Nortriptyline 적정 용법을 위한 Population Pharmacokinetics 및 Bayesian Feedback법의 적용

Population Pharmacokinetics and Bayesian Feedback Method for Nortriptyline Dosage Optimisation

The prediction performance of population kinetics and Bayesian feedback method was evaluated with respect to accuracy, bias, correlation in 18 norm al subject and 29 patients treated with nortriptyline. The root mean squared error (RM SE) served as a precision. To obtain the population kinetic param eter o f nortriptyline in native Korean, NONMEM approach which including structural and statistical kinetic model was used in analysing the 250 plasma level data from 18 norm al subjects after single oral dose of 50mg. The results obtained from the approach using population kinetics-Bayesian feedback method indicate that the future nortriptyline plasma concentration could be predicted with relatively high accuracy(34.9ng/ml) and preccision(RMSE ; 25.6%) with a single measurement of plasm a nortriptyline level after the nortriptyline dose. The accurary(23.3ng/ml) and precision (RMSE ; 15.5%) of the prediction were much more imporved with two-point measurements of plasm a nortriptyline level. In conclusion, feedback approach based on the population kinetic parameters seems to be accurate and reliable for predicting individual dosage requirements in patients treated with nortriptyline.