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Expert Review of Clinical Pharmacology

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https://www.readbyqxmd.com/read/27894202/rolapitant-for-the-prevention-of-delayed-nausea-and-vomiting-over-initial-and-repeat-courses-of-emetogenic-chemotherapy
#1
Bernardo Rapoport, Ronwyn van Eeden, Teresa Smit
Introduction Chemotherapy-induced nausea and vomiting (CINV) is a debilitating side effect of many cytotoxic chemotherapy regimens. Although sustained antiemetic control across repeated chemotherapy cycles is important for cancer treatment continuation, few studies have investigated the efficacy of antiemetic prophylaxis over multiple chemotherapy cycles. Areas Covered Here we discuss the use of antiemetic hydroxytryptamine type 3 (5-HT3) receptor and neurokinin (NK)-1 receptor antagonists for prevention of CINV, limiting our review to clinical trials in the context of multiple-cycle chemotherapy, with a focus on the NK-1 receptor antagonist rolapitant...
November 29, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27892772/administration-of-lidocaine-to-prevent-cognitive-deficit-in-patients-undergoing-coronary-artery-bypass-grafting-and-valve-plasty-a-systematic-review-and-meta-analysis
#2
Afshin Gholipour Baradari, Mohammad Reza Habibi, Valiollah Habibi, Seyed Mahmood Nouraei
INTRODUCTION: The administration of lidocaine to maintain cognitive function following coronary artery bypass grafting (CABG) and valve plasty is a controversial concept in terms of its effectiveness. We performed a systematic review to determine the effectiveness of treatment with lidocaine in preventing the occurrence of cognitive deficit after cardiac surgery. Area covered: To review the current literature on the subject, we searched the PubMed database and the Cochrane Library database (up to May 2015) and compiled a list of retrieved articles...
November 28, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27885838/osimertinib-for-egfr-t790m-mutation-positive-non-small-cell-lung-cancer
#3
Kenzo Soejima, Hiroyuki Yasuda, Toshiyuki Hirano
Significant advances have been made since the development of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) targeting EGFR mutations in non-small-cell lung cancer (NSCLC), however, lung cancer cells eventually acquire resistance to those agents. Osimertinib (AZD9291) has been developed as 3(rd) generation EGFR-TKI with activities against sensitizing mutations and T790M resistance mutation, which account for about 50% of the mechanisms of acquired resistance to 1(st) or 2(nd) generation EGFR-TKIs...
November 25, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27855521/elosulfase-alfa-bmn-110-for-the-treatment-of-mucopolysaccharidosis-iva-morquio-a-syndrome
#4
Christian J Hendriksz
Morquio A syndrome is a rare, autosomal recessive, lysosomal storage disorder caused by a deficiency in the enzyme N-acetylgalactosamine-6-sulfatase (GALNS). In 2014, the use of recombinant human GALNS, elosulfase alfa, was approved in the European Union, Canada, the United States, Australia, and Brazil for the treatment of Morquio A syndrome. Elosulfase alfa is administered intravenously once-weekly at a dose of 2.0 mg/kg. Areas covered: This is a review of the efficacy, safety and tolerability, pharmacokinetics and pharmacodynamics, and other outcomes of elosulfase alfa treatment of patients with Morquio A...
November 23, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27825017/a-pharmacological-overview-of-lamotrigine-for-the-treatment-of-epilepsy
#5
Venkata Ramesh Yasam, Satya Lavanya Jakki, V Senthil, M Eswaramoorthy, S Shanmuganathan, K Arjunan, M J Nanjan
Epilepsy is one of the most common neurological disorders, affecting about 2% of the population worldwide. Lamotrigine (LTG) is a second generation anti-epileptic drug (AED) with broad spectrum of activity, a favourable side-effect profile, simpler dosing than earlier drugs and efficacious in diverse epilepsy syndromes. Areas covered: The present review focuses on pharmacodynamics, pharmacokinetics, clinical efficacy, safety and tolerability of LTG and its effect on cognition, psychiatry, quality of life, women and pregnancy along with effect of enzyme inducing and enzyme inhibiting drugs over LTG and their effect on serum level fluctuations by collecting data from various studies over the years until 2016...
November 21, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27868472/topical-and-systemic-antifungals-in-dermatology-practice
#6
Murat Durdu, Macit Ilkit, Yalda Tamadon, Ali Tolooe, Haleh Rafati, Seyedmojtaba Seyedmousavi
Dermatophytosis is generally defined as an infection of the hair, nails, or glabrous skin. These infections are caused by the keratinophilic fungi Trichophyton spp., Microsporum spp., and Epidermophyton, which have been recovered from both symptomatic and asymptomatic individuals. Although dermatophytosis is generally not a life-threatening condition, these types of infections are among the most common infections worldwide, and their incidence has continued to increase consistently in recent years. Area covered: This article provides an overview of the general characteristics of dermatophytes, including their taxonomy and epidemiology, as well as the different clinical forms and laboratory diagnostics of dermatophytosis...
