{"id":188,"date":"2019-04-24T15:02:19","date_gmt":"2019-04-24T15:02:19","guid":{"rendered":"https:\/\/sepia2.unil.ch\/pharmacology\/?page_id=188"},"modified":"2019-06-20T18:20:29","modified_gmt":"2019-06-20T18:20:29","slug":"dosage-individualization","status":"publish","type":"page","link":"https:\/\/sepia2.unil.ch\/pharmacology\/applications\/dosage-individualization\/","title":{"rendered":"Dosage Individualization"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\"> &#8220;Adaptation of the dosage regimen in function of the clinical  characteristics of the individual, aiming to achieve the best possible  therapeutic efficiency at the lowest risk of unwanted effects&#8221; <\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Description<\/h3>\n\n\n\n<p>The objective of drug therapy is to produce, the desired therapeutic effect, with the highest chance and minimum toxic effects.\n<\/p>\n\n\n\n<p>As described, the <a href=\"\/pharmacology\/dosage-regimen\">dosage regimen<\/a>\n must be first adapted to the patient&#8217;s characteristics and \ncomorbidities. This initial adaptation realizes a priori \nindividualization. After initiating therapy, the patient&#8217;s response to \nthe drug must be evaluated and the dosage regimen further adapted in \ncase of ineffective therapy or appearance of undesirable effects. In \nselected circumstances, the follow-up of an effect marker may improve \nthe monitoring of treatment. Adaptation in response to such feedback \ninformation realizes the a posteriori individualization.\n<\/p>\n\n\n\n<p>The reasons for failure of drug treatment can drive \nfrom physiological inter-individual variation of pharmacokinetic \nparameters, which cannot always be evaluated prior to initiation of drug\n therapy (e.g. genetic metabolic differences). Other causes of treatment\n failure are variation in response due to inter-individual differences \nin pharmacodynamics (e.g. sensitivity towards the drug), including drug \ntolerance (diminished pharmacologic responsiveness to the drug). Disease\n states can further alter the response to drugs, and draw attention to \ndosage individualization.<\/p>\n\n\n\n<figure class=\"wp-block-video aligncenter\"><video height=\"346\" style=\"aspect-ratio: 346 \/ 346;\" width=\"346\" autoplay controls loop src=\"https:\/\/sepia2.unil.ch\/pharmacology\/wp-content\/uploads\/2019\/06\/dosageindividualization.mp4\"><\/video><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Clinical implications<\/h3>\n\n\n\n<p>A priori individualization must be considered \neach time a drug treatment is introduced. After initiating drug therapy,\n the desired response (e.g. analgesia) and the appearance of undesirable\n effects (e.g. sleepiness) should be evaluated for each patient. If \nthese features are not satisfactory, an alteration of the dosage regimen\n should be discussed.\n<\/p>\n\n\n\n<p>For some drugs, it is standard practice to monitor \nsurrogate markers (e.g. prothrombin time) for evaluating the \neffectiveness of therapy. For drugs with a narrow therapeutic window \nhaving no such effect marker easily followed, regimens can be \npersonalized using Therapeutic Drug Monitoring (TDM).<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Related terms<\/h3>\n\n\n\n<p>Therapeutic Drug Monitoring (TDM): In TDM, drug \nplasma or blood concentration is measured and the regimen is adapted \nuntil the plasma concentration is brought into a predefined therapeutic \nrange.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&#8220;Adaptation of the dosage regimen in function of the clinical characteristics of the individual, aiming to achieve the best possible therapeutic efficiency at the lowest risk of unwanted effects&#8221; Description The objective of drug therapy is to produce, the desired therapeutic effect, with the highest chance and minimum toxic effects. As described, the dosage regimen &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/sepia2.unil.ch\/pharmacology\/applications\/dosage-individualization\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Dosage Individualization&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":9,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-188","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/sepia2.unil.ch\/pharmacology\/wp-json\/wp\/v2\/pages\/188","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sepia2.unil.ch\/pharmacology\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/sepia2.unil.ch\/pharmacology\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/sepia2.unil.ch\/pharmacology\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/sepia2.unil.ch\/pharmacology\/wp-json\/wp\/v2\/comments?post=188"}],"version-history":[{"count":5,"href":"https:\/\/sepia2.unil.ch\/pharmacology\/wp-json\/wp\/v2\/pages\/188\/revisions"}],"predecessor-version":[{"id":471,"href":"https:\/\/sepia2.unil.ch\/pharmacology\/wp-json\/wp\/v2\/pages\/188\/revisions\/471"}],"up":[{"embeddable":true,"href":"https:\/\/sepia2.unil.ch\/pharmacology\/wp-json\/wp\/v2\/pages\/9"}],"wp:attachment":[{"href":"https:\/\/sepia2.unil.ch\/pharmacology\/wp-json\/wp\/v2\/media?parent=188"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}