Whiting B, Kelman A W, Bryson S M, Derkx F H, Thomson A H, Fotheringham G H, Joel S E
Br Med J (Clin Res Ed). 1984 Feb 18;288(6416):541-5. doi: 10.1136/bmj.288.6416.541.
Clinical pharmacokinetics is an expanding scientific discipline which can make an impact on treatment in coronary care, intensive care, paediatrics, general medicine and surgery, and general practice. The aim of this study was to establish a rapid system of drug assay, to report the result, to assess the influence of pathological and clinical factors on the pharmacokinetics of certain drugs, and to use a computer to determine the optimum dosage of drugs. The clinical pharmacokinetics laboratory in Stobhill is available to all clinical departments and to general practitioners in the area. Digoxin, theophylline, and phenytoin have been assessed. Initial samples of these drugs showed that only about a third were in the therapeutic range; samples obtained after the issue of the laboratory report showed an improvement. The predictive performance of the computer program improved with feedback of one or two drug concentrations. Dosages of drugs chosen on an empirical basis may not lead to optimum treatment, and by testing samples early the dosage of the drug can be adjusted. It is hoped that the results achieved will encourage other clinical, pharmaceutical, and scientific colleagues to develop laboratories along similar lines.
临床药代动力学是一门不断发展的科学学科，它能对冠心病护理、重症监护、儿科、普通内科和外科以及全科医疗中的治疗产生影响。本研究的目的是建立一个快速的药物检测系统，报告结果，评估病理和临床因素对某些药物药代动力学的影响，并使用计算机确定药物的最佳剂量。斯托布希尔的临床药代动力学实验室可供该地区所有临床科室和全科医生使用。已对地高辛、茶碱和苯妥英进行了评估。这些药物的初始样本显示只有约三分之一处于治疗范围内；在实验室报告发布后获取的样本显示情况有所改善。计算机程序的预测性能随着一两个药物浓度的反馈而提高。凭经验选择的药物剂量可能无法带来最佳治疗效果，通过早期检测样本可以调整药物剂量。希望所取得的结果将鼓励其他临床、药学和科研同事沿着类似的思路建立实验室。
