PEDIATRIYA, GERIATRIYA VA BUYRAK-JIGAR YETISHMOVCHILIGI BO‘LGAN BEMORLARDA FARMAKOKINETIK MODELLASHTIRISH ASOSIDA XAVFSIZ DOZALASH STRATEGIYALARI
Keywords:
farmakokinetik modellashtirish, individual dozalash, pediatriya, geriatriya, buyrak yetishmovchiligiAbstract
Pediatrik, geriatriya hamda buyrak va jigar yetishmovchiligi kuzatiladigan bemorlarda dori vositalarini standart dozalash nojo‘ya dori reaksiyalari, subterapevtik konsentratsiya va davolash samarasizligi xavfini oshiradi. Ushbu maqolaning maqsadi farmakokinetik modellashtirish, populyatsion farmakokinetika, fiziologiyaga asoslangan farmakokinetik modellashtirish va modelga asoslangan individual dozalash usullarining klinik ahamiyatini tahlil qilishdan iborat. Adabiyotlar tahlili shuni ko‘rsatdiki, bolalarda a’zolar yetilishi va tana tarkibining tez o‘zgarishi, keksalarda polifarmatsiya, sarkopeniya hamda farmakodinamik sezuvchanlikning ortishi, buyrak va jigar yetishmovchiligida esa klirens, oqsil bilan bog‘lanish, metabolizm va transport tizimlarining buzilishi dozalashni individual tanlashni talab qiladi. 2023-yilda dunyoda 788 million katta yoshli kishida surunkali buyrak kasalligi mavjudligi, undan 1,48 million o‘lim qayd etilgani xavfsiz farmakoterapiya masalasining naqadar dolzarb ekanini ko‘rsatadi. Modelga asoslangan individual dozalash terapevtik dori monitoringi, klinik laborator ko‘rsatkichlar va elektron tibbiy ma’lumotlar bilan birlashtirilganda dori ekspozitsiyasini aniqroq prognoz qilish imkonini beradi. Maqolada xavf guruhlari uchun amaliy algoritm va O‘zbekiston sog‘liqni saqlash tizimida ushbu yondashuvni tatbiq etish bo‘yicha takliflar berilgan.Pediatrik, geriatriya hamda buyrak va jigar yetishmovchiligi kuzatiladigan bemorlarda dori vositalarini standart dozalash nojo‘ya dori reaksiyalari, subterapevtik konsentratsiya va davolash samarasizligi xavfini oshiradi. Ushbu maqolaning maqsadi farmakokinetik modellashtirish, populyatsion farmakokinetika, fiziologiyaga asoslangan farmakokinetik modellashtirish va modelga asoslangan individual dozalash usullarining klinik ahamiyatini tahlil qilishdan iborat. Adabiyotlar tahlili shuni ko‘rsatdiki, bolalarda a’zolar yetilishi va tana tarkibining tez o‘zgarishi, keksalarda polifarmatsiya, sarkopeniya hamda farmakodinamik sezuvchanlikning ortishi, buyrak va jigar yetishmovchiligida esa klirens, oqsil bilan bog‘lanish, metabolizm va transport tizimlarining buzilishi dozalashni individual tanlashni talab qiladi. 2023-yilda dunyoda 788 million katta yoshli kishida surunkali buyrak kasalligi mavjudligi, undan 1,48 million o‘lim qayd etilgani xavfsiz farmakoterapiya masalasining naqadar dolzarb ekanini ko‘rsatadi. Modelga asoslangan individual dozalash terapevtik dori monitoringi, klinik laborator ko‘rsatkichlar va elektron tibbiy ma’lumotlar bilan birlashtirilganda dori ekspozitsiyasini aniqroq prognoz qilish imkonini beradi. Maqolada xavf guruhlari uchun amaliy algoritm va O‘zbekiston sog‘liqni saqlash tizimida ushbu yondashuvni tatbiq etish bo‘yicha takliflar berilgan.
Downloads
References
1. World Health Organization. Patient safety. Geneva: WHO; 2023.
2. World Health Organization. Global burden of preventable medication-related harm in health care: a systematic review. Geneva: WHO; 2024.
3. World Health Organization. Medication safety in polypharmacy: technical report. Geneva: WHO; 2019.
4. GBD 2023 Chronic Kidney Disease Collaborators. Global, regional, and national burden of chronic kidney disease in adults, 1990–2023. Lancet. 2025;406:2461–2482.
5. Minichmayr IK, Dreesen E, Centanni M, et al. Model-informed precision dosing: State of the art and future perspectives. Adv Drug Deliv Rev. 2024;215:115421.
6. Heimbach T, Chen Y, Chen J, et al. Physiologically-based pharmacokinetic modeling in renal and hepatic impairment populations. Clin Pharmacol Ther. 2021;110(2):297–310.
7. Zhu X, Guo L, Zhang L, Xu Y. Physiologically based pharmacokinetic modeling of lacosamide in hepatic and renal impairment and pediatric populations. Clin Ther. 2024;46(3):258–266.
8. Tanaka R, Irie K, Mizuno T. Physiologically based pharmacokinetic modeling of antibiotics in children: perspectives on model-informed precision dosing. Antibiotics. 2025;14(6):541.
9. Abdulla A, Edwina EE, Flint RB, et al. Model-informed precision dosing of antibiotics in pediatric patients. Front Pediatr. 2021;9:624639.
10. Oualha M, Thy M, Bouazza N, et al. Drug dosing optimization in critically ill children under continuous renal replacement therapy. Expert Opin Drug Metab Toxicol. 2025;21(2):173–190.
11. Matsumoto K, Oda K, Shoji K, et al. Clinical practice guidelines for therapeutic drug monitoring of vancomycin in the framework of model-informed precision dosing. Pharmaceutics. 2022;14(3):489.
12. Sanz-Codina M, Bozkir HÖ, Jorda A, Zeitlinger M. Individualized antimicrobial dose optimization: a systematic review and meta-analysis of randomized controlled trials. Clin Microbiol Infect. 2023;29(7):845–857.
13. Hoffert Y, Dia N, Vanuytsel T, et al. Model-informed precision dosing of tacrolimus: a systematic review. Clin Pharmacokinet. 2024;63(10):1407–1421.
