The 3‐hydroxy‐3‐methylglutaryl coenzyme A reductase inhibitors, also known as “statins” are considered first‐line pharmacologic therapy for reducing low‐density lipoprotein cholesterol (LDL‐C). They have been demonstrated efficacy in a variety of patients populations to reduce atherosclerotic cardiovascular disease (ASCVD) risk. Like any pharmacologic therapy, however, they are not without possible adverse effects that can lead to discontinuation, thus leading to a loss of benefit. The most common side effect related to statin therapy impacting compliance is musculoskeletal related, commonly referred to as statin‐associated muscle systems (SAMS). While the overall incidence is relatively low, the consequences of nonadherence to statin therapy can have a negative impact on patient care. Therefore, it is important for healthcare providers to understand risk factors, how to diagnose, and how to manage this unfortunate adverse effect in order to optimize care.
{"title":"Statin‐associated muscle symptoms—A review: Individualizing the approach to optimize care","authors":"B. Wiggins, J. Backes, D. Hilleman","doi":"10.1002/phar.2681","DOIUrl":"https://doi.org/10.1002/phar.2681","url":null,"abstract":"The 3‐hydroxy‐3‐methylglutaryl coenzyme A reductase inhibitors, also known as “statins” are considered first‐line pharmacologic therapy for reducing low‐density lipoprotein cholesterol (LDL‐C). They have been demonstrated efficacy in a variety of patients populations to reduce atherosclerotic cardiovascular disease (ASCVD) risk. Like any pharmacologic therapy, however, they are not without possible adverse effects that can lead to discontinuation, thus leading to a loss of benefit. The most common side effect related to statin therapy impacting compliance is musculoskeletal related, commonly referred to as statin‐associated muscle systems (SAMS). While the overall incidence is relatively low, the consequences of nonadherence to statin therapy can have a negative impact on patient care. Therefore, it is important for healthcare providers to understand risk factors, how to diagnose, and how to manage this unfortunate adverse effect in order to optimize care.","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90585398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Corey D Cicci, A. Weiss, C. Dang, M. Stanton, R. Feldman
The objective of this study was to evaluate clinical outcomes associated with time to administration and dose of four‐factor prothrombin complex concentrate (4F‐PCC) in patients with ICH on warfarin.
{"title":"Impact of timing and dosing of four‐factor prothrombin complex concentrate administration on outcomes in warfarin‐associated intracranial hemorrhage","authors":"Corey D Cicci, A. Weiss, C. Dang, M. Stanton, R. Feldman","doi":"10.1002/phar.2680","DOIUrl":"https://doi.org/10.1002/phar.2680","url":null,"abstract":"The objective of this study was to evaluate clinical outcomes associated with time to administration and dose of four‐factor prothrombin complex concentrate (4F‐PCC) in patients with ICH on warfarin.","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78266568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Concluding Remarks","authors":"Z. Khachaturian","doi":"10.2307/j.ctvs1g9kk.25","DOIUrl":"https://doi.org/10.2307/j.ctvs1g9kk.25","url":null,"abstract":"","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91437079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca J. Cope, Briann Fischetti, Rebecca Kavanagh, Trisha M Lepa, Maria Sorbera
The prevalence of obesity among persons living with human immunodeficiency virus (HIV) has increased significantly and may be linked to the use of antiretroviral therapy. Although weight‐loss medications approved by the U.S. Food and Drug Administration are recommended as an adjunct to diet and exercise to treat obesity in the general population, little is known about the safety and efficacy of these drugs specifically in persons living with HIV. We review the available evidence regarding the effective use of weight‐loss pharmacotherapy in persons living with HIV and its potential to interact with antiretroviral therapy. Persons living with HIV are frequently not reported or included in clinical trials for weight‐loss medications; however, treatment efficacy is likely similar to the general population. Several important reported or theoretical drug‐drug interactions exist between antiobesity pharmacotherapy and antiretroviral therapy. Orlistat is a weight‐loss drug available in the United States without a prescription and was linked to HIV viral rebound in several case reports. Clinicians should be aware of the potential for loss of HIV viremia control when certain weight‐loss pharmacotherapies are used in combination with antiretrovirals.
