JP6384113B2 - Program, calculation method and calculation apparatus - Google Patents

Description

  The present application relates to a pharmacokinetic program, a calculation method, and a calculation apparatus.

  Some drugs are more likely to cause phytotoxicity if the total dose exceeds a certain limit. Patent Document 1 memorizes the dose of a drug administered to a patient, and injects a warning when the total dose calculated from the stored dose of the drug exceeds the limit total dose of the drug A drug support system is described.

JP 2004-121526 A

However, the ability of patients to metabolize and excrete drugs varies from individual to individual. In addition, the ability of patients to metabolize and excrete drugs may change over time. Therefore, even if the total dose obtained by simply integrating the stored doses of the drug is compared with the limit total dose, accurate information that is useful for prescription cannot be obtained.
In order for the physician to determine the prescription amount of the drug, it is beneficial to present a predicted value of the patient's internal drug amount in the future considering metabolism and excretion.

  One of the objects of the present application is to provide a program, a calculation method, and a calculation apparatus that can calculate the amount of a drug in the body after a lapse of a certain period based on the blood drug concentration of a patient.

One aspect of the present application is a program for causing a computer to execute a process of calculating an in-vivo drug amount of a contraindicated drug when the total dose reaches a predetermined amount, and the blood drug of a patient to whom the drug is administered The blood drug concentration is acquired from a storage device that stores the concentration , a distribution volume is calculated based on the acquired blood drug concentration , the calculated distribution volume is stored in the storage device, and the blood drug concentration On the basis of the blood drug concentration corresponding to the blood drug concentration, to calculate the blood drug concentration after a predetermined period of time, store the calculated blood drug concentration after the predetermined period of time in the storage device, Based on the distribution volume stored in the storage device and the blood drug concentration after the lapse of a predetermined period, the in-body drug amount after the lapse of the predetermined period is calculated.

  According to one aspect of the present application, the amount of a drug in the body after a lapse of a certain period can be calculated based on the blood drug concentration of the patient.

It is a block diagram which shows the hardware structural example of a calculation system. It is a block diagram which shows the hardware structural example of a terminal device. It is explanatory drawing which shows an example of the record layout of user master data. It is explanatory drawing which shows an example of the record layout of patient master data. It is explanatory drawing which shows an example of the record layout of patient profile data. It is explanatory drawing which shows an example of the record layout of test result data. It is explanatory drawing which shows an example of the record layout of medical record data. It is explanatory drawing which shows an example of the record layout of chemical | medical agent master data. It is explanatory drawing which shows an example of the record layout of medical history data. It is explanatory drawing which shows an example of the record layout of chemical | medical agent work data. It is explanatory drawing which shows an example of the record layout of patient chemical | medical agent data. It is a functional block diagram which shows the function structural example of a terminal device. It is explanatory drawing which shows an example of the screen layout of a cumulative body drug amount screen. It is a flowchart which shows an example of the procedure of the amount calculation process in a body. It is a flowchart which shows an example of the procedure of the amount calculation process in a body. It is explanatory drawing which shows an example of the screen layout of a prediction accumulation body drug amount screen. It is a flowchart which shows an example of the procedure of a prediction body drug amount calculation process. It is a flowchart which shows an example of the procedure of a prediction body drug amount calculation process. It is a flowchart which shows an example of the procedure of a prediction body drug amount calculation process.

  A calculation system according to the present embodiment will be described with reference to the drawings. The calculation system according to the present embodiment calculates the in-vivo drug amount after the scheduled number of days has elapsed based on the sample test result of the patient. In addition, the calculation system supports the prescription by the user by accumulating and displaying each in-vivo drug amount calculated every time the sample test is performed and the in-vivo drug amount after the scheduled number of days.

Embodiment 1
Embodiment 1 relates to a form in which the amount of drug in the body is calculated each time a specimen test is performed.
FIG. 1 is a block diagram illustrating a hardware configuration example of the calculation system 10. The calculation system 10 includes a medical record server 20 and a terminal device 30. The medical record server 20 is a mainframe, a workstation, a desktop PC (personal computer), or the like. The medical record server 20 includes a storage device that stores various data related to medical care, and has a function of a database server.

  The terminal device 30 is a desktop PC, a notebook PC, a tablet PC, or the like. Hereinafter, the terminal device 30 is assumed to be a desktop PC. The terminal device 30 is connected to the medical record server 20 via the network 1N. The network 1N includes a LAN (Local Area Network), a WAN (Wide Area Network), the Internet, and the like. The terminal device 30 is operated by medical personnel such as doctors and pharmacists, and accesses the medical record server 20 to read information from various data of the medical record server 20 and write information to the various data. Although three terminal devices 30 are illustrated in FIG. 1, the calculation system 10 may include two or less terminal devices 30 or four or more terminal devices 30.

  FIG. 2 is a block diagram illustrating a hardware configuration example of the terminal device 30. The terminal device 30 includes a CPU (Central Processing Unit) 31, a ROM (Read Only Memory) 32, and a RAM (Random Access Memory) 33. The terminal device 30 includes a hard disk 34, a disk drive 35, a display unit 36, an operation unit 37, a timer 38, and a communication unit 39.

  The CPU 31 is a processor for executing an instruction set described in the software program. The CPU 31 controls each component of the terminal device 30. The CPU 31 reads the program 3P stored in the hard disk 34 to the RAM 33 and executes the program 3P read to the RAM 33.

  The ROM 32 is a read-only storage medium, for example, a nonvolatile semiconductor memory. The ROM 32 stores a BIOS (Basic Input / Output System) executed by the CPU 31 when the terminal device 30 is activated, firmware, and the like.

  The RAM 33 is a main storage device. The RAM 33 is, for example, an SRAM or a DRAM, and temporarily stores work variables, data, and the like that are necessary during the process executed by the CPU 31. A flash memory, a memory card, or the like may be used instead of the RAM 33.

