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Related Concept Videos

Dosage Regimens: Designs and Approaches01:28

Dosage Regimens: Designs and Approaches

194
Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...
194
Dosage Regimen: Individualization01:24

Dosage Regimen: Individualization

122
Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...
122
Determination of Multiple Dosing Parameters: Loading and Maintenance Doses01:25

Determination of Multiple Dosing Parameters: Loading and Maintenance Doses

142
A loading dose is an essential pharmacological strategy to rapidly achieve the target plasma drug concentration necessary for an immediate therapeutic effect. This approach is especially critical for drugs characterized by slow absorption or extended half-lives, where delaying therapeutic plasma levels could compromise treatment outcomes. By administering a loading dose, clinicians ensure a prompt onset of drug action, even for agents with complex pharmacokinetic profiles.Achieving steady-state...
142
Dosage Regimen Designs: Nomograms and Tabulations01:23

Dosage Regimen Designs: Nomograms and Tabulations

113
Nomograms and tabulations are vital tools used by clinicians to design accurate and individualized dosage regimens. These instruments provide a straightforward method for adjusting dosages based on individual patient characteristics, including age, weight, and physiological condition. The foundation of a drug's nomogram is population pharmacokinetic data collected and analyzed using specific models. This data simplifies complex equations, presenting them diagrammatically or tabularly for easy...
113
Rational Dosage Regimen: Maintenance Dose and Loading Dose01:24

Rational Dosage Regimen: Maintenance Dose and Loading Dose

5.1K
A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
5.1K
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

362
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
362

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The Rigid Tube as an Alternative in Controlling the Problematic Airway
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Who Should Ration?

Philip M Rosoff1

  • 1Professor of pediatrics (oncology) and medicine at Duke University Medical Center and Duke University School of Medicine in Durham, North Carolina, and a member scholar in the Trent Center for Bioethics, Humanities & History of Medicine and chair of Duke Hospital's ethics committee.

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Physicians face pressure to control healthcare costs, but individual cost-saving measures may lead to unfair rationing of care based on non-clinical factors. Careful consideration is needed to ensure equitable treatment for all patients.

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Area of Science:

  • Health economics
  • Clinical decision-making
  • Medical ethics

Background:

  • Physicians are increasingly urged to consider financial implications in clinical decision-making due to rising healthcare costs.
  • Judicious financial stewardship is a key component of responsible medical practice.

Observation:

  • Applying cost-saving measures on a case-by-case basis can inadvertently lead to the restriction of interventions.
  • Restrictions may be based on clinically irrelevant patient characteristics such as ethnicity, gender, age, or skin color.
  • This practice can result in arbitrary and inequitable care.

Findings:

  • Individualized cost-consciousness in healthcare can lead to biased rationing of medical interventions.
  • The financial stewardship approach, if not systemically managed, risks compromising patient care equity.

Implications:

  • Urgent need for system-wide healthcare reform to ensure equitable resource allocation.
  • Prudence is advised when implementing "bedside rationing" to prevent discriminatory practices.
  • Ethical considerations must guide financial stewardship in clinical practice to avoid patient harm.