Anesthesiology, Perioperative and Pain Medicine

David Drover, MD

The Mathematics of Drugs

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Dr. David Drover
            An associate professor of anesthesia at Stanford University School of Medicine, Dr. David Drover employs mathematical modeling to study the pharmacokinetics and pharmacodynamics of drugs. “We’ll never improve our care for patients unless we understand what the body does to the drug and what the drug does to the body,” he explains.

            A simple linear regression – which generates an equation to describe a line – should ideally be sufficient to explain aspects of a drug’s behavior, such as volume distribution over time and clearance rates. “It seems straightforward,” says Dr. Drover. However, because drugs behave differently in different people’s bodies, generating an accurate equation is not as simple as it seems. To combat this problem, Dr. Drover spends a lot of time asking the question, “Why aren’t we all the same?

            “It’s everything from how much I weigh to how tall I am, the color of my hair,” explains Dr. Drover. However, even after applying the known exceptions, there remains variability between patients. Understanding these differences may be key to gaining a better understanding of useful drugs.

            Improved models of how drugs behave inside the body will allow physicians to optimize their use for the patient’s benefit. “We’re not doing a service to the patients if we’re not doing the optimal of what the drug is capable of,” he asserts.

           Dr. Drover is currently directly involved with four National Institutes of Health grants for clinical research projects, three of which are pediatric projects. In addition, because of his aptitude for mathematical modeling, Dr. Drover often finds himself analyzing data for other peoples’ research projects. Finally, because of his extensive experience with clinical trials, Dr. Drover spends a significant amount of his time assisting his colleagues with their own NIH submissions.
            “I consider myself a major supporting actor for a lot of stuff,” explains Dr. Drover.

           When not at the computer or in lab, Dr. Drover enjoys working in the OR. “I can sit in the operating room for hours or days,” he says. “I find it entertaining and engaging.”      

Specializing in anesthesia for liver transplants, neurology, and difficult airways, Dr. Drover splits his time evenly between research and the OR. He claims that this balance has been crucial to his job satisfaction. “I think I took up the research as much as a diversion to make myself always like and want to be in OR,” he asserts.

            Despite his demanding schedule, Dr. Drover makes it a point to spend time with his two kids - Ryan and Caitlin. He spends most evenings doing homework with his seventh grade son. “If he’s just doing his homework, I’ll just do my homework,” says Dr. Drover, “But I try not to take too much work home with me in the evenings because work is for work and home is for home.”

            This process, Dr. Drover claims, is “purely mathematical,” requiring him to fit an equation to data points collected in the research lab and create an explanation of how a drug or a person behaves.

            To understand the pharmacodynamics and pharmacokinetics of drugs, Dr. Drover employs mathematical modeling. “In other words, he attempts to fit a line to data points that have to do with clearance rates and volume distribution of drugs throughout the body.

            I have to determine things like the volume distribution clearances and such that I can actually characterize where the drug is going and how long it’s going to stay there.

 

I took up the research as much as a diversion to make myself always like and want to be in OR

I can sit in the operating room for hours, days. Just It preoccupies my mind I find it entertaining engaging

I have three subspecialties: liver transplant service, ENT anesthesia, and neuro=anesthesia.


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