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renal dose adjustment

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https://www.readbyqxmd.com/read/29781751/posology-adjustments-of-oral-antineoplastic-agents-for-special-populations-patients-with-renal-impairment-hepatic-impairment-and-hematologic-toxicities
#1
Julieta González, Matías Quiroga, Vicente Escudero-Vilaplana, Roberto Collado-Borrell, Ana Herranz-Alonso, María Sanjurjo Sáez
BACKGROUND: Oral antineoplastic agents (OAA) have reached 30-50% of all antineoplastic treatments. Although they seem safer than parenteral therapy, many severe problems can occur if the dose is not adequately adjusted in special situations. Our objective is to create a comprehensive guide with dosage adjustment recommendations for OAA in cases of renal and hepatic impairment and hematologic toxicities. RESEARCH DESIGN AND METHODS: We analyzed all OAA approved by EMA in July 2017...
May 21, 2018: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29775201/tacrolimus-population-pharmacokinetics-and-multiple-cyp3a5-genotypes-in-black-and-white-renal-transplant-recipients
#2
Olivia Campagne, Donald E Mager, Daniel Brazeau, Rocco C Venuto, Kathleen M Tornatore
Tacrolimus exhibits inter-patient pharmacokinetic variability attributed to CYP3A5 isoenzymes and the efflux transporter, P-glycoprotein. Most black renal transplant recipients require higher tacrolimus doses compared to whites to achieve similar troughs when race-adjusted recommendations are used. An established guideline provides tacrolimus genotype dosing recommendations based on CYP3A5*1(W/T) and loss of protein function variants: CYP3A5*3 (rs776746), CYP3A5*6 (rs10264272), CYP3A5*7 (rs41303343) and may provide more comprehensive race-adjusted dosing recommendations...
May 18, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29770700/quality-use-of-the-pathology-data-in-home-medicines-reviews-a-retrospective-evaluation
#3
Vera H Buss, Alison Shield, Sam Kosari, Mark Naunton
BACKGROUND: Laboratory tests can be important tools for the assessment of pharmacotherapy. Nonetheless, there are no previous studies that have explicitly focused on the role of pathology data in Home Medicines Reviews (HMR), an Australian medication review program. OBJECTIVE: Evaluate pharmacists' recommendations regarding laboratory testing in the medication review process. METHODS: This retrospective review of HMRs assessed the prevalence of the pathology data provided by general practitioners...
May 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29769119/adefovir-dipivoxil-induced-hypophosphatemic-osteomalacia-in-chronic-hepatitis-b-a-comparative-study-of-chinese-and-foreign-case-series
#4
Nan Chen, Jian-Bo Zhang, Qiujie Zhang, Yun-Peng Zhao, Li-Yan Li, Li-Wei Liu, Fei Yu, Xin Yu, Tao Peng, Kuan-Xiao Tang
BACKGROUND: Adefovir dipivoxil (ADV)-induced renal tubular dysfunction and hypophosphatemic osteomalacia (HO) have been given great consideration in the past few years. However, no standard guidance is available due to a lack of powerful evidence from appropriate long-term prospective case-control studies and variations in the definition of renal adverse events. The aim of this study is to clarify clinical features of ADV-related HO in Chinese chronic hepatitis B patients with long-term ADV treatment in Chinese and non-Chinese comparative case series...
May 16, 2018: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29768642/-rhinocerebral-mucormycosis
#5
Anke Mertens, Christoph Arens, Doreen Barche, Laszlo Scheinpflug, Friedrich Gunther Scholz, Stefan Vielhaber, Cordula Scherlach, Uwe Tröger, Gernot Geginat, Jacqueline Färber
Mucormycosis is a rare but serious type of fungal infection, which can progress rapidly especially in immunsupressed patients.We report about a 47 year old female patient with ptosis on the left eye. The ophthalmological report offered no further pathologic findings. Diabetes mellitus was known and the blood sugar value was very high.A computed tomography of the paranasal sinuses showed a shadow in the ethmoid bone and in an additonally performed MRI-scan, an increase of orbital fat and an extension of the ocular muscle were visible...
