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Journal of Clinical Pharmacy and Therapeutics

S J Showande, O M Adegbolagun, S I Igbinoba, T O Fakeye
WHAT IS KNOWN AND OBJECTIVES: Increasing number of patients use herbs with their medications. Such practice may result in beneficial or harmful herb-drug interactions. A recent survey reported that some participants co-administered Hibiscus sabdariffa, a widely used beverage, or tea, with their antihyperlipidaemic medications. This study therefore evaluated the effect of concomitant administration of Hibiscus sabdariffa calyces' extracts with simvastatin on hyperlipidaemia and pharmacokinetics of the drug in vivo...
September 18, 2017: Journal of Clinical Pharmacy and Therapeutics
C B Polen, H N Mullins Busch, P D Ratliff
WHAT IS KNOWN AND OBJECTIVE: Free-floating thrombi in the right heart occur in a subset of patients with pulmonary embolism with high rates of mortality if untreated. Treatment of choice is controversial and likely patient specific as studies have failed to consistently show a significant difference in mortality between options. CASE SUMMARY: We present a case of a 45-year-old female with a mobile right heart thrombus treated with ultra-slow, low-dose t-PA infusion in combination with heparin...
September 17, 2017: Journal of Clinical Pharmacy and Therapeutics
H Baccouche, A Chakroun, A Zoghlami, S Mahjoub, N Ben Romdhane
WHAT IS KNOWN AND OBJECTIVE: The international normalized ratio (INR) is widely used to monitor patients on vitamin K antagonists. This study aimed to assess the agreement of INR values obtained with different thromboplastin/instrument combinations. MATERIAL AND METHODS: International normalized ratio was determined on plasmas from 330 patients undergoing antivitamin K treatment (with acenocoumarol), using two calibration methods and four reagent/instrument combinations: Both Neoplastine CI and Neoplastine CI Plus on STA-R instrument from Diagnostica STAGO, Asnières, France; and both Thromborel S and Innovin on SYSMEX 2100i instrument from Siemens Health Care Diagnostics, Marbung, Germany...
September 16, 2017: Journal of Clinical Pharmacy and Therapeutics
J V Pergolizzi, J A LeQuang, R Taylor, R B Raffa
WHAT IS KNOWN AND OBJECTIVE: The "Darknet" ("dark web") has emerged as a means by which illegal drug buys and deliveries can be arranged with apparent anonymity and impunity. Healthcare providers should be aware of this growing source of illicit drugs. COMMENT: The "Darknet" refers to networks isolated from the Internet that cannot be accessed via conventional search engines. They require special software that is protected by special encryption. The initial legitimate use of a "Darknet" to conceal personal information against misuse or political reprisal is being exploited to conceal the identity of buyers and sellers in illegal drug transactions...
September 15, 2017: Journal of Clinical Pharmacy and Therapeutics
J L Parrett, A B Reaves, T H Self, R E Owens
WHAT IS KNOWN AND OBJECTIVES: Enzalutamide package labeling recommends avoiding concurrent warfarin use due to potential reductions in warfarin concentrations via enzalutamide-associated hepatic enzyme induction. A case of successful management of this interaction via warfarin adjustments is reported. CASE DESCRIPTION: A 77-year-old Caucasian male, previously relatively stable on warfarin 42-45 mg weekly, reported to clinic after the recent start of enzalutamide and subsequent hospitalization with a subtherapeutic International Normalized Ratio (INR)...
September 12, 2017: Journal of Clinical Pharmacy and Therapeutics
M Naunton, G M Peterson, L S Deeks, H Young, S Kosari
WHAT IS KNOWN AND OBJECTIVE: Proton pump inhibitor (PPI) prescribing may often be inappropriate and expose patients to a risk of adverse effects, while incurring unnecessary healthcare expenditure. Our objective was to determine PPI usage in Australia since 2002 and review international studies investigating inappropriate PPI prescribing, including those that discussed interventions to address this issue. METHODS: Australian Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) data were analysed...
September 11, 2017: Journal of Clinical Pharmacy and Therapeutics
H Rana, N Ferguson, P V Dicpinigaitis
WHAT IS KNOWN AND OBJECTIVE: Despite widespread use of vasopressin for the treatment of septic shock, few cases of diabetes insipidus (DI) following its discontinuation have been reported. CASE SUMMARY: A 54-year-old man presented with pneumonia progressing to septic shock, requiring norepinephrine and vasopressin for refractory hypotension. After clinical improvement, the patient on 3 separate occasions developed polyuria and severe hypernatremia upon discontinuation of vasopressin, with prompt recovery upon its resumption...
