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Expert Review of Clinical Pharmacology

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https://www.readbyqxmd.com/read/29210311/the-role-of-gut-microbiota-in-the-modulation-of-drug-action-a-focus-on-some-clinically-significant-issues
#1
Diego Currò
A healthy gut microbiota is necessary for the normal operation of several body functions, including gastrointestinal sensitivity and motility, lipid and glucid metabolism, immune surveillance, and host behavior. In addition, intestinal bacteria contribute to determining the pharmacological properties of several drugs by producing different drug metabolizing enzymes. Areas covered: Four enzymatic processes are discussed: prodrug activation; drug inactivation; drug deconjugation; and hydrolysis of natural glycosides with further metabolism of released aglycones...
December 6, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29206489/continuous-flow-technology-vs-the-batch-by-batch-approach-to-produce-pharmaceutical-compounds
#2
Kevin P Cole, Martin D Johnson
For the manufacture of small molecule drugs, many pharmaceutical innovator companies have recently invested in continuous processing, which can offer significant technical and economic advantages over traditional batch methodology. This Expert Review will describe the reasons for this interest as well as many considerations and challenges that exist today concerning continuous manufacturing. Areas Covered: Continuous processing is defined and many reasons for its adoption are described. The current state of continuous drug substance manufacturing within the pharmaceutical industry is summarized...
December 5, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29202586/pharmacological-treatments-available-for-the-management-of-underactive-bladder-in-neurological-conditions
#3
Seyedeh-Sanam Ladi-Seyedian, Behnam Nabavizadeh, Lida Sharifi-Rad, Abdol-Mohammad Kajbafzadeh
Underactive bladder (UAB) is a common cause of lower urinary tract dysfunction which has an increasing incidence with aging. It is characterized as an incompetent detrusor contraction with reduced strength and/or duration to completely empty the bladder. UAB is observed in both men and women. The exact definition, classification, and pathophysiological mechanism responsible for UAB is still debatable, however neurologic, myogenic, and iatrogenic causes are explained. The symptom complex related to UAB includes hesitancy, diminished sensation of bladder filling, a slow urinary stream, increased post-void residue, and etc...
December 5, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29192802/adhering-to-the-principles-of-clinical-pharmacology-the-correct-fixed-combinations-of-antihypertensive-drugs
#4
Lopatowska Paulina, Mlodawska Elzbieta, Tomaszuk-Kazberuk Anna, Maciej Banach, Malyszko Jolanta
Introduction Hypertension is one of the primary modifiable risk factors for cardiac and renal diseases. The prevalence of hypertension appears to be around 30-45% of the general population, with a steep increase with ageing. The administration of blood pressure-lowering drugs is to reduce the risk of major clinical cardiovascular outcomes: stroke, myocardial infarction, heart failure and cardiovascular deaths. Hypertension guidelines recommend combination therapy in patients with high cardiovascular risk and with subclinical organ damage as well as when monotherapy fails...
December 1, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29186999/dosing-strategies-to-optimize-currently-available-anti-mrsa-treatment-options-part-2-po-options
#5
Kenna D Payne, Amrita Das, Michelle Ndiulor, Ronald G Hall
Methicillin-resistant Staphylococcus aureus (MRSA) is a problematic pathogen in both outpatient and inpatient settings. Research to optimize the dosing of these agents is needed to slow the development of antimicrobial resistance and to decrease the likelihood of clinical failure. Areas covered: This review summarizes the available data for orally administered antimicrobials routinely used as monotherapy for MRSA infections. We make recommendations and highlight the current gaps in the literature. A PubMed (1966 - Present) search was performed to identify relevant literature for this review...
November 30, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28988509/darunavir-for-use-in-pregnant-women-with-hiv
#6
Robert Pope, Angela Kashuba
Combination antiretroviral therapy is recommended during pregnancy to decrease the rate of HIV transmission to the baby and reduce morbidity in the mother. More than 50% of women are prescribed a protease inhibitor-based regimen during pregnancy. Darunavir was recently reclassified as a first-line protease inhibitor for use in pregnancy in the US Department of Health and Human Services Perinatal Guidelines. Areas covered: This is a brief review of the use of protease inhibitor therapy during pregnancy, and a discussion of darunavir's utility in this area...
November 14, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29048257/desmopressin-acetate-nasal-spray-for-adults-with-nocturia
#7
Joshua A Cohn, Casey G Kowalik, W Stuart Reynolds, Melissa R Kaufman, Douglas F Milam, Roger R Dmochowski, Alan J Wein
Nocturia impacts 70% of individuals over age 70 years. Nocturnal polyuria is present in up to 88% of adults with nocturia, however, treatment options for reducing nighttime urine production have historically been limited to behavioral modification and off label use of timed diuretics and desmopressin. Noctiva(TM) (desmopressin acetate nasal spray, DANS, Serenity Pharmaceuticals, LLC) is a novel formulation of desmopressin approved by the Food and Drug Administration for the treatment of nocturia due to nocturnal polyuria in March 2017...