{"title":"Safety and Efficacy of Weight‐Loss Pharmacotherapy in Persons Living with HIV: A Review of the Literature and Potential Drug‐Drug Interactions with Antiretroviral Therapy","authors":"Rebecca J. Cope, Briann Fischetti, Rebecca Kavanagh, Trisha M Lepa, Maria Sorbera","doi":"10.1002/phar.2342","DOIUrl":"https://doi.org/10.1002/phar.2342","url":null,"abstract":"The prevalence of obesity among persons living with human immunodeficiency virus (HIV) has increased significantly and may be linked to the use of antiretroviral therapy. Although weight‐loss medications approved by the U.S. Food and Drug Administration are recommended as an adjunct to diet and exercise to treat obesity in the general population, little is known about the safety and efficacy of these drugs specifically in persons living with HIV. We review the available evidence regarding the effective use of weight‐loss pharmacotherapy in persons living with HIV and its potential to interact with antiretroviral therapy. Persons living with HIV are frequently not reported or included in clinical trials for weight‐loss medications; however, treatment efficacy is likely similar to the general population. Several important reported or theoretical drug‐drug interactions exist between antiobesity pharmacotherapy and antiretroviral therapy. Orlistat is a weight‐loss drug available in the United States without a prescription and was linked to HIV viral rebound in several case reports. Clinicians should be aware of the potential for loss of HIV viremia control when certain weight‐loss pharmacotherapies are used in combination with antiretrovirals.","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74649390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paige Soukup, Andrew C. Faust, Vindhya Edpuganti, W. Putnam, J. McKinnell
Ceftazidime‐avibactam (CAZ‐AVI) is a novel intravenous β‐lactam/β‐lactamase inhibitor combination used in the treatment of multidrug‐resistant (MDR) gram‐negative infections. Although renal dosing recommendations exist for the medication, limited data are available for dosing in patients receiving continuous renal replacement therapy. In this report, we describe a case in which CAZ‐AVI 2.5 g was administered as a 2‐hour infusion every 8 hours to a 50‐year‐old critically ill patient with MDR Pseudomonas aeruginosa (CAZ‐AVI minimum inhibitory concentration [MIC] 8 μg/ml) pneumonia who was also receiving continuous venovenous hemodiafiltration (CVVHDF). Total serum concentrations of both ceftazidime and avibactam were measured at ~0.5, 2, 4, and 6 hours after completion of the 2‐hour infusion of the 11th dose of CAZ‐AVI. Ceftazidime pharmacokinetic parameters were as follows: maximum serum concentration (Cmax) 152.39 μg/ml, half‐life 5.17 hours, volume of distribution at steady state (Vdss) 11.51 L, clearance 1.54 L/hour, and area under the concentration‐time curve (AUC) 1295.38 hour•μg/ml. This regimen achieved free ceftazidime serum concentrations more than 4 times the MIC for 100% of the dosing interval. Avibactam pharmacokinetic parameters were as follows: Cmax 35.83 μg/ml, half‐life 5.92 hours, Vdss 12.44 L, clearance 1.45 L/hour, and AUC 343.44 hour•μg/ml, which achieved free avibactam concentrations above 1 μg/ml for 100% of the dosing interval. Higher CAZ‐AVI dosing is critical in the treatment of pneumonia due to limited ceftazidime penetration into epithelial lining fluid; however, epithelial lining fluid drug concentrations were not collected or measured. Based on this case report and the available evidence, a dose of CAZ‐AVI 2.5 g infused over 2 hours every 8 hours appears to be appropriate for critically ill patients who are being treated for pneumonia and are receiving CVVHDF.
