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Related Concept Videos

Dosage Regimen: Individualization01:24

Dosage Regimen: Individualization

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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...
111
Dosage Regimens: Designs and Approaches01:28

Dosage Regimens: Designs and Approaches

184
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...
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Dosage Regimens: Partial Pharmacokinetic Parameters01:01

Dosage Regimens: Partial Pharmacokinetic Parameters

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It is not uncommon for complete drug pharmacokinetic profiles to remain elusive in pharmacokinetics. This necessitates certain educated assumptions by pharmacokineticists to determine appropriate dosage regimens without comprehensive pharmacokinetic data from animal or human studies. One prevalent assumption is setting the bioavailability factor, denoted as F, to 1 or 100%. This assumption caters to the scenario where a drug doesn't achieve full systemic absorption, resulting in the patient...
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Determination of Multiple Dosing Parameters: Loading and Maintenance Doses01:25

Determination of Multiple Dosing Parameters: Loading and Maintenance Doses

133
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...
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Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

172
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Dosage Regimen Designs: Nomograms and Tabulations01:23

Dosage Regimen Designs: Nomograms and Tabulations

105
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...
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Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
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Cryoprecipitate Utilization Patterns Observed With a Required Prospective Approval Process vs Electronic Dosing

Robert L Kruse1, Melissa Neally1, Brian C Cho2

  • 1Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.

American Journal of Clinical Pathology
|May 24, 2020
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Summary

Electronic Medical Record (EMR)-guided cryoprecipitate dosing maintained usage but increased wastage compared to transfusion medicine (TM) resident approval. Balancing efficiency with product waste is crucial.

Keywords:
CryoprecipitateElectronic medical recordsPatient blood management

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Area of Science:

  • Transfusion Medicine
  • Healthcare Informatics

Background:

  • Cryoprecipitate dosing traditionally required transfusion medicine (TM) resident approval.
  • Electronic Medical Record (EMR) systems offer potential for optimizing transfusion protocols.

Purpose of the Study:

  • To evaluate the impact of EMR-guided pooled cryoprecipitate dosing versus TM resident approval on usage and wastage.
  • To assess the effectiveness of EMR-based guidance in managing cryoprecipitate inventory.

Main Methods:

  • A comparative study was conducted assessing cryoprecipitate usage and wastage before and after implementing EMR-guided dosing.
  • Pooled cryoprecipitate for adults and single-donor cryoprecipitate for pediatric patients (<50 kg) were analyzed.
  • EMR guidance replaced TM consultation for pooled cryoprecipitate orders, while single-unit orders still required consultation.

Main Results:

  • Pooled cryoprecipitate usage remained similar (178 ± 13 vs 187 ± 15 doses/month) post-intervention.
  • Wastage of pooled cryoprecipitate significantly increased from 7.7% ± 1.5% to 12.7% ± 1.4% (P=.038).
  • No significant change in wastage was observed for pediatric cryoprecipitate doses.

Conclusions:

  • EMR-guided cryoprecipitate dosing achieved comparable usage to TM auditing but led to increased product wastage.
  • Reduced TM oversight may contribute to higher wastage rates.
  • The benefits of real-time electronic guidance must be weighed against potential delays in critical transfusion therapy and increased product waste.