September 11, 2017: Journal of Clinical Pharmacy and Therapeutics
J H Sin, R H Elshaboury, R M Hurtado, A R Letourneau, R G Gandhi
WHAT IS KNOWN AND OBJECTIVE: There is a lack of data regarding therapeutic drug monitoring (TDM) of antitubercular agents in the setting of continuous venovenous haemofiltration (CVVH). We describe TDM results of numerous antitubercular agents in a critically ill patient during CVVH and haemodialysis. CASE SUMMARY: A 49-year-old man was initiated on treatment for disseminated Mycobacterium tuberculosis. During hospital admission, the patient developed critical illness and required renal replacement therapy...
September 11, 2017: Journal of Clinical Pharmacy and Therapeutics
Y Y Chen, P Zhang, X M Zhou, D Liu, J C Zhong, C J Zhang, L J Jin, H M Yu
WHAT IS KNOWN: Angiotensin-converting enzyme 2 (ACE2) plays an important role in the development of essential hypertension (EH). Genetic factors remarkably influence circulating ACE2 level. OBJECTIVE: Because heritability had remarkable effects on circulating ACE2, we designed this study to shed light on whether circulating levels of ACE2, angiotensin-(1-7) and angiotensin-(1-9) were linked to single nucleotide polymorphisms (SNPs) and haplotypes in ACE2 gene. METHODS: A total of 213 patients with newly diagnosed mild to moderate EH were enrolled in the present study...
September 11, 2017: Journal of Clinical Pharmacy and Therapeutics
Yumiko Akamine, Hideaki Kagaya, Tadashi Ohkubo, Shigeru Satoh, Masatomo Miura
WHAT IS KNOWN AND OBJECTIVE: The anti-tacrolimus antibodies used in commercial immunoassay methods have cross-reactivity with tacrolimus metabolites. The aim of this study was to investigate differences in the effects of CYP3A5 polymorphism on tacrolimus concentrations obtained by four immunoassay methods in renal transplant patients. METHODS: Samples (n = 508) were evaluated using four immunoassays (chemiluminescence enzyme immunoassay [CLIA], affinity column-mediated immunoassay [ACMIA], electrochemiluminescence immunoassay [ECLIA] and latex agglutination turbidimetric immunoassay [LTIA])...
September 10, 2017: Journal of Clinical Pharmacy and Therapeutics
F Mousinho, T Mendes, P Sousa E Santos, A P Azevedo, G Mousinho, C Malcata, E Viegas, B Madureira, F Falcão, A P Gomes, F Lima
WHAT IS KNOWN AND OBJECTIVE: Thrombocytopenia, not associated with bone marrow primary disease, is a common clinical problem. The possibility of drug-induced thrombocytopenia must be considered, especially in hospitalized patients. Drugs can cause thrombocytopenia by several mechanisms including direct bone marrow or other organ toxicity, and immune reactions. CASE DESCRIPTION: We describe a patient presenting with thrombocytopenia likely related to bisoprolol. WHAT IS NEW AND CONCLUSION: We report a case of bisoprolol-induced thrombocytopenia which resolved with drug discontinuation and steroid therapy...
September 3, 2017: Journal of Clinical Pharmacy and Therapeutics
X Q Zhu, C F Guo, Y G Wen, D W Shang, J Q Hu, S H Deng, Y Tan, C Qiu
WHAT IS KNOWN AND OBJECTIVE: Little is known regarding changes in blood coagulation parameters associated with tetracycline antibiotics. We report a possible case of elevated PT, APPT and PT/INR associated with doxycycline and cefoperazone co-administration. CASE SUMMARY: An 83-year-old Chinese male inpatient with severe pneumonia, chronic renal insufficiency and malnutrition experienced elevated PT, APPT and PT/INR which occurred within a few days of doxycycline added to his cefoperazone treatment and returned to normal after removal of it...
August 28, 2017: Journal of Clinical Pharmacy and Therapeutics
A Sato, M Shimura, M Gosho
WHAT IS KNOWN AND OBJECTIVE: Adaptive design methods are expected to be ethical, reflect real medical practice, increase the likelihood of research and development success and reduce the allocation of patients into ineffective treatment groups by the early termination of clinical trials. However, the comprehensive details regarding which types of clinical trials will include adaptive designs remain unclear. We examined the practical characteristics of adaptive design used in clinical trials...