{"title":"Steady‐State Ceftazidime‐Avibactam Serum Concentrations and Dosing Recommendations in a Critically Ill Patient Being Treated for Pseudomonas aeruginosa Pneumonia and Undergoing Continuous Venovenous Hemodiafiltration","authors":"Paige Soukup, Andrew C. Faust, Vindhya Edpuganti, W. Putnam, J. McKinnell","doi":"10.1002/phar.2338","DOIUrl":"https://doi.org/10.1002/phar.2338","url":null,"abstract":"Ceftazidime‐avibactam (CAZ‐AVI) is a novel intravenous β‐lactam/β‐lactamase inhibitor combination used in the treatment of multidrug‐resistant (MDR) gram‐negative infections. Although renal dosing recommendations exist for the medication, limited data are available for dosing in patients receiving continuous renal replacement therapy. In this report, we describe a case in which CAZ‐AVI 2.5 g was administered as a 2‐hour infusion every 8 hours to a 50‐year‐old critically ill patient with MDR Pseudomonas aeruginosa (CAZ‐AVI minimum inhibitory concentration [MIC] 8 μg/ml) pneumonia who was also receiving continuous venovenous hemodiafiltration (CVVHDF). Total serum concentrations of both ceftazidime and avibactam were measured at ~0.5, 2, 4, and 6 hours after completion of the 2‐hour infusion of the 11th dose of CAZ‐AVI. Ceftazidime pharmacokinetic parameters were as follows: maximum serum concentration (Cmax) 152.39 μg/ml, half‐life 5.17 hours, volume of distribution at steady state (Vdss) 11.51 L, clearance 1.54 L/hour, and area under the concentration‐time curve (AUC) 1295.38 hour•μg/ml. This regimen achieved free ceftazidime serum concentrations more than 4 times the MIC for 100% of the dosing interval. Avibactam pharmacokinetic parameters were as follows: Cmax 35.83 μg/ml, half‐life 5.92 hours, Vdss 12.44 L, clearance 1.45 L/hour, and AUC 343.44 hour•μg/ml, which achieved free avibactam concentrations above 1 μg/ml for 100% of the dosing interval. Higher CAZ‐AVI dosing is critical in the treatment of pneumonia due to limited ceftazidime penetration into epithelial lining fluid; however, epithelial lining fluid drug concentrations were not collected or measured. Based on this case report and the available evidence, a dose of CAZ‐AVI 2.5 g infused over 2 hours every 8 hours appears to be appropriate for critically ill patients who are being treated for pneumonia and are receiving CVVHDF.","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84217486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1212/01.con.0000617308.50884.2b
K. Campbell
{"title":"Learning Objectives","authors":"K. Campbell","doi":"10.1212/01.con.0000617308.50884.2b","DOIUrl":"https://doi.org/10.1212/01.con.0000617308.50884.2b","url":null,"abstract":"","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90646075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Smalls, Reagan E Kiger, L. Norris, C. Bennett, B. Love
Hepatitis B virus (HBV) is a global disease with significant morbidity and mortality. Worldwide, ~257 million people are chronically infected with HBV, defined as having a positive hepatitis B surface antigen, but millions more have prior HBV exposure indicated by positive hepatitis B core antibody. Reactivation of hepatitis B implies a sudden increase in viral replication in a patient with chronic HBV infection or prior HBV exposure. Hepatitis B virus reactivation (HBVr) can occur spontaneously, but it is more commonly triggered by immunosuppressive therapies for cancer, immunologic diseases, or transplantation. Elimination of hepatitis C virus (HCV) in HBV‐HCV coinfected individuals treated with direct‐acting antivirals (DAAs) has also been identified as an important cause of HBVr. Hepatitis B virus reactivation is an underappreciated but important complication of common medical therapies that can delay treatment or result in clinical episodes of hepatitis, hepatic failure, or death. In this review, factors associated with HBVr, particularly medication‐related risks, are explored. We review data involving rituximab and ofatumumab, doxorubicin, corticosteroids, tumor necrosis factor antagonists, tyrosine kinases, bortezomib, hematologic stem cell transplantation, and DAAs for HCV treatment. In addition, we discuss screening strategies, choice of antiviral prophylaxis, and the optimal duration of therapy for HBVr. With additional awareness, screening, and appropriate antiviral therapy, it is expected that most cases of HBVr can be prevented.
