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The Alberta Drug Administration Modeller (ADAM): a life-size, hands-on pharmacokinetics learning tool for our future healthcare professionals Open Access

Descriptions

Other title
Subject/Keyword
therapeutics
clinical pharmacology
pharmacokinetics
patient safety
education
Type of item
Thesis
Degree grantor
University of Alberta
Author or creator
Zuna, Ines
Supervisor and department
Dr. Andrew Holt
Examining committee member and department
Dr. Glen Baker (Psychiatry)
Dr. Ayman El-Kadi (Pharmacy and Pharmaceutical Science)
Dr. Harley Kurata (Pharmacology)
Department
Department of Pharmacology
Specialization

Date accepted
2017-07-07T15:20:35Z
Graduation date
2017-11:Fall 2017
Degree
Master of Science
Degree level
Master's
Abstract
The processes of absorption, distribution, metabolism, and elimination (ADME) determine a drug’s pharmacokinetics (PK). Each of these processes is described with abstract modelling, and the relationships are characterised through equations and graphical analysis using both noncompartmental and compartmental methods. Patient physiology and environmental factors strongly influence these processes, affecting treatment outcomes and drug efficacy. As such, it is important for health professionals to use all patient and drug characteristics to relate desired pharmacological outcomes of the drug therapy with the appropriate route of administration, dose, and duration. Successful implementation of a dosing regimen depends not only on acknowledgement of factors, but on thorough understanding of drug PK, how the relationships relate, and how these factors affect the processes of ADME. Unfortunately, many health care students and health professionals are not adequately prepared to translate these concepts into the clinic, resulting in prescribing, dosing, and calculation errors; comprehension of mathematical modelling and current limitations in content delivery contribute significantly to this issue. Numerous instructors and institutions have attempted to implement curricula and learning techniques to circumvent the difficulty in learning, all with varying levels of success. In response to the lack of clinical context of teaching PK, we have developed a clinical application (Alberta Drug Administration Modeller; ADAM) aimed at enhancing student understanding of PK by providing a hands-on, patient-simulated learning experience. ADAM is comprised of a series of peristaltic pumps, representing the contributions of different organs to drug distribution and elimination kinetics, connected with Tygon tubing to mimic circulation. Drug (methylene blue dye) is administered to ADAM, and plasma and urine samples are collected over time; drug concentrations are determined spectrophotometrically and results graphed vs. time. The modeller mimics outcomes of 1- and 2-compartment distribution kinetics, IV injection and oral (PO) dosing, renal or hepatic failure, metabolic enzyme induction or inhibition, various adipose profiles, and applications to chronic dosing regimens including repeated IV/PO dosing with and without loading dose, and both intermittent and continuous IV infusion protocols. Data generated by the ADAM were analysed by hand using appropriate equations, and also entered into a PK modelling software package, PKSolver. Results showed consistency between the two analysis methods, validating the ADAM as a PK modelling tool. ADAM was introduced into a pharmacology undergraduate practical laboratory class and student performance was evaluated before and after lab modules. In line with an increase in students’ self-reported understanding of PK concepts and calculation competence following the lab modules, PK test results also showed a significant improvement in student performance (p<0.001). Student attitudes were favourable, and the majority of students rated the ADAM as an effective educational learning tool for PK. Simple in design, ADAM successfully mimics human drug outputs while providing students with a hands-on learning opportunity and engagement with PK concepts and calculations. Highly quantitative, intuitive, and effective, ADAM translates the complexity of PK into a language health care students will understand.
Language
English
DOI
doi:10.7939/R38W38G6X
Rights
This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for the purpose of private, scholarly or scientific research. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
Citation for previous publication
Zuna I, Holt A. (2017) ADAM, a hands-on patient simulator for teaching principles of drug disposition and compartmental pharmacokinetics. British Journal Clinical Pharmacology. doi:10.1111/bcp.13357.

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