August 28, 2017: Journal of Clinical Pharmacy and Therapeutics
A Kamekis, A Bertsias, J Moschandreas, E Petelos, M Papadakaki, V Tsiantou, A Saridaki, E K Symvoulakis, K Souliotis, N Papadakis, T Faresjö, A Faresjö, L Martinez, D Agius, Y Uncu, T Sengezer, G Samoutis, J Vlcek, A Abasaeed, B Merkouris, C Lionis
WHAT IS KNOWN AND OBJECTIVE: Polypharmacy has a significant impact on patients' health with overall expenditure on over-the-counter (OTC) medicines representing a substantial burden in terms of cost of treatment. The aim of this study, which was conducted within the framework of a European Project funded by the European Union under the Seventh Framework Programme and was entitled OTC-SOCIOMED, was to report on possible determinants of patient behaviour regarding the consumption of medicines, and particularly OTCs, in the context of primary care...
August 19, 2017: Journal of Clinical Pharmacy and Therapeutics
Y Prado, T Zambrano, L A Salazar
WHAT IS KNOWN AND OBJECTIVE: Statins are first-line therapy for reducing high cholesterol levels. However, response to these drugs shows high interindividual variability. We aimed to investigate the influence of two single nucleotide polymorphisms (SNP) (ABCB1 rs1128503 and ABCG2 rs2231142) in the ABC transporter genes on response to short-term low-dose atorvastatin in Chilean hypercholesterolaemic patients. METHODS: We studied 127 Chilean hypercholesterolaemic patients treated with 10 mg/d atorvastatin for 4 weeks...
August 19, 2017: Journal of Clinical Pharmacy and Therapeutics
E Duffy, S Ritchie, S Metcalfe, B Van Bakel, M G Thomas
WHAT IS KNOWN AND OBJECTIVE: Interventions intended to slow the emergence and spread of antibacterial resistance through enhanced antimicrobial stewardship will be more effective if informed by an accurate knowledge of current patterns of antibacterial consumption. For example, knowledge of the relative magnitude of community antibacterial consumption in relation to hospital antibacterial consumption within each nation or region should help guide decisions about the relative importance of community and hospital antimicrobial stewardship programmes...
August 18, 2017: Journal of Clinical Pharmacy and Therapeutics
V Escudero-Vilaplana, S Osorio-Prendes, R Collado-Borrell, E González-Arias, M Sanjurjo-Sáez
WHAT IS KNOWN AND OBJECTIVE: Limited data are available on eosinophilia as a drug adverse event. We describe a case of eosinophilia from lenalidomide therapy. CASE DESCRIPTION: A 50-year-old woman received lenalidomide, dexamethasone and cyclophosphamide as POEMS syndrome treatment. Eosinophil count rose during lenalidomide treatment and decreased in the periods off treatment. Naranjo nomogram suggested a probable association between the use of lenalidomide and eosinophilia...
August 17, 2017: Journal of Clinical Pharmacy and Therapeutics
B Chen, H-Q Shi, X-X Liu, W-X Zhang, J-Q Lu, B-M Xu, H Chen
WHAT IS KNOWN AND OBJECTIVES: Tacrolimus (TAC) is widely used as part of immunosuppressive regimens. There is great interindividual variation on the disposition of TAC. The aim of this study was to develop a population pharmacokinetic (PPK) model for Chinese liver transplant patients and evaluate genetic polymorphism and other possible factors on the PK parameters. The exposure of TAC is to be estimated through Bayesian modelling. METHODS: A total of 47 sets of rich-time PK and 1234 conventional therapeutic drug monitoring (TDM) data were collected from 125 Chinese liver transplant patients...
August 17, 2017: Journal of Clinical Pharmacy and Therapeutics
Melissa Cowley, Mark Naunton, Jackson Thomas, Freya Waddington, Gregory M Peterson
WHAT IS KNOWN AND OBJECTIVE: Television medical dramas depict the healthcare industry and draw considerable interest from the public, while pharmacists play an integral part in providing medication-related advice to the public and other health practitioners in real life. The main objective of this retrospective, observational study was to assess the appropriateness of medication advice given in televised medical dramas and how frequently pharmacists were involved in providing the medication advice...
August 17, 2017: Journal of Clinical Pharmacy and Therapeutics
P Hari, D Romanus, H J Henk, L K Becker, S J Noga, V A Morrison
WHAT IS KNOWN AND OBJECTIVE: Second-line therapy (SLT) trials in relapsed/refractory multiple myeloma (RRMM) report superior outcomes with triplet combinations. We sought to determine factors associated with triplet SLT in routine practice. METHODS: A retrospective cohort with claims for MM between 01/01/2008 and 03/31/2015 was grouped by 1-2 ("doublet") or 3+ ("triplet") agent therapy. Charlson comorbidity index (CCI) and disability status; CRAB symptoms (hypercalcaemia, renal/bone disease, anaemia); and relapse risk were determined...
August 17, 2017: Journal of Clinical Pharmacy and Therapeutics
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