DoseChecker has been designed to assist the staff pharmacists at Barnes and Jewish Hospitals (teaching hospitals affiliated with the university) with monitoring drug orders for a set of drugs, which must be carefully dosed for patients with possible renal impairment.

Certain types of drugs require careful quantitative dosing, particularly in patients with renal impairment. In these patients, drug concentrations can build to toxic levels. Drug dosing decisions should focus, then, on maintaining concentrations, which maximize therapeutic effects while controlling the risk of toxicity. Renal function varies over time and can be estimated as a function of calculated creatinine clearance. DoseChecker is an expert system, which monitors patients with active orders for drugs known to require careful dosing. Using parameters such as patient weight and serum creatinine, DoseChecker calculates creatinine clearance and applies a set of dosing guidelines developed by pharmacokinetic experts to determine if the dosing is appropriate. If it does not fall within established guidelines, an alert is generated for a pharmacist, who then consults with the patient's attending physician to determine whether the dosage should be adjusted. DoseChecker uses a relational database containing patient demographic information and clinical data such as serum creatinine measurements and drug orders. Suspected dosing violations are stored so that trends can be detected.


DoseChecker is a hospital based system.


DoseChecker has been developed by the Washington University School of Medicine Department of Internal Medicine Division of Medical Informatics.


Tim Bailey

Washington University School of Medicine, Department of Internal Medicine, Division of Medical Informatics, 660 South Euclid Campus, Box 8005, St. Louis, Missouri, 63110 USA, Phone: (314) 454-8651 or visit their homepage at or

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