Practical, individualized dosing: 21st century therapeutics and the clinical pharmacometrician.

摘要

A child with acute abdominal pain presents to the emergency department. The experienced surgeon carefully examines the child, judiciously orders tests, and is sufficiently convinced by the evidence that the patient is suffering from appendicitis and that surgery is required. In the operating room, the surgeon enters the abdomen in the manner most supported by evidence and reason...and then with eyes closed, blindly gropes around hoping to find and remove the inflamed tissue based on the typical location in an average patient, Ridiculous, yes? Yet this has generally been the approach to the use of potentially toxic drugs: hope that the patient is close enough to average to warrant typical or "standard