The hard disk 34 is an auxiliary storage device. The hard disk 34 may be replaced with a flash memory capable of storing a large amount of information or an optical disk 3d such as a CD (Compact Disc), a DVD (Digital Versatile Disc), or a BD (Blu-ray (registered trademark) Disc). . The hard disk 34 may be attached inside the terminal device 30 or may be placed outside the terminal device 30. The hard disk 34 may be replaced with a storage device accessible via the network 1N.
The hard disk 34 stores a program 3P executed by the CPU 31 and various data.

  The disk drive 35 reads information from an optical disk 3d such as a CD, DVD, or BD, which is an external storage medium, and records the information on the optical disk 3d.

  The display unit 36 is a display device that displays an image. The display part 36 has screens, such as a liquid crystal display, an organic EL (Electro Luminescence) display, a CRT (Cathode Ray Tube) display, for example, and displays the various information which concerns on the program 3P on the said screen according to the instruction | indication from CPU31.

  The operation unit 37 is an input device such as a keyboard, a mouse, a touch panel, and a power switch on which a user performs various inputs. The operation unit 37 generates an input signal based on an operation by a user. The generated input signal is output to the CPU 31 via the bus 3b.

  The timer 38 is a device that counts a predetermined time by counting clocks. The timer 38 outputs the clocked result to the CPU 31.

  The communication unit 39 is a wired or wireless communication modem, a LAN card, a router, a USB (Universal Serial Bus) terminal, a connection connector, or the like. The communication unit 39 is connected to the network 1N.

  The CPU 31 may read the program 3P from the optical disk 3d via the disk drive 35. The CPU 31 may read the program 3P from an external information processing device or storage device via the communication unit 39. Further, a semiconductor memory 3m such as a flash memory storing the program 3P may be mounted in the terminal device 30.

Various data stored in the storage device of the medical record server 20 will be described. Various data includes user master data 1D, patient master data 2D, patient profile data 3D, examination result data 4D, and medical record data 5D. Various data includes drug master data 6D, drug history data 7D, drug work data 8D, and patient drug data 9D.
The various data is, for example, in a table format, but may be in other data formats.

Various data will be described in detail.
FIG. 3 is an explanatory diagram showing an example of a record layout of the user master data 1D. The user master data 1D is data that stores basic information of users who use the calculation system 10.
The user master data 1D includes columns of user ID, user name, and department code. The user ID is a symbol that identifies the user. In the following, it is assumed that the user is a doctor who prescribes a medicine to a patient. The user name is the name of the user. The medical department code is a symbol for identifying the medical department to which the user belongs.

FIG. 4 is an explanatory diagram showing an example of a record layout of the patient master data 2D. The patient master data 2D is data for storing basic patient information.
The patient master data 2D includes columns for patient number, patient name, sex, and date of birth. The patient number is a number that identifies a patient. The patient name is the name of the patient. The gender is the gender of the patient. The date of birth is the date of birth of the patient.

FIG. 5 is an explanatory diagram showing an example of a record layout of the patient profile data 3D. The patient profile data 3D is data for storing physical information related to an individual patient.
The patient profile data 3D includes columns for patient number, height, weight, and measurement date. The patient number is the same as the patient number in the patient master data 2D. Height and weight are the measured height and measured weight of the patient, respectively. The measurement date is the date on which the height and weight of the patient were measured.

  The patient profile data 3D includes columns of a drug allergy flag, a drug number, and a drug name. The drug allergy flag is a flag indicating whether or not the patient develops drug allergy. If the drug allergy flag = 1, the patient develops drug allergy. If the drug allergy flag = 0, the patient does not develop drug allergy. The example of FIG. 5 shows that the patient with patient number = 1 has drug allergy, and the patients with patient numbers = 2, 3 have no drug allergy. The drug number is a number for identifying a drug. In the drug number column, in the case of a patient who develops drug allergy, the drug number corresponding to the drug is stored. The drug name is the name of the drug. In the drug name column, in the case of a patient who develops drug allergy, a name corresponding to the drug is stored.

  The patient profile data 3D includes columns of food allergy flag, food allergy information, and remarks. The food allergy flag is a flag indicating whether or not the patient develops food allergy. If the food allergy flag = 1, the patient develops a food allergy. If the food allergy flag = 0, the patient does not develop food allergies. The example of FIG. 5 shows that the patient with patient number = 1 has food allergy. The food allergy information is food in which the patient develops food allergies. Remarks are information provided for reference.

FIG. 6 is an explanatory diagram showing an example of a record layout of the inspection result data 4D. The test result data 4D is data for storing the sample test result of the patient.
The test result data 4D includes columns of patient number, user ID, document number, order number, execution number, execution date, and blood concentration. The patient number is the same as the patient number in the patient master data 2D. The user ID is the same as the user ID of the user master data 1D. The document number is a symbol for identifying the medical record. The order number is a symbol for identifying the order. The execution number is a symbol that identifies the examination. The implementation date is the date when the inspection was performed. The blood concentration is the concentration of the drug dissolved in the blood. The blood concentration is often expressed by the weight of a drug contained in 1 ml of blood, and the unit is, for example, mg / ml.

FIG. 7 is an explanatory diagram showing an example of a record layout of the medical record data 5D. The medical record data 5D is data for storing patient medical information.
The medical record data 5D includes columns of patient number, patient name, user ID, and user name. The patient number is the same as the patient number in the patient master data 2D. The patient name is the same as the patient name in the patient master data 2D. The user ID is the same as the user ID of the user master data 1D. The user name is the same as the user name in the user master data 1D.

  The medical record data 5D includes columns of a document number, an order number, a medical date, an execution number, and a preparation number. The document number is a symbol for identifying the medical record. The order number is a symbol for identifying the order. The medical treatment date is the date on which the doctor performed medical treatment on the patient. The execution number is the same as the execution number of the inspection result data 4D. The formulation number is a number for identifying a drug. The formulation number indicates the drug prescribed to the patient by the doctor.