October 30, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29076384/pharmacology-and-pharmacokinetics-of-imatinib-in-pediatric-patients
#8
Meinolf Suttorp, Martin Bornhäuser, Markus Metzler, Frédéric Millot, Eberhard Schleyer
The tyrosine kinase inhibitor (TKI) imatinib was rationally designed to target BCR-ABL1 which is constitutively activated in chronic myeloid leukemia (CML). Following the tremendous success in adults, imatinib also became licensed for treatment of CML in minors. The rarity of pediatric CML hampers the conduction of formal trials. Thus, imatinib is still the single TKI approved for CML treatment in childhood. Areas covered: This review attempts to provide an overview of the literature on pharmacology, pharmacokinetic, and pharmacogenetic of imatinib concerning pediatric CML treatment...
October 27, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29064296/tolerability-and-efficacy-of-colestipol-hydrochloride-for-accelerated-elimination-of-teriflunomide
#9
Derrick Robertson, Crystal Dixon, Angela Aungst, Bradlee McCoy, Natalie Moreo, Lise Casady, Janice Maldonado
BACKGROUND: Teriflunomide is an oral disease modifying therapy approved for the treatment of relapsing forms of multiple sclerosis. Teriflunomide' s pharmacokinetics (PK) contribute to its slow elimination, on average taking 6-8 months, though it can take up to 2 years in some instances. This slow elimination can become problematic in certain clinical situations - such as during pregnancy, when teriflunomide has potential teratogenic effects. In such scenarios, an accelerated elimination procedure (AEP) is recommended...
October 24, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28956955/a-resurging-boom-in-new-drugs-for-epilepsy-and-brain-disorders
#10
Iyan Younus, Doodipala Samba Reddy
Epilepsy is one of the most common neurological diseases affecting approximately 50 million people worldwide. Despite many advances in epilepsy research, nearly a third of patients with epilepsy have refractory or pharmacoresistant epilepsy. Despite the approval of a dozen antiepileptic drugs (AEDs) over the past decade, there are no agents that halt the development of epilepsy. Thus, newer and better AEDs that can prevent refractory seizures and modify the disease are needed for curing epilepsy. Areas covered: In this article, we highlight the recent advances and emerging trends in new and innovative drugs for epilepsy and seizure disorders...
October 23, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28984487/dapagliflozin-and-saxagliptin-tablets-for-adults-with-type-2-diabetes
#11
André J Scheen
Saxagliptin (a dipeptidyl peptidase-4 inhibitor, DPP-4i) and dapagliflozin (a sodium-glucose cotransporter type 2 inhibitor, SGLT2i) improve glucose control in type 2 diabetes (T2D) through different potentially complementary mechanisms, thus offering the opportunity for a combined therapy. Area covered: The characteristics of the saxagliptin/dapagliflozin combination are analysed, focusing on: 1) pharmacokinetic and pharmacodynamic properties; 2) efficacy and safety in phase III trials with concurrent and sequential add-on therapy; and 3) potential use in clinical practice, including in special populations (cardiovascular disease, heart failure, chronic kidney disease, elderly)...
October 18, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29039686/prevention-and-treatment-of-hiv-infection-in-neonates-evidence-base-for-existing-who-dosing-recommendations-and-implementation-considerations
#12
Diana F Clarke, Martina Penazzato, Edmund Capparelli, Tim R Cressey, George Siberry, Nandita Sugandhi, Mark Mirochnick
Antiretroviral drugs are used in neonates for prevention and treatment of HIV infection. Use of antiretrovirals to prevent perinatal HIV transmission is well established. Early identification of neonates infected with HIV and rapid initiation of combination antiretroviral treatment during the neonatal period is now recommended by WHO and DHHS. However, few antiretrovirals are available in formulations suitable for neonates and there are limited safety and pharmacokinetic data for most antiretrovirals in neonates...
October 17, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28689434/role-of-genetic-testing-in-patients-undergoing-percutaneous-coronary-intervention
#13
Jae Youn Moon, Francesco Franchi, Fabiana Rollini, Jose R Rivas Rios, Megha Kureti, Larisa H Cavallari, Dominick J Angiolillo
Variability in individual response profiles to antiplatelet therapy, in particular clopidogrel, is a well-established phenomenon. Genetic variations of the cytochrome P450 (CYP) 2C19 enzyme, a key determinant in clopidogrel metabolism, have been associated with clopidogrel response profiles. Moreover, the presence of a CYP2C19 loss-of-function allele is associated with an increased risk of atherothrombotic events among clopidogrel-treated patients undergoing percutaneous coronary interventions (PCI), prompting studies evaluating the use of genetic tests to identify patients who may be potential candidates for alternative platelet P2Y12 receptor inhibiting therapies (prasugrel or ticagrelor)...
