There is, theoretically, a third option, with patients testing themselves with or without self-management of dosing.
RRT must be conducted with the appropriate management of drug dosing, thermal control, volume and electrolyte balance.
Effective PST or PSM requires not only able and motivated patients, a user-friendly, intelligent Electronic Patient Record and a suitable algorithm for management of dose adjustment, but also depends on reliable and accurate point of care testing devices.
Commercial CPOE systems, including Horizon Expert Orders, often use formulary references such as First Databank [ 31] or Lexicon-Multum [ 32] for static dosing advice (e.g., drug-drug interactions or allergy alerts) but not for active dosing assistance or management of the dosing process where tailored doses are suggested based on the patient's clinical profile.
For management of drug toxicity sunitinib dose was reduced to 37.5/25 mg in 44% of cases (60 patients).
In their overview of reviews of interventions focused on improving consumers' use of non-IPT medication, Ryan et al. examined self-monitoring and self-management, simplification of dosing, and involvement of pharmacists [ 31].
It is apparent from the present study that interindividual pharmacokinetic differences among patients can be compensated by clinical management of the doses of methadone (e.g. dose requirements of UM patients).
Globally from the present study, it is apparent that interindividual pharmacokinetic differences among patients can be compensated by clinical management of the doses of methadone, with little influence, if any, from pharmacogenetics of drug metabolizing enzymes and protein transporters.
While the proposed treatment algorithm is based on the current knowledge and experience gained to date, further research will establish the best management strategy, dosing frequency and timing of injection and monitoring.
McCollough, CH; Chen, GH; Kalender, W Lengg, S; Samei, E; Taguchi, K; Wang, G; Yu, L; Pettigrew, RI, Achieving routine submillisievert CT scanning: report from the summit on management of radiation dose in CT., Radiology, vol 264 no. 2 (2012), pp. 567-580 [abs1148/radiol.12112265] [abs].