FIG. 8 is an explanatory diagram showing an example of the record layout of the medicine master data 6D. The medicine master data 6D is data for storing basic information on medicines.
The drug master data 6D includes columns of a drug product number, a drug product name, an effect, and a bioavailability. The formulation number is a number that identifies the formulation. The formulation name is the name of the formulation. The effect is that of the formulation. The bioavailability is a constant representing the rate at which a drug administered to a living body reaches the systemic circulation. Alternatively, the bioavailability is the ratio of the amount of drug used on the whole body blood flow out of the amount of drug administered to the living body. For example, when a drug is administered intravenously, its bioavailability is 100%. The bioavailability is less than 100% in the case of orally administered drugs due to metabolism in the liver, etc., and varies depending on the type of drug.

  The drug master data 6D includes columns of a dangerous drug flag, a limit amount, a drug product influence level flag, a drug product influence level, and drug effect level information. The dangerous drug flag is a flag indicating whether or not the drug has a certain limit in the total dose. Some drugs, such as anticancer drugs, are more likely to cause phytotoxicity if their total lifetime dose exceeds a certain limit. Hereinafter, a drug that increases the possibility of developing a phytotoxicity when the total lifetime dose exceeds a certain limit amount is referred to as a dangerous drug. When the dangerous drug flag = 1, this indicates that the drug is a dangerous drug. When the dangerous drug flag = 0, it indicates that the drug is not a dangerous drug. The limit dose is the limit total dose of dangerous drugs. The unit of the limit amount is, for example, mg.

  The drug product influence degree flag is a flag indicating whether or not the drug requires attention for swallowing. Interactions may occur when drugs are swallowed. Depending on the interaction, there are cases where the effectiveness of the drug becomes too strong and where the efficacy of the drug becomes weak. If the effect of the drug becomes too strong, side effects are likely to occur, and the gastrointestinal tract, liver, etc. may be damaged. When the formulation influence level flag = 1, it indicates that the drug is a drug that requires attention for swallowing. When the formulation influence level flag = 0, it indicates that the drug is a drug that does not require attention for swallowing. The drug product influence degree is a rate at which adverse effects occur due to interaction. The unit of formulation influence is, for example,%. The drug influence level information is information such as a drug name of the partner that causes the interaction. In the case of the first record in FIG. 8, information on warfarin that interacts with amiodarone is stored in the drug influence information.

FIG. 9 is an explanatory diagram showing an example of a record layout of the drug history data 7D. The drug history data 7D is data for storing a prescription history of a drug prescribed to a patient.
The drug history data 7D includes columns of patient number, document number, formulation number, formulation name, and order number. The patient number is the same as the patient number in the patient master data 2D. The document number is the same as the document number of the medical record data 5D. The formulation number is the same as the formulation number in the drug master data 6D. The formulation name is the same as the formulation name in the drug master data 6D. The order number is the same as the order number of the medical record data 5D.

  The drug history data 7D includes columns for the administration start date, the dose, the administration end date, the prescription schedule flag, the administration stop flag, and the administration stop date. The administration start date is the date on which the administration of the drug to the patient was started by one prescription. The dosage is a daily drug dosage based on a single prescription. The unit of dosage is, for example, mg / day. The administration end date is the date when the administration of the drug that has been performed on the patient by one prescription is completed.

  The prescription schedule flag is a flag indicating whether or not it is planned to prescribe the same medicine as the preparation number string to the patient in the next medical examination. When the prescription schedule flag = 1, the doctor indicates that the patient is scheduled to prescribe the same medicine as the preparation number string. The administration stop flag is a flag indicating whether or not the prescription of the drug in the preparation number sequence to the patient has been stopped in the current medical care. When the administration stop flag = 1, the doctor indicates that the patient has stopped prescribing the drug in the formulation number column in the current medical care. The administration discontinuation date is the date on which administration of the drug in the formulation number column to the patient was discontinued. For example, the second record in FIG. 9 indicates that the administration of amiodarone was discontinued on October 20, 2013 for the patient with patient number = 1.

FIG. 10 is an explanatory diagram showing an example of a record layout of the medicine work data 8D. The medicine work data 8D is data for temporarily storing work data when calculating various amounts of medicine.
The drug work data 8D includes columns of patient number, formulation number, formulation name, dose, administration start date, administration end date, administration period, administration discontinuation date, and administration interruption period. The patient number is the same as the patient number in the patient master data 2D. The formulation number is the same as the formulation number in the drug master data 6D. The formulation name is the same as the formulation name in the drug master data 6D. The dose is the same as the dose in the drug history data 7D.

  The administration start date is the same as the administration start date of the first record for a certain patient and certain drug in the drug history data 7D. The administration end date is the same as the administration end date of the last record for a certain patient and a certain drug in the drug history data 7D. The administration period is a cumulative administration period that does not consider interruption of drug administration. The unit of the administration period is, for example, a day. The administration discontinuation date is the same as the administration discontinuation date in the drug history data 7D. The administration interruption period is a period during which the drug administration is interrupted, and the unit is, for example, a day. The administration interruption period is calculated based on the administration stop date and the administration start date when the administration is resumed from the administration stop date with reference to the drug history data 7D.

  The drug work data 8D includes columns of a limit amount, a drug product influence level flag, a drug product influence level, a bioavailability, an execution number, and a blood concentration. The limit amount is the same as the limit amount of the medicine master data 6D. The preparation influence level flag is the same as the preparation influence degree flag of the drug master data 6D. The drug product influence degree is the same as the drug product influence degree of the drug master data 6D. The bioavailability is the same as the bioavailability of the medicine master data 6D. The execution number is the same as the execution number of the inspection result data 4D. The blood concentration is the same as the blood concentration in the test result data 4D.

