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Using Accessible Patient Data to Individualize Sample Timing for Pharmacokinetic Studies (303675)

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Keywords: pharmacokintecs, design of experiments, optimal design, joint modeling

The optimal timing of blood samples in designing pharmacokinetic studies is uncertain. However, easily measured patient data may reduce this uncertainty. For example, the pharmacodynamics of paralytic drugs such as vecuronium are readily observed by electrical stimulation of the ulnar nerve at the wrist, which causes the thumb (and other digits) to twitch. The degree of paralysis is thus measured by the force produced in thumb following a sequence of one or more rapid stimuli. Using Bayesian compartmental methods and prior information from the anesthesia literature, these easily measured data can be used to approximate individual pharmacokinetics, and thus optimize the timing of blood samples in that individual. We demonstrate that this approach is more efficient than an optimal one-size-fits-all blood sampling schedule. We provide software to implement these methods for a variety of pharmacokinetic models, including a suite of graphical methods to facilitate their use by clinical care providers.