21. A Deep Focus on the Problems Around Medical Prescriptions

I was recently going through a book – BMA’s – ‘New Guide to Medicines & Drugs’.  Apologies, I am not an expert in medicine, but I could not stop thinking about it in at least general terms.

I am voicing this opinion in this article only from the point of view of economic rationalization of the use of chemicals and formulations which may be considered as critical resources and from the point of view of the patient who may be receiving more drugs than is needed in a given condition or may be receiving wrong in-effective drugs- given his body special conditions etc.,

I was fascinated by the complexities around the prescription of medicine in the right dosage to the patient.

I could understand the below –

1. Receptors play an important role in assimilating a drug in the body

2. There are several types of receptors – in the intestines, blood vessel linings, pulmonary tracts, mucous linings etc.,

3. There are different ways of administering a drug to a patient – via mouth, via injections, via suppositories, via rectal, via inhalations etc.,

4. Liver has an important role to play – it breaks the drugs into the effective compound that may target different receptors.

5. Some drugs may interact with other drugs and may get reduced in its potency or may get increased in its potency (strength or absorption rate)

6. Some drugs may interact with some foods and may get reduced in its potency or may get increased in its potency (strength or absorption rate)

7. Some drugs may interact with some alcohols and may get reduced in its potency or may get increased in its potency (strength or absorption rate)

8. Some drugs may interact with other narcotics and may get reduced in its potency or may get increased in its potency (strength or absorption rate)

9. It is difficult to engineer a direct attack with drugs on a limited site in the body but this is becoming possible by the use of the new administering technologies (like micro-bio-absorbable drug releasing robots)

10. Kidneys and large intestines are expected to excrete the unused load of the drugs consumed.

11. Drugs targeting the healing/corrections of the rectum either use such drugs that are guaranteed to pass the organ of small intestines and successfully reach the large intestines, or such drugs are administered via the rectum.

12. A term called ‘Therapeutic Effect’ further reduces (narrow therapeutic window) or increases (wider therapeutic window) the chance of a cure.

13. The ‘cure’ also happens in a ‘range’ from the 2 ends – complete-cure and no-cure.

Considering the complexity of the body conditions and the drug assimilations and the complexity of interactions with other agents like the food and alcohol, we can easily comprehend the enormity of the problem of administering the right combination of drug to a human in the right dosage and in the right location.

Thus, every human is special – this needs to be understood and accommodated by the medical and hospital care researchers and carers before drawing guidelines on administering the right medicines.

The problem above – many different parameters in the body, many different elements/compounds and formulations in the drug compounds and other many different environmental parameters of the patient can be constructed as a series of partial differential equations and then by using AI technologies ably audited by medical doctors we can then suggest the right drug and the right administration method to target a particular cure.

The below actions/endeavours should be taken up by the medical research team. This is at a very high level and may need the deployment of mathematical and statistical experts to correct the approach and the final outcome.

1.   We should direct our R&D to create the generic set of partial differential equations (PDEs) for the human species (for example, one PDE per receptor class and the location in the body). This endeavour by the medical research team may take a considerably long time to focus and achieve.

2.   Once this is done, the next steps are to absorb the above knowledge and bring it into the practical use cases concerning the internal medicines.

3.  For a given patient, modify this generic equation to match with his/her general physical conditions as applicable. AI technology can help a experienced doctor here.

4.  For a given patient, further modify the PDEs as per his/her body condition and as per his/her lifestyle (high risk or low risk etc.,) – considering his/her drinking/smoking habits etc., AI technology can help a experienced doctor here.

5.  For a given patient, modify the PDEs further to match with his/her food intakes and exercise regime. AI technology can help a experienced doctor here.

6.   For a given patient, modify the PDEs further to match with the climate in which he lives. AI technology can help a experienced doctor here.

While the above is under development, the medical teams should also develop IT/AI tech solutions by collaborating with their IT tech experts to develop software solutions that processes the PDEs of the patients and which can also reference the master data containing the drugs/compound/formulations and its properties and suggest the potential outcomes in terms of dosage and strength of the medicine to be consumed by the patient.

Also, reference implementation using the properties of the generic drugs and by considering the generic PDEs of human species and conditioned by situations like high-risk lifestyle etc., should be made part of the software solution to draw the green, amber and red boundaries around any particular prescriptions.

So, I suggest the below method to diagnose a patient.

1. Obtain the PDEs of a patient, updated as per his recent medical condition using the software.

2. Set the problem in focus in the software, and by using the patient’s PDEs as the drivers, arrive at the potential solutions.

3. This has to be evaluated by the expert doctor before prescribing the right medicines to the patient using the right administration techniques. This has to be validated in the traditional way too - for example , by considering the outcomes of lab tests and the related conclusions. This will reduce the room for any potential error.

4. The same AI tech tool can be used to study any adverse effects or ineffective conditions and can provide the necessary feedback to put the system into continuous improvement mode.

Hari Om!