  The drug work data 8D includes columns of distribution volume, in-vivo drug metabolism, and elimination rate constant. The distribution volume is a volume obtained when it is assumed that the drug is instantaneously distributed to each tissue at a concentration equal to that in plasma. The distribution volume is an apparent volume in which the drug is dispersed with respect to blood, body fluid, and the like. The volume of distribution is equal to the amount of drug in the body divided by the blood concentration. The unit of the distribution volume is, for example, L / kg, mL / g. The amount of drug metabolism in the body is so-called clearance, and is the ability to excrete the drug outside the body. The amount of drug metabolized in the body is the volume of the amount of fluid that is metabolized and excreted from blood in a certain time. The unit of drug metabolism in the body is, for example, mL / min, L / hour, and the like. The disappearance rate constant is a proportional constant of the disappearance rate at which the administered drug is metabolized and excreted and disappears from the body. The disappearance rate of the drug is proportional to the amount of drug in the body, and is determined by the product of the amount of drug in the body and the rate of disappearance rate constant.

  The drug work data 8D includes columns of predicted blood concentration, in-vivo drug amount, and predicted in-vivo drug amount. The predicted blood concentration is the blood concentration of the drug after the scheduled prescription period has elapsed since the time of blood collection. The amount of drug administered into the body decreases due to metabolism and excretion, but reaches a balance after a certain period of time. The amount of drug remaining in the body at this time is the amount of drug in the body. The unit of the drug amount in the body is, for example, mg. The amount of drug in the body can be determined by the product of the distribution volume and the blood concentration or the product of the drug metabolism in the body and the blood concentration. The predicted amount of drug in the body is the amount of drug in the body after the scheduled prescription period.

FIG. 11 is an explanatory diagram showing an example of a record layout of the patient medicine data 9D. The patient drug data 9D is data for storing a patient's in-body drug amount, predicted in-vivo drug amount, and the like.
The patient drug data 9D includes columns of patient number, formulation number, formulation name, administration start date, administration end date, and administration period. The patient number is the same as the patient number in the patient master data 2D. The formulation number is the same as the formulation number in the drug master data 6D. The formulation name is the same as the formulation name in the drug master data 6D. The administration start date is the same as the administration start date of the drug work data 8D. The administration end date is the same as the administration end date of the drug work data 8D. The administration period is the same as the administration period of the drug work data 8D. The administration discontinuation date is the same as the administration discontinuation date in the drug history data 7D.

  The patient drug data 9 </ b> D includes columns of a drug discontinuation date, a drug discontinuation period, a limit amount, a drug product influence degree flag, a drug product influence degree, and drug influence degree information. The administration interruption period is the same as the administration interruption period of the drug work data 8D. The limit amount is the same as the limit amount of the medicine master data 6D. The preparation influence level flag is the same as the preparation influence degree flag of the drug master data 6D. The drug influence level information is the same as the drug influence level information of the drug master data 6D.

The patient drug data 9D includes columns of predicted blood concentration, in-vivo drug amount, and predicted in-vivo drug amount. The predicted blood concentration is the same as the predicted blood concentration of the drug work data 8D. The in-body drug amount is the same as the in-body drug amount in the drug work data 8D. The predicted in-body drug amount is the same as the predicted in-body drug amount of the drug work data 8D.
Each time the terminal device 30 calculates the in-vivo drug amount or the predicted in-vivo drug amount, a new record is added to the patient drug data 9D.

  FIG. 12 is a functional block diagram illustrating a functional configuration example of the terminal device 30. The terminal device 30 includes a reception unit 301, a DB access unit 302, a calculation unit 303, and an output unit 304. The reception unit 301 corresponds to the hardware operation unit 37 and is a functional unit that receives patient identification information and the like. The DB access unit 302 is a functional unit that accesses the medical record server 20 that is a database server and acquires data from various data stored in the medical record server 20. The calculation unit 303 is a functional unit that calculates various values related to pharmacokinetics using data acquired by the DB access unit 302. The DB access unit 302 accesses the medical record server 20 and writes the results calculated by the calculation unit 303 into various data stored in the medical record server 20.

The calculation unit 303 calculates the distribution volume and the in-body drug metabolism amount. The amount of drug in the body here is a value when administration of the drug to the patient is interrupted. The distribution volume and the amount of drug metabolism in the body are expressed by the following equations (1) and (2), respectively. For details on pharmacokinetic formulas and other information, refer to the following website.
http://jstdm.umin.jp/yogo/kiso.html

  In addition, the administration period in Formula (2) is a unit of time (hr). The calculation unit 303 calculates the in-vivo drug amount based on the calculated distribution volume, in-vivo drug metabolism amount, and the like.

The output unit 304 is a functional unit that outputs the result calculated by the calculation unit 303 to the display unit 36.
FIG. 13 is an explanatory diagram showing an example of the screen layout of the cumulative in-body drug amount screen 1f. The cumulative in-body drug amount screen 1f is a screen that displays, for example, a stacked bar graph showing the cumulative value of the in-vivo drug amount for each day of the sample test calculated based on the prescription history from the first prescription to the present and the blood concentration tested. It is. On the cumulative in-body drug amount screen 1f, the limit amount that is the limit total dose is displayed on the horizontal axis for reference, and the cumulative value of the in-vivo drug amount is displayed on the horizontal axis. In addition, the cumulative in-vivo drug amount screen 1f shows the cumulative dose, which is the total dose up to the present, along the horizontal axis for reference. On the cumulative in-vivo drug amount screen 1f, an administrable dose corresponding to the difference between the limit dose and the cumulative dose is also displayed. When prescribing a drug to a patient, a doctor who is a user of the calculation system 10 determines prescription content with reference to information on the cumulative in-body drug amount screen 1f.

The operation of the calculation system 10 will be described.
The user operates the terminal device 30 to log in to the calculation system 10. The user selects a patient from a patient selection screen (not shown).

