[Informatics in medicine: drug monitoring in the elderly. Software for clinical procedures]

The Author describes the main procedure for the clinical control of pharmacokinetics and therapeutical programmes in medical practice, taking the use of digitalic alkaloids as an example. The procedure entails: a) Data records: this comprises a system for loading the patient's data into three different structures. The first record contains general information regarding the patient and it is used independently during the therapeutic regimen selection phase. The second record contains details of previous therapy, while the third concerns the input of digitalemic vales. b) The programme: it elaborates the main pharmacokinetic constants (Ka, Kcp, Kpc, Kslope, VC) of the predicted two-compartment model and Sheiner's expression is used to correct it for the reference statistical population. c) Distribution values in the compartments: the chapter illustrates the mean values of alkaloid tissue distribution in normal subjects, the mean value of digoxin with protein binding, the importance of circulating pharmacological ranges and the digitalisation load in relation to tissue deposits. d) Print-out: this represents the observation and therapy selection phase. A typical example of digoxin therapy is illustrated using a dot-matrix plotter and the methods are discussed for interpreting the results of this print-out.