Mawer G E
Clin Pharmacokinet. 1976;1(1):67-78. doi: 10.2165/00003088-197601010-00006.
Computer programs for drug dosage adjustment may be fixed, adaptive or empirical. The aminoglycoside antibiotic dosage requirements of individual patients are relatively predictable, and it seems to be adequate to assume that volume of distribution is a fixed proportion of body weight and that renal clearance is a fixed proportion of creatinine clearance. This approach has been less successful with digoxin because patient compliance, the proportion absorbed and liver clearance are not yet predictable. Accordingly, adaptive programs have been developed which use feedback from drug concentration measurements to predict the future dosage needs of the patient. When individual needs are known for a large patient group it becomes possible to predict the dosage requirements of a new patient from the same population by empirical methods. Computer programs for dosage adjustment will not be widely used until their scope is increased and objective evidence of clinical benefit is obtained.
用于药物剂量调整的计算机程序可以是固定的、适应性的或经验性的。个体患者对氨基糖苷类抗生素的剂量需求相对可预测，而且似乎可以假设分布容积是体重的固定比例，肾脏清除率是肌酐清除率的固定比例。这种方法在使用地高辛时不太成功，因为患者的依从性、吸收比例和肝脏清除率尚不可预测。因此，已经开发出适应性程序，利用药物浓度测量的反馈来预测患者未来的剂量需求。当已知一大组患者的个体需求时，就可以通过经验方法从同一人群中预测新患者的剂量需求。用于剂量调整的计算机程序在其范围扩大并获得临床益处的客观证据之前不会得到广泛应用。