14 and 15 are flowcharts showing an example of the procedure of the in-vivo drug amount calculation process. In the following processing, the CPU 31 appropriately writes work data to the medicine work data 8D and reads the work data from the medicine work data 8D.
The CPU 31 receives the patient number of the patient selected by the user (step S101). CPU31 searches the formulation number of medical record data 5D based on the received patient number (step S102). In step S102, if the patient has a drug prescription order or a drug injection order, the CPU 31 succeeds in the search. The CPU 31 determines whether the search is successful (step S103).

  If the CPU 31 determines that the search has not been successful (step S103: NO), the process ends. When determining that the search is successful (step S103: YES), the CPU 31 determines whether or not the prescription drug history of the patient is stored in the drug history data 7D (step S104). If the CPU 31 determines that the prescription drug history of the patient is not stored in the drug history data 7D (step S104: NO), the process is terminated. When the formulation number corresponding to the received patient is stored in the medical record data 5D, the record of the patient is stored in the drug history data 7D, and therefore the process of step S104 is an exception process.

  When it is determined that the prescription drug history of the patient is stored in the drug history data 7D (step S104: YES), the CPU 31 stores the drug master data 6D based on the medical record data 5D and the formulation number in the drug history data 7D. Search is performed (step S105). The CPU 31 determines whether or not the dangerous drug flag of the searched medicine is 1 (step S106). CPU31 complete | finishes a process, when it determines with the dangerous drug flag of the searched chemical | medical agent not being 1 (step S106: NO).

  When the CPU 31 determines that the dangerous drug flag of the searched drug is 1 (step S106: YES), the CPU 31 searches the test result data 4D for the execution number and blood concentration corresponding to the received patient number (step S107). . The CPU 31 newly inserts a patient record corresponding to the patient number received in the medicine work data 8D (step S108). The content of the record newly inserted in step S108 includes a patient number, a formulation number, a formulation name, a bioavailability, a limit amount, a formulation impact level flag, and a formulation impact level. Further, the contents of the record newly inserted in step S108 include an execution number and blood concentration.

  The CPU 31 acquires drug administration history information corresponding to the selected patient from the content of the drug history data 7D (step S109). The drug administration history information here includes a dose (per day), an administration start date, an administration end date, and an administration period. Further, when there is an interruption period in the administration of the drug to the patient, the drug administration history information here includes the administration stop date and the administration interruption period. The CPU 31 calculates and acquires the administration period and the administration interruption period from the contents of the drug history data 7D. The CPU 31 writes the acquired drug administration history information in the newly inserted record in the drug work data 8D (step S110).

  The CPU 31 determines whether or not the acquired drug administration history information includes an administration interruption period (step S111). CPU31 calculates distribution volume using (1) Formula, when it determines with the acquired chemical | medical agent administration log | history information not including an administration interruption period (step S111: NO) (step S112). The CPU 31 calculates the in-vivo drug amount by multiplying the distribution volume by the blood concentration (step S113). The CPU 31 may calculate the in-vivo drug amount from the administration period × the dose per day × the bioavailability. The CPU 31 writes the calculated distribution volume and in-vivo drug amount in the record of the drug work data 8D (step S114).

  When it is determined that the acquired drug administration history information includes the administration interruption period (step S111: YES), the CPU 31 calculates the in-vivo drug metabolism amount using the equation (2) (step S115). The CPU 31 calculates the in-vivo drug amount by multiplying the in-vivo drug metabolism amount by the blood concentration (step S116). The CPU 31 may calculate the in-vivo drug amount from the bioavailability × dose per day / (administration period−interruption period). The CPU 31 writes the calculated in-vivo drug metabolism amount and in-vivo drug amount in the record of the drug work data 8D (step S117).

  The CPU 31 writes the numerical value related to the calculated pharmacokinetics and the data written in the drug work data 8D into the patient drug data 9D (step S118). The CPU 31 displays the cumulative in-body drug amount screen 1f (step S119), and ends the process. In step S119, the CPU 31 refers to each past in-vivo drug amount stored in the patient drug data 9D and displays the cumulative in-body drug amount screen 1f.

  In step S119, every time a blood test is performed, the CPU 31 displays the in-vivo drug amount on the cumulative in-vivo drug amount screen 1f by using the past record regarding the dangerous drug inserted into the patient drug data 9D. Further, the CPU 31 refers to the drug history data 7D, calculates the cumulative dose, and displays the calculated cumulative dose on the cumulative in-body drug amount screen 1f. Further, the CPU 31 refers to the drug work data 8D and displays the limit amount on the cumulative in-body drug amount screen 1f.

  In step S119, the CPU 31 may retrieve patient allergy information corresponding to the selected patient number from the patient profile data 3D and display the retrieved result on the cumulative in-body drug amount screen 1f. Further, in step S119, the CPU 31 may retrieve the height and weight of the patient from the patient profile data 3D. The CPU 31 may calculate the body surface area using the empirical formula for the searched height and weight, and display the calculated body surface area on the cumulative in-body drug amount screen 1f.

  In the present embodiment, the CPU 31 uses the drug work data 8D. However, the CPU 31 may store the work data in the RAM 33 or the hard disk 34 and execute the in-vivo drug amount calculation process.

  In the present embodiment, the terminal device 30 calculates the in-vivo drug amount using various data that the medical storage server 20 has. However, the terminal device 30 may store various data stored in the medical storage server 20 in its own hard disk 34 and calculate the in-vivo drug amount using the various data stored in the hard disk 34.

  In the present embodiment, the blood concentration of the medicine is stored in the test result data 4D. However, the test result data 4D may include the urine drug concentration. In such a case, the CPU 31 may calculate various values related to pharmacokinetics using the drug concentration in urine.

