Using the cumulative odds Logit model to explore the application of the questionnaire derived from PANSS / 药学学报

Currently, aripiprazole, olanzapine and risperidone are three anti-psychiatry agents commonly used in the treatment of schizophrenia. Although the efficacy of these drugs is good, schizophrenia cannot be completely cured yet. Patients need long-term medication. The family members of patients may play a key role to understand the disease status of patients after patient discharge from hospital. PANSS is a commonly used scale in the clinic to evaluate the disease status and drug effects of anti-psychiatry agents. It was professionally written, and is not user friendly to amateurs. In the previous study, we developed a questionnaire for patient's family members to monitor the disease status. In this study, we explored the correlations between the results of questionnaire and 5 kinds of disease state corresponding to different PANSS score interval using the cumulative odds Logit model. The final results show that the model had relatively good prediction ability for aripiprazole, olanzapine and risperidone, suggesting that the questionnaire has an extensive prospect of clinical applications.

Population pharmacokinetics of vancomycin and prediction of pharmacodynamics in the Chinese people / 药学学报

Population pharmacokinetics of vancomycin (VAN) in the Chinese patients was described by using nonlinear mixed-effects modeling (NONMEM). 619 VAN serum concentrations data from 260 patients including 177 males and 83 females were collected separately from two centers. A one-compartment model was used to describe this sparse data. No significant difference was observed between two center datasets by introducing SID covariate. The final model was as CL= (θ (base0+ θ(max) x(1 -e(-θ(Age)(Age/72) and V = θ x θ (Age)(Age/72). The creatinine clearance (CL(Cr)) and Age were identified as the most significant covariate in the final model. Typical values of clearance (CL) and volume of distribution (V) in the final model were 2.91 L x h(-1) and 54.76 L, respectively. Internal model validation by Bootstrap and NPDE were performed to evaluate the robustness and prediction of the final model. The median and 95% confidence intervals for the final model parameters were based on 1000 Bootstraps. External model evaluation was conducted using an independent dataset that consisted of 34 patients to predict model performance. Pharmacodynamic assessment for VAN by AUC (0-24 h) to MIC ratios of over 400 was considered to be the best to predict treatment outcomes for patients. AUC (0-24 h) was calculated by clearance based on the above population model. The results indicate that the conventional dosing regimen probably being suboptimal concentrations in aged patients. The approach via population pharmacokinetic of VAN combined with the relationship of MIC, Age, CL(Cr) and AUC(0-24 h)/MIC can predict the rational dose for attaining efficacy.