What are the dangers of missing a dose and overdose?

Question

I'm a computer engineering student that would like to address this issue on my next project using prototype and maybe a web-based software or app. But before that, I had to understand why patients need to take their doses as prescribed (on time, proper medication, and proper quantity). I hope you could help me understand this from your medical point of view. If you could also cite some papers or sources that could either support your answer or further my understanding, I would be very grateful. Also as medical personnel, how do you make sure that patients take their medication properly/as prescribed?

Answer 1

Karlee - GREAT PROJECT ! Let me see if I can simply explain the trouble with dosed medications. Generally, a drug has what is called a therapeutic level (or level that the intended response is expected) and a toxic level (when the medication becomes a danger). Medications are prescribed to each the intended effect without reaching the danger level. This usually requires medication to be taken at intervals to maintain a level of the drug in the bloodstream. For instance, a drug given at 500 mg is generally a dose of 5mg per kilogram of body weight ( there's some room for play!). If that is a tablet or slow-release preparation, it may take 40 mins or more to enter the blood stream. The drug also has a "half-life" or erosion rate. let's say our drug has a half-life of 2 hours. That means our 500 mg will be down to around 250mg within 2 hours. 125mg by the 3rd hour and so on. Now lets say the pharmacy guys figured out the drug makes the patient "well" if at least 200 mg are in the bloodstream, but sick if the level climbs above 600mg. The trick is to keep the level in between those levels. So 2 hours into therapy, we need to add SOME medication, but not too much. So the patient is prescribed 200 mg every 2 hours.... BUT, that means that eventually we will fall below our level. ie: 500 (-2hr 1/2 life)= 250 + 200 = (450) - 2hr 1/2life = 225 +200 (1 2hr 1/2 life) = 425 ..... .... If we give 500 + 250 every 2 hrs we should be dead on... but what if the patient misses a dose or takes it too early?!?!? Do you see the problem?

I sure hope that helped :D

Jonathan H