  According to the calculation system 10, it is possible to calculate the in-body drug amount. By displaying the calculated in-vivo drug amount in comparison with the accumulated dose on the accumulated in-body drug amount screen 1f, the user can prescribe a dangerous drug in consideration of the patient's metabolism, excretion function, etc. it can. Moreover, the calculation system 10 can present a more accurate in-vivo drug amount to the user by calculating the in-vivo drug amount in consideration of the drug discontinuation period.

Embodiment 2
The second embodiment relates to a form in which the amount of drug in the body is calculated after the scheduled prescription period using blood concentration. The processing in the second embodiment is executed subsequent to the processing in the first embodiment.
In the second embodiment, the same reference numerals are assigned to the same components as those in the first embodiment, and detailed description thereof is omitted.

  In the second embodiment, the accepting unit 301 accepts identification information of one or more types of medicines. Moreover, the reception part 301 receives the number of days by which a chemical | medical agent is prescribed. The calculation unit 303 calculates the amount of drug metabolism in the body, the disappearance rate constant of the drug, and the predicted blood concentration. The predicted blood concentration here is the blood concentration after elapse of the accepted scheduled days. The predicted blood concentration includes a predicted blood concentration when the dangerous drug does not interact with the swallowing drug and a predicted blood concentration when the dangerous drug interacts with the swallowing drug. The amount of drug metabolism in the body is expressed by the following equation (3).

  The prescription period of the formula (3) is in units of time (hr). The disappearance rate constant of the drug is expressed by the following equation (4).

  The predicted blood concentration when the dangerous drug does not interact with the swallowing drug is expressed by the following equation (5).

  The predicted blood concentration when a dangerous drug interacts with a swallowing drug is expressed by the following equation (6).

  24 in the formulas (5) and (6) is a constant for converting the prescription schedule days into hours (hr).

FIG. 16 is an explanatory diagram showing an example of a screen layout of the predicted cumulative in-vivo drug amount screen 2f.
The output unit 304 displays the predicted cumulative in-vivo drug amount and the cumulative dose on the predicted cumulative in-vivo drug amount screen 2f. The predicted cumulative in-vivo drug amount is a drug amount obtained by adding the in-vivo drug amount after the scheduled number of days for which the drug is prescribed to the integrated value of each in-vivo drug amount from the time of the first prescription to the present.

  The predicted cumulative in-vivo drug amount screen 2f is a screen that displays the predicted cumulative in-vivo drug amount as, for example, a stacked bar graph. On the predicted cumulative in-vivo drug amount screen 2f, the limit amount of dangerous drugs is displayed on the horizontal axis, and the predicted cumulative in-vivo drug amount is displayed on the horizontal axis. Further, the cumulative dose is also displayed on the predicted cumulative in-vivo drug amount screen 2f. On the predicted cumulative in-vivo drug amount screen 2f, a dose that can be administered corresponding to the difference between the limit amount and the cumulative dose is also displayed. When prescribing a drug to a patient, a doctor who is a user of the calculation system 10 determines prescription content with reference to information on the predicted cumulative in-body drug amount screen 2f.

  The operation of the calculation system 10 will be described. The user selects one or more types of medicines to be prescribed from a prescription request screen (not shown). Further, the user inputs the prescription schedule days on the prescription request screen.

17, 18 and 19 are flowcharts showing an example of the procedure of the predicted in-body drug amount calculation process. In the following processing, the CPU 31 appropriately writes work data to the medicine work data 8D and reads the work data from the medicine work data 8D.
The CPU 31 accepts one or more types of drugs selected by the user (step S201). CPU31 receives the prescription prescription days input by the user (step S202). The CPU 31 determines whether there are a plurality of types of received medicines (step S203). If the CPU 31 determines that the received medicines are not plural types (step S203: NO), that is, if one kind of medicine is received, the process proceeds to step S207.

  CPU31 searches the record of the medicine master data 6D corresponding to a dangerous drug, when it determines with the received chemical | medical agent being multiple types (step S203: YES) (step S204). CPU31 determines whether a formulation influence degree flag is 1 based on the searched record (step S205). The case where the drug product influence level flag is 1 is a case where a drug that interacts with a dangerous drug is included in the received plural types of drugs. CPU31 advances a process to step S207, when it determines with a formulation influence degree flag not being 1 based on the searched record (step S205: NO).

  If the CPU 31 determines that the formulation influence flag is 1 based on the retrieved record (step S205: YES), the CPU 31 writes information on the interaction in the drug work data 8D (step S206). Here, the information related to the interaction is a preparation influence degree flag and a preparation influence degree included in the medicine master data 6D.

  The CPU 31 acquires various amounts necessary for calculating the distribution volume and the in-vivo drug metabolism amount by the equations (1) and (3) from various data in the same manner as in the first embodiment (step S207). . In step S207, the CPU 31 also acquires various amounts necessary for the subsequent processing from various data. The CPU 31 calculates the distribution volume from the equation (1) (step S208). The CPU 31 writes the calculated distribution volume in the record of the medicine work data 8D (step S209). The CPU 31 calculates the in-vivo drug metabolism amount using equation (3) (step S210). The CPU 31 writes the calculated in-vivo drug metabolism amount in the record of the drug work data 8D (step S211).

  The CPU 31 calculates the disappearance rate constant of the drug using the calculated in-vivo drug metabolism amount and the equation (4) (step S212). The CPU 31 writes the calculated medicine disappearance rate constant in the record of the medicine work data 8D (step S213). CPU31 determines whether the formulation influence degree flag written in the record of medicine work data 8D is 1 (Step S214).

If the CPU 31 determines that the drug product influence flag written in the record of the drug work data 8D is not 1, that is, 0 (step S214: NO), the predicted blood is calculated using the calculated disappearance rate constant and the equation (5). The medium density is calculated (step S215). When the CPU 31 determines that the formulation influence degree flag written in the record of the drug work data 8D is 1 (step S214: YES), the CPU 31 calculates the predicted blood concentration using the calculated disappearance rate constant and the equation (6). (Step S216). The CPU 31 writes the calculated predicted blood concentration in the records of the drug work data 8D and the patient drug data 9D, respectively (step S217).
In step S215, the predicted blood concentration is calculated using the calculated disappearance rate constant, but the predicted blood concentration may be calculated using a generally known disappearance rate constant.

