PubMed HealthSearch

PubMed · 7977423

Expert systems.

Abstract

The concept of computerized expert systems is explained, the potential utility of these systems in pharmacy is explored, and strategies and imperatives for implementing them are described. Computerized expert systems attempt a higher level of analysis than traditional computer programs. They can be defined as systems that attempt to make or assist in a decision that is not yet completely and reliably definable in objective terms. Because of the information-intensive nature of pharmacy practice, this field is particularly suited to use of expert systems. Current applications include screening for drug interactions and therapeutic drug monitoring. Expert systems must offer a substantial advantage over human expertise (for example, by quickly analyzing enormous quantities of data); those that perform functions that humans could perform have failed to gain widespread use. An ideal hospital expert system would have access to any data available about a patient's care and would detect critical situations as they occur. Such a system would require pharmacists to shift from a prescription-based orientation to a case-management orientation. Factors to consider in implementing an expert system include linkage among multiple departments, usage options, development strategies, and maintenance requirements. Computerized expert systems hold great potential for application to pharmacy and may influence the pharmacist's role in patient care.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

R Morrell, B Wasilauskas, R Winslow. 1994-08-15. Expert systems.. https://pubmed.ncbi.nlm.nih.gov/7977423/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions.

Herbal medicinals are being used by an increasing number of patients who typically do not advise their clinicians of concomitant use. Known or potential drug-herb interactions exist and should be screened for. If used beyond 8 weeks, Echinacea could cause hepatotoxicity and therefore should not be used with other known hepatoxic drugs, such as anabolic steroids, amiodarone, methotrexate, and ketoconazole. However, Echinacea lacks the 1,2 saturated necrine ring associated with hepatoxicity of pyrrolizidine alkaloids. Nonsteroidal anti-inflammatory drugs may negate the usefulness of feverfew in the treatment of migraine headaches. Feverfew, garlic, Ginkgo, ginger, and ginseng may alter bleeding time and should not be used concomitantly with warfarin sodium. Additionally, ginseng may cause headache, tremulousness, and manic episodes in patients treated with phenelzine sulfate. Ginseng should also not be used with estrogens or corticosteroids because of possible additive effects. Since the mechanism of action of St John wort is uncertain, concomitant use with monoamine oxidase inhibitors and selective serotonin reuptake inhibitors is ill advised. Valerian should not be used concomitantly with barbiturates because excessive sedation may occur. Kyushin, licorice, plantain, uzara root, hawthorn, and ginseng may interfere with either digoxin pharmacodynamically or with digoxin monitoring. Evening primrose oil and borage should not be used with anticonvulsants because they may lower the seizure threshold. Shankapulshpi, an Ayurvedic preparation, may decrease phenytoin levels as well as diminish drug efficacy. Kava when used with alprazolam has resulted in coma. Immunostimulants (eg, Echinacea and zinc) should not be given with immunosuppressants (eg, corticosteroids and cyclosporine). Tannic acids present in some herbs (eg, St John wort and saw palmetto) may inhibit the absorption of iron. Kelp as a source of iodine may interfere with thyroid replacement therapies. Licorice can offset the pharmacological effect of spironolactone. Numerous herbs (eg, karela and ginseng) may affect blood glucose levels and should not be used in patients with diabetes mellitus.

Drug Interactions