May 16, 2018: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/29767471/converting-immunosuppression-from-an-oral-suspension-to-a-granule-formulation-of-tacrolimus-in-pediatric-renal-transplant-recipients
#6
Georgia Malakasioti, Christine Booth, Stephen D Marks
OS of tacrolimus prepared from tacrolimus powder is not licensed for children. A licensed GF for OS allows flexibility for body weight-based dose adjustments. This study aimed at exploring the efficacy of conversion from OS to the GF of tacrolimus in stable pediatric renal transplant recipients. Records of 25 pediatric renal transplant recipients aged under 18 years who were switched from an unlicensed tacrolimus OS to GF were reviewed. At day 0, 1 week, and 4-8 weeks post-conversion, there were no differences regarding daily tacrolimus dose (3...
May 16, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29767223/evaluation-of-renal-function-estimation-formulas-specific-to-dynamic-renal-function-for-drug-dosing-in-critically-ill-patients
#7
Lianjie Xiong, Z Kevin Lu, April Miller Quidley, Bebbyn S Alford, P Brandon Bookstaver
OBJECTIVES: The study compared estimated creatinine clearance (eCrCl) between the Cockcroft-Gault (CG) equation and the Jelliffe, Chiou, and Brater equations designed for estimation in dynamic renal function and resulting antimicrobial dosing concordance of five antimicrobials (cefepime, meropenem, piperacillin/tazobactam, vancomycin, and fluconazole) commonly used in the intensive care unit (ICU). METHODS: Electronic medical records were used to identify the target patient population...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29766208/-adequate-anti-infective-treatment-importance-of-individual-dosing-and-application
#8
A Brinkmann, A C Röhr, A Köberer, T Fuchs, W A Krüger, C König, D Richter, M A Weigand, O R Frey
Sepsis-induced changes in pharmacokinetic parameters are a well-known problem in intensive care medicine. Dosing of antibiotics in this setting is therefore challenging. Alterations to the substance-specific kinetics of anti-infective substances have an effect on the distribution and excretion processes in the body. Increased clearance and an increased distribution volume (Vd ) and particularly compromized organ function with reduced antibiotic elimination are often encountered in patients with sepsis. Renal replacement treatment, which is frequently used in intensive care medicine, represents a substantial intervention in this system...
May 15, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29764549/-clinical-verification-of-vancomycin-population-pharmacokinetics-in-patients-with-augmented-renal-clearance
#9
Haodi Lu, Lian Tang, Shengmin Xue, Zhiwei Zhuang, Jie Fang, Fuli Zhao, Erning Shang
OBJECTIVE: To evaluate the predictive value and to verify the clinical effect of JPKD-vancomycin for the trough concentration of vancomycin in patients with augmented renal clearance (ARC), and to provide a reference for clinical individualized drug therapy. METHODS: A retrospective analysis was conducted. The clinical data of 48 adult patients with ARC using vancomycin and monitoring steady-state trough concentration of vancomycin admitted to Suzhou Hospital Affiliated to Nanjing Medical University from July 2013 to July 2017 were collected...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29762865/population-pharmacokinetics-of-vancomycin-in-patients-undergoing-allogeneic-hematopoietic-stem-cell-transplantation
#10
Akira Okada, Misato Kariya, Kei Irie, Yutaka Okada, Nobuhiro Hiramoto, Hisako Hashimoto, Ryosuke Kajioka, Chika Maruyama, Hidefumi Kasai, Mami Hamori, Asako Nishimura, Nobuhito Shibata, Keizo Fukushima, Nobuyuki Sugioka
Vancomycin is a commonly used antimicrobial agent for patients undergoing allogeneic hematopoietic stem-cell transplantation (allo-HSCT). Vancomycin has large inter- and intraindividual pharmacokinetic variability, which is mainly described by renal function; various studies have indicated that vancomycin pharmacokinetics are altered in special populations. However, little is known regarding vancomycin pharmacokinetics in patients undergoing allo-HSCT. Therefore, we aimed to develop a population pharmacokinetic (PopPK) model of vancomycin in patients undergoing allo-HSCT for effective and safe antimicrobial therapy and to develop a vancomycin dosing nomogram for a vancomycin optimal-dosing strategy...
May 15, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29762861/pharmacokinetic-pharmacodynamic-analysis-of-isavuconazole-against-aspergillus-spp-and-candida-spp-in-healthy-subjects-and-patients-with-hepatic-or-renal-impairment-by-monte-carlo-simulation
#11
Xiaowei Zheng, Gaoqi Xu, Liqin Zhu, Luo Fang, Yiwen Zhang, Haiying Ding, Yinghui Tong, Jiao Sun, Ping Huang
The aim of this pharmacokinetic/pharmacodynamic (PK/PD) study is to evaluate the efficacy of various isavuconazole dosing regimens for healthy individuals and patients with hepatic or renal impairment against Aspergillus spp. and Candida spp. Monte Carlo simulations were conducted using pharmacokinetic (PK) parameters and pharmacodynamics (PD) data to determine the probabilities of target attainment and cumulative fractions of response in terms of area under the concentration curve/minimum inhibition concentration (AUC/MIC) targets of isavuconazole...