  The CPU 31 calculates the predicted in-vivo drug amount by multiplying the predicted blood concentration by the distribution volume (step S218). The predicted amount of drug in the body is the amount of drug in the body after the number of days for which the drug is scheduled to be prescribed. The CPU 31 acquires the distribution volume from the medicine work data 8D for the calculation in step S218. The CPU 31 writes the calculated in-vivo drug amount in the records of the drug work data 8D and the patient drug data 9D, respectively (step S219). The CPU 31 displays the predicted cumulative in-vivo drug amount screen 2f on the display unit 36 (step S220).

  In step S220, the CPU 31 refers to each past in-vivo drug amount stored in the patient drug data 9D and the in-vivo drug amount calculated in the first embodiment, and displays the predicted cumulative in-vivo drug amount screen 2f. In step S220, the CPU 31 refers to the drug history data 7D, calculates the cumulative dose, and displays the calculated cumulative dose on the predicted cumulative in-vivo drug dose screen 2f. Further, the CPU 31 refers to the drug work data 8D to display the limit amount on the predicted cumulative in-body drug amount screen 2f.

  The user determines the prescription content and inputs the determined prescription content on the prescription request screen. CPU31 receives the inputted prescription content (Step S221). The CPU 31 writes the received prescription content in the medical record data 5D and the medication history data 7D (step S222), and ends the process.

  In the present embodiment, the CPU 31 uses the drug work data 8D. However, it goes without saying that the CPU 31 may store the work data in the RAM 33 or the hard disk 34 and execute the predicted in-vivo drug amount calculation process.

According to the calculation system 10, it is possible to calculate the amount of the drug in the body after the scheduled prescription period using the blood concentration.
There are individual differences in metabolism and excretion. Metabolism and excretion ability may change over time. The calculation system 10 uses the blood concentration of the medicine based on blood collected from the patient to calculate the blood concentration after the scheduled prescription period. Therefore, the calculated blood concentration is a value reflecting the latest individual difference. The calculation system 10 calculates the in-body drug amount after the scheduled prescription period has elapsed based on the blood concentration reflecting the latest individual difference. Accordingly, the in-vivo drug amount calculated by the calculation system 10 is also a more accurate value reflecting the latest individual difference.

  When the patient swallows a dangerous drug together with another drug, the calculation system 10 calculates the predicted in-body drug amount in consideration of the influence degree of the drug interaction. Thereby, the user can prescribe a dangerous drug to a patient with reference to a more accurate predicted in-vivo drug amount or predicted accumulated in-vivo drug amount.

  The disclosed embodiments are to be considered in all respects as illustrative and not restrictive. The scope of the present invention is defined by the terms of the claims, rather than the description above, and is intended to include any modifications within the scope and meaning equivalent to the terms of the claims.

  The technical features (components) described in each embodiment can be combined with each other, and a new technical feature can be formed by combining them.

  Regarding the above embodiment, the following additional notes are disclosed.

(Appendix 1)
When the total dose reaches a predetermined amount, a program that causes a computer to execute a process of calculating the in-vivo drug amount of a contraindicated drug,
Calculate the distribution volume based on the blood drug concentration of the patient to whom the drug was administered,
Based on the calculated blood drug concentration, calculate the blood drug concentration after a predetermined period from the blood collection time corresponding to the blood drug concentration,
A program for causing a computer to execute a process of calculating an in-body drug amount after a predetermined period of time based on the distribution volume and a blood drug concentration after a predetermined period of time.

(Appendix 2)
The program according to claim 1, wherein the processing for calculating the distribution volume calculates the distribution volume based on the blood drug concentration, the dose of the drug, and the bioavailability of the drug.

(Appendix 3)
Calculate the drug metabolism of the patient based on the blood drug concentration,
Calculate the drug disappearance rate constant based on the calculated drug metabolism and the distribution volume,
The program according to claim 1 or 2, wherein the process of calculating the blood drug concentration after the predetermined period has elapsed uses the calculated drug disappearance rate constant to calculate the blood drug concentration after the predetermined period has elapsed.

(Appendix 4)
The process of calculating the blood drug concentration after the lapse of the predetermined period includes the blood drug concentration of a patient who has been administered the contraindicated drug and another drug different from the drug, and the contraindicated drug and other drug. The program according to any one of appendix 1 to appendix 3, wherein the blood drug concentration after a predetermined period of time is calculated based on the degree of influence related to the interaction.

(Appendix 5)
Based on the dose of the drug and the bioavailability of the drug, the amount of the drug in the body is calculated,
The program according to any one of appendix 1 to appendix 4, wherein the calculated in-vivo drug amount and the in-vivo drug amount after elapse of the predetermined period are added to calculate an accumulated in-vivo drug amount after elapse of the predetermined period.

(Appendix 6)
The process of calculating the amount of drug metabolism is to calculate the amount of drug metabolism based on the drug administration period excluding the drug concentration in the blood and the drug administration interruption period of the patient where the administration of the drug was interrupted,
The program according to appendix 3, wherein the in-vivo drug amount is calculated based on the calculated drug metabolism amount and the blood drug concentration.

(Appendix 7)
The program according to claim 5, wherein the cumulative amount of drug in the body after the lapse of the predetermined period and the total dose of the drug are output.

(Appendix 8)
The program according to appendix 5 or appendix 7, which outputs the cumulative amount of drug in the body after the lapse of the predetermined period, the total dose of the drug, and the limit total dose of the drug.

