  
Partial Virological Response

scholarly journals P08 Is there a difference in the frequency of manipulated orally and rectally administered medicines to paediatric in-patients in Sweden in the year 2009 and 2018 respectively? A register study

2019 ◽  
Vol 104 (6) ◽  
pp. e20.2-e20
Author(s):  
A Andersson ◽  
S Eksborg ◽  
S Lindemalm ◽  
U Förberg
Keyword(s):  
Drug Dosage ◽  
Drug Dose ◽  
Dosage Forms ◽  
Age Group ◽  
Vulnerable Patients ◽  
Change In Practice ◽  
Drug Dosage Form ◽  
Child Friendly ◽  
One Year ◽  
Dosing Accuracy

BackgroundSince there is a lack of drugs in suitable strengths and child-friendly dosage forms, manipulation is sometimes necessary in paediatrics. A manipulation is the physical alteration of a drug dosage form with the purpose to extract and administer the prescribed proportion of a drug dose.The purpose of this study was to calculate the frequency of manipulated medicines administered to paediatric in-patients at a large Children´s Hospital for two separate years and compare whether there has been a change in practice.Material and MethodsData were collected for all administered doses during 2 separate years (2009 and 2018) at the paediatric wards at our Children´s Hospital, from a hospital-based electronic register. All administered doses where the number of tablets or suppositories were decimal were added and calculated as a percentage of the total number of oral and rectal administrations. Data are anonymous but information regarding gender, age, hospital ward and number of drugs per patient were available and were analysed.ResultsIn one year, approximately 450 000 doses of medicine are administered to paediatric patients in our Children´s hospital.The results will be analysed with regards to differences between patient age, gender, prescribing year and drug substance. A pilot study showed that 10% of all solid oral administrations to patients 6 - 12 years old, were part of a tablet. For patients 0 - 2 years over 20% of all solid rectal administrations were part of a suppository.The extent of manipulation is affected by a lot of factors, where the most prominent is whether there are strengths suitable for that age-group available on the market or not.ConclusionMost often there is a lack of knowledge how manipulation of medicines influences the dosing accuracy and often we do this to our most vulnerable patients.Disclosure(s)Nothing to disclose

Optimal drug dosage regimens in cancer chemotherapy with neural networks

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 2134-2134
Author(s):  
A. G. Floares ◽  
C. Floares ◽  
M. Cucu ◽  
M. Marian ◽  
L. Lazar
Keyword(s):  
Neural Networks ◽  
Cancer Chemotherapy ◽  
Drug Dosage ◽  
Dosage Regimens ◽  
Optimal Drug
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