Tag Archives: drug interactions

Reaching physicians with complicated patients

Creating an effective AdWords advertisement

Reaching physicians with complicated patients

Reaching physicians is somewhat of an art. Physicians tend to be extremely busy, and due to their lack of available time, they don’t want to waste their time by listening to some company try to sell them something that they think probably won’t help them. Physicians want to improve patient care, but they don’t want complex software or significant learning curves. To understand how to reach physicians, we must use fewer words. We must also understand what is important to them. This rule is true with any form of marketing, but it is especially true with doctors. Here’s what’s important to physicians:

  1. Improving patient outcomes and saving lives;
  2. Saving time;
  3. Preventing mistakes.

The background of specialty medicine

It is not uncommon, particularly within specialty medicine, for a provider to have a patient with complex multi-drug regimens that may be completely unrelated to the specialist’s area of expertise. Unfortunately, however, it is quite common for drugs with very different domains of pharmacotherapeutic effects to interact in unexpected ways. If a doctor knew in advance that the drug they intent to prescribe, for example, would cause a potentially lethal change in the level of an enzyme that is acted on by an unrelated drug that the patient was taking, then the physician would certainly choose an analogue of the drug, choose an alternative treatment option, or do something other than expose the patient to the risk imposed by the dangerous combined effect.

The vision of drug interactions

A drug interaction tool would provide exactly this service. It would allow physicians to restructure a patient’s drug regimen to ensure that desired therapeutic outcomes are achieved without serious adverse short or long term consequences. Such a tool would also save the physician considerable time that would otherwise be spent trying to investigate the issue by digging through literature and hoping to find the desired information. Such a tool would also save patients considerable money and time, prevent unneeded doctor visits, labs, and tests, and improve their overall satisfaction with their medical care. Although physicians may like to think that they don’t make mistakes, we all know that we are imperfect; therefore, a drug interaction tool would help doctors detect errors and prevent mistakes that could yield harm to patients and costly litigation.

Creating the ad – an invitation without false claims

Unfortunately, in this digital age, there are multitudes of technologies available to the provider that falsely claim to save physicians’ time, reduce medical errors and costs, and improve the quality of medical care. Very few of these technologies are able to justify their claims, and even fewer of these technologies are able to prove the legitimacy of their justifications. Like most of us, physicians really want increased intelligence. They want answers to questions that they haven’t asked yet, but they don’t want the answers until they are ready for them. They want a tool that improves their clinical decision making accuracy, but they don’t want to sacrifice countless hours of their time only to determine if they are wasting their time or not. By developing a service that is free to try and has a very simple interface, physicians won’t need to waste their time.  They can try the tool, and if it helps them, then they will be happy; if it doesn’t help them, that’s fine – they will have wasted very little of their time and none of their money. We try to convey our message in advertisements like this one:

Druginteractionschecker.com

Predict metabolites’ effects.

Improve patient outcomes.

This ad is a simple invitation to come and see. When the free app is ready, we will adjust the ad accordingly.  This ad reflects what the service offers: It provides predictive intelligence that improves patient outcomes. In general, from a marketing perspective, reaching our target audience requires that we use the language that our customers are most likely to use. This is precisely what we have done.

 

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What techniques exist for predicting drug interactions?

By Devin G. Bost

Feb. 17, 1014

Problem One: Identifying the metabolites

Many people overlook the fact that after a drug is consumed, it is broken down by the body. A finite series of mechanisms exist to process the drug. The P450 set of enzymes are key in metabolizing most known drugs, and through the liver, they break the drug down into various components. Many of those components, called metabolites, are still biologically active. In some cases, the metabolites of a drug are much more reactive than the initial drug. Thalidomide is a famous example of this. Other good examples include intermediates, coordination complexes, and adducts formed by metabolites of drugs of abuse. Ethanol, for example, is much less dangerous than its metabolite, acetaldehyde, which reacts with DNA, initiating carcinogenesis, and can spontaneously detonate at room temperature.

Solution: Representing the metabolites as an XML data tree

Large chemical databases of allow developers to computationally predict the potential metabolites formed by a given drug. XML is known as a hierarchal data structure. Recently, advances in SQL database technology has improved the functionality and usability of this data type. Using known chemical degradation processes, stored procedures (in the database) can be used to compute each potential metabolite of a given source drug. Mathematically, limitations to SQL stored procedures can be overcome by linking to external software libraries. For example, using Microsoft SQL Server 2012, a database administrator can easily import a dynamic linked library (DLL) to extend database functionality to include a program written in an object-oriented language (e.g. C++, C#, or VB.NET) over the Common Language Runtime (CLR). This technique enables database developers to extend the typical functionality of the database and perform advanced computations with external software libraries designed for mathematical modeling and simulation. Using an XML data type, databases can store the entire computed tree of metabolites for each initial drug. After the computations are performed, the data is easily stored in the database for later use.

Problem Two: How do we identify interactions between drugs and/or metabolites?

According to (Wishart & Materi, 2007), “In the areas of drug discovery and development, [pharmacokinetic (PK)] modeling might be regarded as one of the first and most successful examples of computational system biology,” considering also the discoveries of (Huisinga, Telgmann, & Wulkow, 2006) and (Mager, 2006), “A key limitation of ODEs or systems of ODEs is the need for complete and quantitative data on  concentrations, reaction rates, diffusion rates, degradation rates and many other parameters.” With special thanks to Henry Eyring[1]

Solution

Large metabolomics databases, such as the ones listed by (Wishart & Materi, 2007), reduce the quantity of computational predictions that are required by the developer. Furthermore, these databases provide a means for testing the accuracy of predictions against known empirical data and experimental findings. Developing and integrating the models for computing and joining the required parameters then remains the ultimate task for the developer.

References

Huisinga, W., Telgmann, R., & Wulkow, M. (2006). The virtual laboratory approach to pharmacokinetics: design principles and concepts. Drug discovery today, 11(17), 800-805.

Mager, D. E. (2006). Quantitative structure–pharmacokinetic/pharmacodynamic relationships. Advanced drug delivery reviews, 58(12), 1326-1356.

Wishart, D. S., & Materi, W. (2007). Current Progress in computational metabolomics. Briefings in Bioinformatics, 8(5), 279-293.


[1] Henry Eyring is best known for his contributions on transition state theory. He has been recognized by numerous awards in chemistry, including a Nobel Prize. Interestingly, Henry Eyring is the father of a religious leader, Henry B. Eyring. As of Feb. 17, 2014, Henry B. Eyring is serving as a member of the First Presidency of The Church of Jesus Christ of Latter-Day Saints.