Current drug metabolism最新文献

Physiologically based pharmacokinetic (PBPK) modeling is a computational technique that uses the physicochemical properties of drugs and physiological information to simulate plasma and tissue concentrations. PBPK modeling has become a mainstream approach in drug research and development, frequently employed to support regulatory packages for new drug applications. Understanding the pharmacokinetic characteristics of anti-HIV drugs is essential for successful treatment. In recent decades, PBPK modeling has been commonly used in the development and clinical therapy of anti-HIV medications. This review discusses the prevalence and application of PBPK modeling in the pharmacokinetics of anti-HIV drugs. Among the articles retrieved for this review, PBPK modeling was predominantly employed for anti-HIV drugs in contexts, such as pregnancy, drug-drug interactions, and pediatrics. The most commonly used software programs for this model are Simcyp, MATLAB, and PK-sim. This review will provide insights for researchers in applying PBPK models to manage patients with HIV infection, aiming to enhance the efficacy of anti-HIV drug therapy and prevent undesirable adverse effects.

Introduction: Polypharmacy is frequently practiced in the management of schizophrenia due to its chronic nature, recurrent relapses, and associated comorbidities. While combining psychotropic medications may benefit patients with treatment-resistant symptoms, it poses risks such as drug-drug interactions (DDIs), adverse effects, and reduced medication adherence. The absence of uniform prescribing standards further complicates clinical decision-making.

Methods: This narrative review was conducted using a scoping methodology. Databases including Pub- Med, Scopus, and Web of Science were searched for English-language publications from 2000 to 2024. Search terms included "schizophrenia," "polypharmacy," "drug-drug interactions," "clinical outcomes," and "pharmacogenetics." Eligible sources included clinical trials, observational studies, systematic reviews, and treatment guidelines. Exclusion criteria were non-English articles, gray literature, and individual case reports.

Results: Polypharmacy is reported in 30-60% of individuals with schizophrenia, especially in institutionalized or treatment-resistant populations. Treatment regimens often involve multiple antipsychotics along with adjunctive antidepressants or mood stabilizers. This approach is associated with increased risks of metabolic syndrome, cardiovascular events (e.g., QT prolongation), extrapyramidal symptoms, and decreased adherence. Interindividual variability in pharmacogenetics further affects drug efficacy and safety. Innovative approaches like genotype-guided therapy and computerized clinical decisionsupport systems are promising but not yet widely implemented.

Discussion: Although polypharmacy may offer symptomatic relief in specific scenarios, it requires careful management due to its potential to cause harm. Rational prescribing, close monitoring, and attention to individual patient factors such as pharmacogenetic profiles are essential to optimize therapy.

Conclusion: Ensuring a balance between therapeutic benefit and adverse effects is crucial when employing polypharmacy in schizophrenia treatment. Integrating personalized medicine strategies, regular monitoring, and deprescribing practices when feasible can enhance clinical outcomes and patient safety.

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Background: Propofol is an intravenous agent for clinical anesthesia. As the influence of the hypobaric-hypoxic environment (Qinghai-Tibetan region, altitude: 2800-4300 m, PaO2: 15.1-12.4 kPa) on the metabolism of Propofol is complex, the research results on the metabolic characteristics of Propofol in high-altitude areas remain unclear. This study aimed to investigate the pharmacokinetic characteristics of Propofol in a high-altitude hypoxic environment using animal experiments.

Methods: Rats were randomly divided into three groups: high-altitude, medium-altitude, and plain groups. The time of disappearance and recovery of the rat righting reflex was recorded as the time of anesthesia induction and awakening, respectively. The plasma concentration of Propofol was determined by gas chromatography-mass spectrometry. A pharmacokinetic analysis software was used to analyze the blood-drug concentrations and obtain the pharmacokinetic parameters.

Results: We observed that when Propofol anesthetizes rats, the anesthesia induction time was shortened, andthe recovery time was prolonged with increased altitude. Compared with the plain group, the clearance ofPropofol decreased, whereas the half-life, area under the concentration-time curve, peak plasma concentration,and average residence time extension increased.

Conclusion: The pharmacokinetic characteristics of Propofol are significantly altered in high-altitude hypoxic environments.