{"title":"Hepatitis B Virus Reactivation: Risk Factors and Current Management Strategies","authors":"D. Smalls, Reagan E Kiger, L. Norris, C. Bennett, B. Love","doi":"10.1002/phar.2340","DOIUrl":"https://doi.org/10.1002/phar.2340","url":null,"abstract":"Hepatitis B virus (HBV) is a global disease with significant morbidity and mortality. Worldwide, ~257 million people are chronically infected with HBV, defined as having a positive hepatitis B surface antigen, but millions more have prior HBV exposure indicated by positive hepatitis B core antibody. Reactivation of hepatitis B implies a sudden increase in viral replication in a patient with chronic HBV infection or prior HBV exposure. Hepatitis B virus reactivation (HBVr) can occur spontaneously, but it is more commonly triggered by immunosuppressive therapies for cancer, immunologic diseases, or transplantation. Elimination of hepatitis C virus (HCV) in HBV‐HCV coinfected individuals treated with direct‐acting antivirals (DAAs) has also been identified as an important cause of HBVr. Hepatitis B virus reactivation is an underappreciated but important complication of common medical therapies that can delay treatment or result in clinical episodes of hepatitis, hepatic failure, or death. In this review, factors associated with HBVr, particularly medication‐related risks, are explored. We review data involving rituximab and ofatumumab, doxorubicin, corticosteroids, tumor necrosis factor antagonists, tyrosine kinases, bortezomib, hematologic stem cell transplantation, and DAAs for HCV treatment. In addition, we discuss screening strategies, choice of antiviral prophylaxis, and the optimal duration of therapy for HBVr. With additional awareness, screening, and appropriate antiviral therapy, it is expected that most cases of HBVr can be prevented.","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87046697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adel A. Alrwisan, Y. Wei, B. Brumback, P. Antonelli, A. Winterstein
To examine whether concomitant use of quinolones and stimulants increases the risk of cardiac events in adults.
研究成人同时使用喹诺酮类药物和兴奋剂是否会增加心脏事件的风险。
{"title":"Concomitant Use of Quinolones and Stimulants and the Risk of Adverse Cardiovascular Symptoms: A Retrospective Cohort Study","authors":"Adel A. Alrwisan, Y. Wei, B. Brumback, P. Antonelli, A. Winterstein","doi":"10.1002/phar.2343","DOIUrl":"https://doi.org/10.1002/phar.2343","url":null,"abstract":"To examine whether concomitant use of quinolones and stimulants increases the risk of cardiac events in adults.","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74273828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tesfahun C. Eshetie, T. Nguyen, Marianne H Gillam, L. K. Kalisch Ellett
People with Alzheimer's disease (AD) often have multimorbidity and take multiple medicines. Yet few studies have examined medicine utilization for comorbidities comparing people with and without AD.
{"title":"Medication Use for Comorbidities in People with Alzheimer's Disease: An Australian Population‐Based Study","authors":"Tesfahun C. Eshetie, T. Nguyen, Marianne H Gillam, L. K. Kalisch Ellett","doi":"10.1002/phar.2341","DOIUrl":"https://doi.org/10.1002/phar.2341","url":null,"abstract":"People with Alzheimer's disease (AD) often have multimorbidity and take multiple medicines. Yet few studies have examined medicine utilization for comorbidities comparing people with and without AD.","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75792953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiaoli Du, W. Peng, Q. Fu, Q. Ma, Zhu Zhu, Taisheng Li
To identify the pharmacokinetic differences of antiretroviral drugs between HIV‐infected Chinese patients and patients of other race/ethnicities.
目的:确定中国HIV感染者与其他种族/民族患者抗逆转录病毒药物的药代动力学差异。
{"title":"A Review of Clinical Pharmacokinetic and Pharmacodynamic Profiles of Select Antiretrovirals: Focus on Differences among Chinese Patients","authors":"Xiaoli Du, W. Peng, Q. Fu, Q. Ma, Zhu Zhu, Taisheng Li","doi":"10.1002/phar.2333","DOIUrl":"https://doi.org/10.1002/phar.2333","url":null,"abstract":"To identify the pharmacokinetic differences of antiretroviral drugs between HIV‐infected Chinese patients and patients of other race/ethnicities.","PeriodicalId":19812,"journal":{"name":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89914429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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