Patients responses

Promoting Patient Responsibility for Antidepressant Drug Therapy... 

Stream-line antimicrobial therapy based on clinical judgment, patient response, and microbiological data... 

Consider short-course therapy (8 d) based on clinical judgment and patient response... 

Develop a therapeutic plan for patients with chronic asthma that maximizes patient response while minimizing adverse drug events and other drug-related problems. 

The optimal treatment of acute severe asthma depends on the severity of the exacerbation (Figs. 11-2 and 11-3). The patient s condition usually deteriorates over several hours, days, or weeks however, rapid deterioration can occur in some patients.3 Gradual deterioration may indicate failure of long-term controller therapy. Patients with rapid deterioration usually respond well to bronchodilator therapy.40 Severity at the time of the evaluation can be estimated by signs and symptoms, but patient response 30 minutes after inhalation of a bronchodilator is the best predictor of outcome.12... 

Develop a plan to assess the efficacy and adverse effects of GH therapy, and consider if the patient s therapy requires any dose adjustments based on IGF-I level, patient response, and adverse effects. 

Clinicians must follow patient responses to immunosuppressant therapy, including identifying and treating the adverse sequelae associated with lifelong immunosuppression, such as cardiovascular disease, malignancy, infection, and osteoporosis, among others. 

Splenectomy generally is considered after 3 to 6 months if the patient continues to require 10 to 20 mg/day of prednisone to keep the platelet count greater than 30,000/mm3 (30 x 103/jliL or 30 X 109/L) or within 6 weeks of diagnosis in patients with platelet counts of less than 10,000/mm3 (10 x 103/ju,L or 10 x 109/L) despite treatment. Even though individual patient response cannot be predicted, approximately two-thirds of refractory patients have a favorable response to splenectomy within a couple of days. After splenectomy, approximately 85% of adults attain a stable hemostatic response, and 70% to 80% of children attain complete remission. Within 5 to 10 years, approximately 25% of responding adult patients relapse. Laproscopic splenectomy is preferable to open splenectomy because it speeds the recovery and shortens the duration of hospitalization. The major drawback of splenectomy is bacterial sepsis, occurring at incidence rates of about 1%. 

Figure 66-4 provides an overview of patient- and antimicrobial agent-specific factors to consider when selecting an antimicrobial regimen. It further delineates monitoring of therapy and actions to take depending on the patients response to therapy. The duration of therapy depends on patient response and type of infection being treated. 

Treatment is based on several factors including likelihood of patient compliance, whether it is the first or a recurrent episode, host immunity, and pregnancy. However, patient response has been linked to the time it takes to initiate treatment after symptom onset. 

Evaluate patient response and devise alternative treatment regimens for non-responding... 

Clinicians should play a role in chemotherapy safety, patient education, and monitoring patient response to therapy. For example, cumulative doses of anthracyclines should be monitored along with signs and symptoms of heart failure. Clinicians also should monitor concurrent medications along with chemotherapy for drug interactions. 

Beck, J. G., Berisford, M. A., The effects of caffeine on panic patients Response components of anxiety. Behavior Therapy 23(3), 405-422, 1992. 

Dudley C, Keavney B, Casadei B, Conway J, Bird R, Ratcliffe P. Prediction of patient responses to antihypertensive drugs using genetic polymorphisms investigation of renin-angiotensin system genes. J Hypertens 1996 14 259-262. 

Figure 9. Clinical test on a patient response curve of the optical fibre sensor and of Tonocap.

All NSAIDs have similar efficacy in reducing pain and inflammation in OA (Table 2-1), although individual patient response differs among NSAIDs. 

First, determine patient responsiveness. If there is no response, immediately activate the emergency medical response team and obtain an automated external defibrillator (AED) if one is available. 

No real practical dosage limits with opioids mentioned can be titrated to patient response. If myoclonic jerking occurs, consider switching to alternative opioid. 

Doses (titrate up or down based on patient response)... 

The efficacy document E7 (ICH 1993) states that the drug should be studied in all patient groups, elderly included, for which they have a significant utility. It also includes new uses, new formulations and new combinations of established medicinal products when there is specific reason to expect that conditions common in the elderly (e.g. renal or hepatic impairment, impaired cardiac function, concomitant illness or medication) are likely to be encountered. This also applies for when the geriatric patients response (safety, tolerability, efficacy) is different from the nongeriatrics. ... 

Develop information technology (IT) systems to support the patient (responsibilities and demand), and also the health care process for better follow up on treatment in the individual patient and populations... 

Increased concentrations in plasma of markers such as P1NP or cross-linked C-terminal telopeptides (CTx), or urinary excretion of DPD, indicate increased bone turnover but are generally not useful for initial diagnosis of osteoporosis. Changes in plasma concentrations or urinary excretion of bone markers may be useful for monitoring patients response to therapy. 

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