Redefining normal variability of drug disposition

Background: The pharmacokinetics of many drugs are said to be predictable. This is often used to imply the ease of dosing or dose-adjustments. However, predictability requires both accuracy (lack of bias) and precision (reproducibility). In the context of pharmacokinetics, precision refers to the ability to achieve a specified target concentration in different individuals. Precision is […]

Integrating a PKPD computer simulation in the BPharm course

Background: Coagulation is an important process in haemostasis. It involves a complex interaction of clotting enzymes and proteins and includes numerous feedback and feedforward reactions. Warfarin, a widely used anticoagulant, has a complex dose-response relationship in addition to large between subject variability. Recently, a simulation software (CoaguSim) was developed in-house to simulate the time course […]

Evaluation of a Bayesian dose-individualisation method for enoxaparin

Background: Enoxaparin is a low molecular weight heparin used in the treatment of thrombosis. The current approved treatment dose of enoxaparin is based on total body weight and its dosing frequency is based dichotomously on creatinine clearance. Recent evidence has shown these dosing strategies to be suboptimal and Bayesian dose-individualisation has been proposed as a […]

Developing a model for estimating lean body weight in children

Background: Body composition changes in relation to age and maturation. Mathematical models for estimating lean body weight (LBW) have been developed in adults. There are currently no models available to predict LBW in children as a function of age or maturation. Aim: To develop a semi-mechanistic model to estimate LBW in paediatric patients. Methods: (1)Using […]

A case for routine monitoring of enoxaparin treatment

Background: Enoxaparin is a low molecular weight heparin (LMWH) used in the treatment of thrombosis. Unlike unfractionated heparin (UFH), no routine monitoring of plasma activity is recommended for enoxaparin treatment. The activity of enoxaparin in plasma is determined by assaying anti-activated factor X (anti-Xa). Aim: (1) To identify an anti-Xa treatment target for enoxaparin. (2) […]