May 15, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29761830/itc-commentary-on-metformin-clinical-drug-drug-interaction-study-design-that-enables-an-efficacy-and-safety-based-dose-adjustment-decision
#12
Maciej J Zamek-Gliszczynski, Xiaoyan Chu, Jack A Cook, Joseph M Custodio, Aleksandra Galetin, Kathleen M Giacomini, Caroline A Lee, Mary F Paine, Adrian S Ray, Joseph A Ware, Matthias B Wittwer, Lei Zhang
Metformin drug-drug interaction (DDI) studies are conducted during development of drugs that inhibit organic cation transporters and/or multidrug and toxin extrusion proteins (OCTs/MATEs). Monitoring solely changes in systemic exposure, the typical DDI study endpoint appears inadequate for metformin, which is metabolically stable, has poor passive membrane permeability, and undergoes transporter-mediated tissue distribution and clearance. Evaluation of renal clearance, antihyperglycemic effects, and potentially lactate as an exploratory safety marker, can support rational metformin dose adjustment...
May 15, 2018: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29761242/safety-and-efficacy-of-benzbromarone-and-febuxostat-in-hyperuricemia-patients-with-chronic-kidney-disease-a-prospective-pilot-study
#13
Haibo Yu, Xinying Liu, Yaxiang Song, Jiafen Cheng, Hui Bao, Ling Qin, Xuan Zhou, Ling Wang, Ai Peng
BACKGROUND: To compare the safety and efficacy of benzbromarone and febuxostat in hyperuricemia patients with estimated glomerular filtration rate (eGFR) 20-60 mL/min/1.73 m2 . METHODS: This study was a single-centered, parallel-grouped, randomized clinical trial (RCT). We randomly assigned hyperuricemia participants with eGFR 20-60 mL/min/1.73 m2 into benzbromarone and febuxostat treatment group. Drugs were adjusted by titration from small doses. RESULTS: Seventy-three eligible participants enrolled, 66 subjects (33 in each group) were included finally for analysis...
May 14, 2018: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29756595/96-weeks-treatment-of-tenofovir-alafenamide-vs-tenofovir-disoproxil-fumarate-for-hepatitis-b-virus-infection
#14
Kosh Agarwal, Maurizia Brunetto, Wai Kay Seto, Young-Suk Lim, Scott Fung, Patrick Marcellin, Sang Hoon Ahn, Namiki Izumi, Wan-Long Chuang, Ho Bae, Manoj Sharma, Harry L A Janssen, Calvin Q Pan, Mustafa Kemal Çelen, Norihiro Furusyo, Dr Shalimar, Ki Tae Yoon, Huy Trinh, John F Flaherty, Anuj Gaggar, Audrey H Lau, Andrea L Cathcart, Lanjia Lin, Neeru Bhardwaj, Vithika Suri, G Mani Subramanian, Edward J Gane, Maria Buti, Henry L Y Chan
BACKGROUND & AIMS: Tenofovir alafenamide (TAF) is a new prodrug of tenofovir developed to treat patients with chronic hepatitis B virus (HBV) infection at a lower dose than tenofovir disoproxil fumarate (TDF) through more efficient delivery of tenofovir to hepatocytes. In 48-week results from two ongoing, double-blind, randomized phase III trials, TAF was non-inferior to TDF in efficacy with improved renal and bone safety. We report 96-week outcomes for both trials. METHODS: In two international trials, patients with chronic HBV infection were randomized 2:1 to receive 25 mg TAF or 300 mg TDF in a double-blinded fashion...
April 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29747941/-analysis-of-drug-related-problems-in-a-tertiary-university-hospital-in-barcelona-spain
#15
Olivia Ferrández, Borja Casañ, Santiago Grau, Javier Louro, Esther Salas, Xavier Castells, Maria Sala
OBJECTIVE: To describe drug-related problems identified in hospitalized patients and to assess physicians' acceptance rate of pharmacists' recommendations. METHODS: Retrospective observational study that included all drug-related problems detected in hospitalized patients during 2014-2015. Statistical analysis included a descriptive analysis of the data and a multivariate logistic regression to evaluate the association between pharmacists' recommendation acceptance rate and the variable of interest...