(Appendix 9)
When the total dose reaches a predetermined amount, a calculation method for calculating the in-vivo drug amount of a contraindicated drug,
Calculate the distribution volume based on the blood drug concentration of the patient to whom the drug was administered,
Based on the blood drug concentration, calculate the blood drug concentration after a predetermined period from the blood collection time corresponding to the blood drug concentration,
A calculation method for calculating a drug amount in the body after the predetermined period based on the calculated distribution volume and the blood drug concentration after the predetermined period.

(Appendix 10)
When the total dose reaches a predetermined amount, a calculation device that calculates the in-vivo drug amount of a contraindicated drug,
A volume calculation unit for calculating a distribution volume based on a blood drug concentration of a patient to which the drug is administered;
Based on the blood drug concentration, a concentration calculator that calculates the blood drug concentration after a predetermined period from the blood collection time corresponding to the blood drug concentration;
Based on the distribution volume calculated by the volume calculation unit and the blood drug concentration after the predetermined period calculated by the concentration calculation unit; A calculation device.

(Appendix 11)
A drug amount calculating unit for calculating the amount of the drug in the body based on the dose of the drug and the bioavailability of the drug;
Cumulative drug amount for calculating the cumulative in-body drug amount after a predetermined period by adding the in-vivo drug amount calculated by the drug amount calculation unit and the in-vivo drug amount after the predetermined period calculated by the post-elapsed drug amount calculation unit A calculation unit;
A read-out unit that reads out each dose of the drug from a storage unit in which the dose of the drug according to one or more prescriptions is stored;
A total dose calculating unit that calculates the total dose of the drug based on the dose of the drug read by the read unit;
The calculation apparatus according to claim 10, further comprising: an output unit that outputs the cumulative in-body drug amount after a predetermined period of time calculated by the cumulative drug amount calculation unit and the total dose calculated by the total dose calculation unit.

(Appendix 12)
The readout unit reads the limit total dose from the storage unit in which the limit total dose of the drug is stored,
The output unit outputs the cumulative in-vivo drug amount after a predetermined period calculated by the cumulative drug amount calculation unit, the total dose calculated by the total dose calculation unit, and the limit total dose read by the readout unit. 11. The calculation device according to 11.

DESCRIPTION OF SYMBOLS 10 Calculation system 20 Medical record server 30 Terminal device 31 CPU
33 RAM
34 Hard disk 39 Communication section

Claims (8)

When the total dose reaches a predetermined amount, a program that causes a computer to execute a process of calculating the in-vivo drug amount of a contraindicated drug,
Obtaining the blood drug concentration from a storage device that stores the blood drug concentration of the patient to whom the drug has been administered ;
Calculate the distribution volume based on the obtained blood drug concentration ,
Storing the calculated distribution volume in the storage device;
The blood on the basis of drug concentration, to calculate the blood concentration after a predetermined time period has elapsed from the blood collecting time that corresponds to the drug concentration in the blood,
Storing the calculated blood drug concentration after the predetermined period in the storage device;
A program for causing a computer to execute a process of calculating an in-vivo drug amount after a predetermined period based on the distribution volume stored in the storage device and a blood drug concentration after the predetermined period. The program according to claim 1, wherein the process of calculating the distribution volume calculates the distribution volume based on the blood drug concentration, the dose of the drug, and the bioavailability of the drug. In the computer,
Calculate the drug metabolism of the patient based on the blood drug concentration,
Calculating the drug elimination rate constant based on the calculated drug metabolic rate and the volume of distribution
Let the process run ,
The program according to claim 1 or 2, wherein the process of calculating the blood drug concentration after the predetermined period has elapsed calculates the blood drug concentration after the predetermined period has elapsed, using the calculated drug disappearance rate constant. The process of calculating the blood drug concentration after the lapse of the predetermined period includes the blood drug concentration of a patient who has been administered the contraindicated drug and another drug different from the drug, and the contraindicated drug and other drug. The program according to any one of claims 1 to 3, wherein a blood drug concentration after a predetermined period of time is calculated based on an influence degree related to the interaction. In the computer,
Based on the dose of the drug and the bioavailability of the drug, the amount of the drug in the body is calculated,
Add the calculated amount of drug in the body and the amount of drug in the body after the lapse of the predetermined period to calculate the cumulative amount of drug in the body after the lapse of the predetermined period.
The program as described in any one of Claim 1 to 4 which performs a process . The process of calculating the amount of drug metabolism is to calculate the amount of drug metabolism based on the drug administration period excluding the drug concentration in the blood and the drug administration interruption period of the patient where the administration of the drug was interrupted,
In the computer,
Calculate the amount of drug in the body based on the calculated drug metabolism and the blood drug concentration
The program according to claim 3, wherein the program is executed . When the total dose reaches a predetermined amount, a calculation method for calculating the in-vivo drug amount of a contraindicated drug,
Computer
Obtaining the blood drug concentration from a storage device that stores the blood drug concentration of the patient to whom the drug has been administered ;
Calculate the distribution volume based on the obtained blood drug concentration ,
Based on the blood drug concentration, calculate the blood drug concentration after a predetermined period from the blood collection time corresponding to the blood drug concentration,
A calculation method for calculating a drug amount in the body after the predetermined period based on the calculated distribution volume and the blood drug concentration after the predetermined period. When the total dose reaches a predetermined amount, a calculation device that calculates the in-vivo drug amount of a contraindicated drug,
An acquisition unit that acquires the blood drug concentration from a storage device that stores the blood drug concentration of a patient to whom the drug has been administered ;
A volume calculation unit for calculating a distribution volume based on the obtained blood drug concentration ;
Based on the blood drug concentration, a concentration calculator that calculates the blood drug concentration after a predetermined period from the blood collection time corresponding to the blood drug concentration;
Based on the distribution volume calculated by the volume calculation unit and the blood drug concentration after the predetermined period calculated by the concentration calculation unit; A calculation device.

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