Clinical utility of a bayesian dosing program for phenytoin

M. D. Privitera, R. W. Homan, T. M. Ludden, C. C. Peck, M. R. Vasko

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

We performed two studies to assess the clinical utility of a Bayesian regression analysis computer program for phenytoin (PHT). In a randomized prospective study of 40 epileptic patients, the dosing program was significantly more accurate (p = 0.002) and less biased (p = 0.02) than a group of physicians at hitting a target PHT serum-concentration. Initial serum PHT concentrations that were not steady state were associated with the largest dosing errors by physicians but did not affect the accuracy of the dosing program. In a second study, we used the dosing program to predict 91 serum concentrations in 31 patients with PHT toxicity after the drug was stopped (initial concentration 26-69 μg/ml). The program predicted serum concentrations with a mean error of 3.49 ± 0.29 μg/ml without significant tendency to overor underpredict. We conclude that this dosing program may aid clinicians by improving dosing accuracy and predicting serum concentrations in patients with PHT toxicity.

Original languageEnglish (US)
Pages (from-to)285-294
Number of pages10
JournalTherapeutic Drug Monitoring
Volume11
Issue number3
DOIs
StatePublished - May 1989

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Keywords

  • Computer
  • Pharmacoinetics
  • Phenytoin
  • Toxicity

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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