November 19, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27868450/pharmacological-management-of-diabetic-dyslipidemia
#7
T D Filippatos, M Florentin, M Georgoula, M S Elisaf
Diabetes mellitus is associated with increased cardiovascular disease (CVD) risk. Areas covered: Main goal of hypolipidemic treatment is low-density lipoprotein cholesterol (LDL-C) lowering with the use of statins. Addition of ezetimibe is useful in diabetic patients who cannot achieve their LDL-C target. However, many diabetic patients have increased residual CVD risk, which is mainly attributed to high triglycerides and low high-density lipoprotein (HDL-C) values. The addition of fenofibrate targets these variables and possibly reduces residual CVD risk, but a possible beneficial effect has been shown only in a pre-specified subgroup analysis in patients with high triglycerides and low HDL-C values...
November 19, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27817212/the-factor-xa-inhibitor-edoxaban-for-the-prevention-of-stroke-and-systemic-embolism-in-patients-with-atrial-fibrillation
#8
Joan Minguet, Helen M Sims, Katherine H Smith, Peter Bramlage
With the rising prevalence of nonvalvular atrial fibrillation (NVAF) in the general population, the development of new drugs for prevention of thromboembolic events is essential. Non-vitamin K antagonist oral anticoagulants (NOACs) have been shown to present a number of advantages over conventionally used agents, such as predictable pharmacokinetics and no requirement for continuous anticoagulant monitoring. The most recently approved NOAC for the NVAF indication is edoxaban. Several subgroup analyses from the edoxaban phase III ENGAGE AF-TIMI 48 trial have now been published, alongside meta-analysis data comparing the four currently approved NOACs...
November 17, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27835034/novel-pharmacological-treatment-strategies-for-posttraumatic-stress-disorder
#9
Eileen Thomas, Dan J Stein
A wide range of medications have been studied for posttraumatic stress disorder (PTSD) and a number are registered for this indication. Nevertheless, current pharmacotherapies are only partially effective in some patients, and are minimally effective in others. Thus novel treatment avenues need to be explored. Areas covered: In considering novel pharmacological agents for the treatment of PTSD, this paper takes a translational approach. We outline how advances in our understanding of the underlying neurobiology of PTSD may inform the identification of potential new treatment targets, including glutamatergic, noradrenergic and opioid pathways...
November 11, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27828731/the-pharmacological-challenges-of-treating-tuberculosis-and-hiv-coinfections
#10
Eric F Egelund, Lori Dupree, Emily Huesgen, Charles A Peloquin
Tuberculosis (TB) is the most prevalent opportunistic infection among HIV patients, and the leading cause of death among HIV patients worldwide. Simultaneous treatment of both diseases is recommended by current guidelines, but can be challenging due to the potential for drug-drug interactions, overlapping toxicities, difficulty adhering to medications, and an increased risk for immune reconstitution inflammatory syndrome (IRIS). Clinical manifestations of TB can also vary between HIV-infected patients and uninfected patients, which can increase the risk for delayed diagnosis...
November 9, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27785937/paracetamol-and-morphine-for-infant-and-neonatal-pain-still-a-long-way-to-go
#11
Manuel A Baarslag, Karel Allegaert, John N Van Den Anker, Catherijne A J Knibbe, Monique Van Dijk, Sinno H P Simons, Dick Tibboel
Pharmacologic pain management in newborns and infants is often based on limited scientific data. To close the knowledge gap, drug-related research in this population is increasingly supported by the authorities, but remains very challenging. This review summarizes the challenges of analgesic studies in newborns and infants on morphine and paracetamol (acetaminophen). Areas covered: Aspects such as the definition and multimodal character of pain are reflected to newborn infants. Specific problems addressed include defining pharmacodynamic endpoints, performing clinical trials in this population and assessing developmental changes in both pharmacokinetics and pharmacodynamics...
November 9, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27813436/pharmacometrics-based-decision-tools-facilitate-mhealth-implementation
#12
Fahima Nekka, Chantal Csajka, M Elanie Wilbaux, Sachin Sanduja, Jun Li, Marc Pfister
The healthcare system is experiencing a paradigm shift in delivering its services, evolving from a reactive "one size-fits-all" structure to a patient-centric model focusing on individualized medicine. This change is driven by scientific progress, including quantitative evaluation and optimization of treatment strategies through pharmacometric approaches, harnessing the power of the digital revolution. Areas Covered: This review describes four main steps to apply pharmacometrics-based decision support tools, consisting of validated scientific components, available technical options, consideration of regulatory aspects, and achievement of efficient commercialization...
November 4, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27776436/disclosing-negative-trial-results-procedure
#13
Cristina Scavone, Concetta Rafaniello, Liberata Sportiello, Liberato Berrino, Annalisa Capuano
No abstract text is available yet for this article.
