Estimation of the individual metabolic state and its consideration in optimal pharmacotherapy.

The efficacy and safety of long-term therapy depends on the dose regimen. The early recognition of individual pharmacokinetic defects is a professional task of the clinical pharmacologist. The application of test compounds has been used to differentiate between slow and fast metabolizers. Modern techniques for identifying and quantitating drug metabolites facilitate the determination of the individual metabolic state without resorting to compounds foreign to the particular therapy. This paper exemplifies this principle by examining the metabolism and pharmacokinetics of carbamazepine, oxprenolol, hydralazine, maprotiline and diclofenac sodium. The systematic collection and analysis of representative samples of data is shown to be a prerequisite for the conclusive assessment and interpretation of the individual metabolic state.