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S Ruffo

Publications and source records attributed to S Ruffo.

26 records · Page 2Linked to original sources

A calculator program for clinical application of the Bayesian method of predicting plasma drug levels.

A pharmacokinetic program that allows individualization of drug dosage regimens through the Bayesian method is described. The program, which is designed for the Hewlett-Packard HP-41 CV calculator, is based upon the one-compartment open model with either instantaneous or zero-order absorption. Individualized estimation of the patient's kinetic parameters (clearance and volume of distribution) is performed by analyzing the plasma levels measured in the patient as well as considering the population data of the drug. After estimating the individual kinetic parameters by the Bayesian method, the program predicts the dosage regimen that will elicit the desired peak and trough plasma levels at steady state. For comparison purposes, the least-squares estimates for clearance and volume of distribution are calculated, and dosage prediction can also be made on the basis of the least-squares estimates. The least-squares estimates can be used to calculate population pharmacokinetic parameters according to the Standard Two-Stage method. Several examples of clinical use of the program are presented. The examples refer to patients with classic hemophilia who were treated with Factor VIII concentrates. In these patients, the Bayesian kinetic parameters of Factor VIII have been estimated through the calculator program. The Bayesian parameter estimates generated by the HP-41 have been compared with those determined by a Bayesian program (ADVISE) designed for microcomputers.

Computers↗

Individualization of Factor VIII dosage.

The usefulness of a calculator programme that enables individualization of the dosage of Factor VIII, based on the concentration-time data measured after a test-dose, was assessed. The programme was tested in 12 haemophiliacs who required multiple-dose treatment with Factor VIII. Individual kinetic parameters were estimated in each patient from the plasma level data following the test-dose. Then, each patient received the multiple dose treatment with Factor VIII according to the dosage regimen suggested by the calculator programme. The time-curve of Factor VIII plasma levels at steady state was predicted by using the kinetic variables previously estimated. The plasma levels of Factor VIII were measured in all patients at steady state. As a result, good agreement between predicted and measured steady state concentrations was observed (r2 = 0.9797; P less than 0.001). The calculator programme tested in the present study appears to be a useful tool for individualizing the dosage regimen of Factor VIII in haemophiliacs.

Adolescent↗