October 12, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28965427/malaria-medicines-to-address-drug-resistance-and-support-malaria-elimination-efforts
#14
Jane Achan, Julia Mwesigwa, Chinagozi Precious Edwin, Umberto D'alessandro
Antimalarial drugs are essential weapons to fight malaria and have been used effectively since the 17(th) century. However, P.falciparum resistance has been reported to almost all available antimalarial drugs, including artemisinin derivatives, raising concerns that this could jeopardize malaria elimination. Areas covered: In this article, we present a historical perspective of antimalarial drug resistance, review current evidence of resistance to available antimalarial drugs and discuss possible mitigating strategies to address this challenge...
October 11, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28994323/atezolizumab-in-invasive-and-metastatic-urothelial-carcinoma
#15
Michael Crist, Arjun Balar
Until recently, there has been little advancement in the management of invasive and metastatic urothelial cancer in over 30 years, and outcomes with cisplatin-based chemotherapy remain unchanged. Inhibitors targeting PD-1 signaling on cytotoxic T-cells have revolutionized bladder cancer therapy leading to durable responses. Atezolizumab is an engineered humanized anti-PD-L1 monoclonal antibody that inhibits PD-L1 binding to PD-1 and B7.1, enhancing immune-mediated tumor killing and is currently approved as second-line treatment after failure of platinum-based chemotherapy as well as first-line in cisplatin-ineligible patients...
October 10, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28956645/multimodal-treatment-of-advanced-renal-cancer-in-2017
#16
Alessia Mennitto, Elena Verzoni, Paolo Grassi, Raffaele Ratta, Giovanni Fucà, Giuseppe Procopio
in the last decades, the treatment of renal cell carcinoma has become more complex due to the introduction of novel systemic agents and the improvement of the loco-regional therapies that prolong survival maintaining a good quality of life. Areas covered: in this review, we summarize the currently available local and systemic treatment options, their indications and their hypothetical role in the management of advanced renal cell carcinoma, highlighting the need of multimodality treatment paradigms within interdisciplinary decision-making...
September 28, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28942660/pathways-to-the-elimination-of-hepatitis-c-prioritising-access-for-all
#17
Alisa E Pedrana, Rachel Sacks-Davis, Joseph S Doyle, Margaret E Hellard
No abstract text is available yet for this article.
September 25, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28920710/use-of-strong-opioids-for-chronic-pain-in-osteoarthritis-an-insight-into-the-latin-american-reality
#18
Miguel Angel Ruiz Iban, Javier Benavides, Juan Pablo Forero, Sacha Bittelman, Rafael Martinez, Miguel Angel Mite, Jorge Diaz Heredia, Sergio Ulloa, Mauro Marcelo Lizárraga Ferrand
Osteoarthritis is the most common cause of arthritis and one of the main causes of chronic pain. Although opioids are frequently employed for chronic pain treatment, their usage for osteoarthritis pain remains controversial due to the associated adverse effects. Most guidelines reserve their use for refractory pain in patients with hip and knee osteoarthritis. The situation is even more complex in Latin America, where the prevalence of insufficient pain treatment is high because of the limited availability and use of strong opioids...
September 24, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28933969/psychopharmacological-advances-in-eating-disorders
#19
Hubertus Himmerich, Janet Treasure
Anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED) are the primary eating disorders (EDs). The only psychopharmacological treatment options for EDs with approval in some countries include fluoxetine for BN and lisdexamfetamine for BED. Given the high comorbidity and genetic correlations with other psychiatric disorders, it seems possible that novel medications for these conditions might also be effective in EDs. Areas Covered: The current scientific literature has increased our understanding of how medication could be beneficial for patients with EDs on a molecular, functional and behavioral level...
September 21, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28922979/a-review-of-drug-drug-interactions-in-older-hiv-infected-patients
#20
Aarthi Chary, Nancy N Nguyen, Kimberly Maiton, Mark Holodniy
The number of older HIV-infected people is growing due to increasing life expectancies resulting from the use of antiretroviral therapy (ART). Both HIV and aging increase the risk of other comorbidities, such as cardiovascular disease, osteoporosis, and some malignancies, leading to greater challenges in managing HIV with other conditions. This results in complex medication regimens with the potential for significant drug-drug interactions and increased morbidity and mortality. Area covered: We review the metabolic pathways of ART and other medications used to treat medical co-morbidities, highlight potential areas of concern for drug-drug interactions, and where feasible, suggest alternative approaches for treating these conditions as suggested from national guidelines or articles published in the English language...
September 19, 2017: Expert Review of Clinical Pharmacology
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