November 2, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27797595/the-pharmacological-management-of-severe-influenza-infection-existing-and-emerging-therapies
#14
Aisling Mc Mahon, Ignacio Martin-Loeches
Over the last century several influenza outbreaks have traversed the globe, most recently the influenza A(H1N1) 2009 pandemic. On each occasion, a highly contagious, virulent pathogen has emerged, leading to significant morbidity and mortality amongst those affected. Areas covered: Early antiviral therapy and supportive care is the mainstay of treatment. Treatment should be started as soon as possible and not delayed for the results of diagnostic testing. Whilst oseltamivir is still the first choice, in case of treatment failure, oseltamivir resistance should be considered, particularly in immunosuppressed patients...
October 31, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27781556/mood-therapeutics-novel-pharmacological-approaches-for-treating-depression
#15
Ioline D Henter, Rafael T de Sousa, Philip W Gold, Andre R Brunoni, Carlos A Zarate, Rodrigo Machado-Vieira
Real-world effectiveness trials suggest that antidepressant efficacy is limited in many patients with mood disorders, underscoring the urgent need for novel therapeutics to treat these disorders. Areas Covered: Here, we review the clinical evidence supporting the use of novel modulators for the treatment of mood disorders, including specific glutamate modulators such as: 1) high-trapping glutamatergic modulators; 2) subunit (NR2B)-specific N-methyl-D-aspartate (NMDA) receptor antagonists; 3) NMDA receptor glycine-site partial agonists; and 4) metabotropic glutamate receptor (mGluR) modulators...
October 26, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27781488/current-challenges-in-the-pharmacological-management-of-thyroid-dysfunction-in-pregnancy
#16
I Khan, O E Okosieme, J H Lazarus
Thyroid dysfunction is common in pregnancy and has adverse fetal and maternal health consequences. A number of challenges in the management of gestational thyroid dysfunction remain unresolved including uncertainties in optimal thresholds for correction of hypothyroidism and strategies for pharmacological management of hyperthyroidism. Areas covered: We addressed key challenges and areas of uncertainty in the management of thyroid dysfunction in pregnancy. Expert commentary: Gestational thyroid hormone reference intervals vary according to population ethnicity, iodine nutrition, and assay method and each population should derive trimester specific reference intervals for use in pregnancy...
October 26, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27771961/building-a-better-understanding-of-the-burden-of-disease-in-familial-chylomicronemia-syndrome
#17
Zahid Ahmad, Rob Halter, Michael Stevenson
No abstract text is available yet for this article.
October 24, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27766899/impact-of-shed-soluble-targets-on-the-pk-pd-of-approved-therapeutic-monoclonal-antibodies
#18
Divya Samineni, Sandhya Girish, Chunze Li
Suboptimal treatment for monoclonal antibodies (mAbs) directed against endogenous circulating soluble targets and the shed extracellular domains (ECD) of the membrane-bound targets is an important clinical concern due to the potential impact of mAbs on the in vivo efficacy and safety. Consequently, there are considerable challenges in the determination of an optimal dose and/or dosing regimen. Areas covered: This review outlines the impact of shed antigen targets from membrane-bound proteins and soluble targets on the PK and/or PD of therapeutic mAbs that have been approved in the last decade...
October 21, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27724114/the-challenges-of-pharmacokinetic-variability-of-first-line-anti-tb-drugs
#19
Bella Devaleenal D, Geetha Ramachandran, Soumya Swaminathan
Inter-individual variations in the pharmacokinetics (PK) of anti-TB drugs are known to occur, which could have important therapeutic implications in patient management. Areas covered: We compiled factors responsible for PK variability of anti-TB drugs reported from different settings that would give a better understanding about the challenges of PK variability of anti-TB medications. We searched PubMed data base and Google scholar from 1976 to the present using the key words "Pharmacokinetics", "pharmacokinetic variability", "first-line anti-TB therapy", "Rifampicin", "Isoniazid", "Ethambutol", "Pyrazinamide", "food", "nutritional status", "HIV", "diabetes", "genetic polymorphisms" and "pharmacokinetic interactions"...
October 11, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27673415/current-treatment-of-heart-failure-with-reduction-of-left-ventricular-ejection-fraction
#20
Wilbert S Aronow
Heart failure is the commonest cause of hospitalization and of rehospitalization This review paper is a comprehensive review of current treatment of heart failure in 2016. The target of this review is all health care professionals who treat patients with heart failure. Areas covered: This article discusses stages of heart failure, treatment of heart failure with general measures, and drug therapy with diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta blockers, aldosterone antagonists, isosorbide dinitrate plus hydralazine, digoxin, other neurohormonal antagonists, sacubitril/valsartan, calcium channel blockers, and ivabradine...
October 11, 2016: Expert Review of Clinical Pharmacology
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