May 7, 2018: Gaceta Sanitaria
https://www.readbyqxmd.com/read/29746394/pharmacokinetics-of-doripenem-in-healthy-koreans-and-monte-carlo-simulations-to-explore-optimal-dosage-regimens-in-patients-with-normal-and-enhanced-renal-function
#16
So Won Kim, Sangmin Choe, Dong Jin Kim, Dae Young Zang, Dong-Hwan Lee
BACKGROUND: Dose adjustment is often required in patients with normal or enhanced renal function. The aim of this study is to investigate the pharmacokinetic (PK) properties of doripenem and explore optimal dosing regimens in patients with normal or enhanced renal function according to various minimum inhibitory concentrations (MIC). METHODS: The authors conducted a clinical trial and analyzed PK samples in 11 healthy Korean subjects applying non-compartmental analysis (NCA) and a population approach...
May 9, 2018: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29744908/dose-response-relationships-between-internally-deposited-uranium-and-select-health-outcomes-in-gaseous-diffusion-plant-workers-1948-2011
#17
James H Yiin, Jeri L Anderson, Stephen J Bertke, David J Tollerud
OBJECTIVE: To examine dose-response relationships between internal uranium exposures and select outcomes among a cohort of uranium enrichment workers. METHODS: Cox regression was conducted to examine associations between selected health outcomes and cumulative internal uranium with consideration for external ionizing radiation, work-related medical X-rays and contaminant radionuclides technetium (99 Tc) and plutonium (239 Pu) as potential confounders. RESULTS: Elevated and monotonically increasing mortality risks were observed for kidney cancer, chronic renal diseases, and multiple myeloma, and the association with internal uranium absorbed organ dose was statistically significant for multiple myeloma...
May 9, 2018: American Journal of Industrial Medicine
https://www.readbyqxmd.com/read/29733909/radiosensitivity-of-lung-metastases-by-primary-histology-and-implications-for-stereotactic-body-radiation-therapy-using-the-genomically-adjusted-radiation-dose
#18
Kamran A Ahmed, Jacob G Scott, John A Arrington, Arash O Naghavi, G Daniel Grass, Bradford A Perez, Jimmy J Caudell, Anders E Berglund, Eric A Welsh, Steven A Eschrich, Thomas J Dilling, Javier F Torres-Roca
INTRODUCTION: We assessed the radiosensitivity of lung metastases based on primary histology using a validated gene signature and model lung metastases for the genomically adjusted radiation dose (GARD). METHODS: Tissue samples were identified from our prospective observational protocol. The radiosensitivity index (RSI) 10 gene assay was run on samples and calculated alongside GARD using the previously published algorithms. A cohort of 105 patients with 137 lung metastases treated with SBRT at our institution was used for clinical correlation...
May 4, 2018: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/29731610/treatment-adherence-among-adult-hypertensive-patients-a-cross-sectional-retrospective-study-in-primary-care-in-romania
#19
Ioan Tilea, Dorina Petra, Septimiu Voidazan, Elena Ardeleanu, Andreea Varga
Purpose: This study was performed to elucidate the level of adherence to antihypertensive treatment in adult subjects attending a family medicine clinic in a city in central Romania. Patients and methods: A cross-sectional, retrospective study was performed on a cohort of hypertensive adults. A total of 525 participants were selected from 1,714 adults attending a single urban family medicine practice. Assessment of adherence to therapy was performed by a chart review of prescription and clinical records over a 4-year study period...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29731062/cyp3a5-3-genetic-polymorphism-and-tacrolimus-concentration-in-myanmar-renal-transplant-patients
#20
Y Y Htun, H K Swe, T M Saw
BACKGROUND: Genetic polymorphism is an important factor that influences tacrolimus concentrations and has the potential to predict the optimal dosage of tacrolimus in personalized medicine. Tacrolimus, a drug of narrow therapeutic index, is used in renal transplant recipients as an immunosuppressant agent. It is a substrate of cytochrome P450 3A (CYP3A) and has highly variable pharmacokinetic parameters. OBJECTIVE: The aim of this study was to identify the proportion of CYP3A5 gene polymorphism in Myanmar kidney transplant recipients and to determine the impact of CYP3A5 gene polymorphisms on tacrolimus level in CYP3A5 expressors and nonexpressors...
May 2018: Transplantation Proceedings
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