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Systematic review of gabapentinoid use during pregnancy and its impact on pregnancy and childhood outcomes: A ConcePTION study. 关于孕期使用加巴喷丁诺及其对妊娠和儿童结局影响的系统性综述:ConcePTION 研究。
IF 2.2 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-10-18 DOI: 10.1016/j.therap.2024.10.049
Anna-Belle Beau, Jingping Mo, Xavier Moisset, Justine Bénévent, Christine Damase-Michel

Objective: In the general population, there has been a noticeable rise in the dispensing of gabapentinoids in recent years. The aim of this study was to provide an overview of all available data on the use and safety of gabapentinoids during pregnancy.

Methods: A systematic review was performed in PubMed and Reprotox using the search terms: "gabapentin", "pregabalin", "antiepileptic drugs" and terms associated with pregnancy. We included all studies in English that reported on the use and safety of gabapentin and pregabalin during pregnancy. We excluded abstracts, literature reviews, case reports and studies involving fewer than 5 exposures. Descriptive analyses and narrative syntheses were performed.

Results: A total of 27 high-quality studies were described. The prevalence of gabapentinoid use during pregnancy remained very low, at less than 1%. Five studies reported significant findings with increased risks of overall congenital anomalies, specific anomalies (nervous system, eyes, oro-facial clefs, urinary and genital system), miscarriage, stillbirth and specific neurodevelopmental outcomes after exposure to pregabalin during pregnancy. Concerning exposure to gabapentin, increased risks of preterm birth, preeclampsia, small-for-gestational-age and NICU admission were reported in two studies.

Conclusions: Prenatal exposure to pregabalin is associated with an increased risk of congenital anomalies and long-term neurodevelopmental outcomes while gabapentin exposure was associated with an increased risk of preeclampsia, preterm birth and small-for-gestational age. Larger studies are needed to confirm these data and explore additional outcomes. The combined evidence from this systematic review and animal studies raises concerns about the safety of using gabapentinoids during pregnancy. Careful evaluation of the benefit-risk balance for both mother and fetus/infant is essential when these medications cannot be avoided during pregnancy.

目的:在普通人群中,近年来加巴喷丁类药物的配药量明显增加。本研究旨在概述有关妊娠期使用加巴喷丁类药物及其安全性的所有可用数据:方法:在 PubMed 和 Reprotox 上进行了系统性综述,搜索关键词为方法:我们在 PubMed 和 Reprotox 上进行了系统性综述,使用的检索词包括:"加巴喷丁"、"普瑞巴林"、"抗癫痫药物 "以及与妊娠相关的术语。我们纳入了所有报道孕期使用加巴喷丁和普瑞巴林的安全性的英文研究。我们排除了摘要、文献综述、病例报告和涉及少于 5 次暴露的研究。我们进行了描述性分析和叙述性综述:结果:共对 27 项高质量的研究进行了描述。孕期使用加巴喷丁诺类药物的发生率仍然很低,不到 1%。五项研究报告了重大发现,即孕期接触普瑞巴林后,总体先天畸形、特定畸形(神经系统、眼睛、口腔裂、泌尿和生殖系统)、流产、死产和特定神经发育结果的风险增加。关于暴露于加巴喷丁,有两项研究报告了早产、子痫前期、小于胎龄和入住新生儿重症监护室的风险增加:结论:产前暴露于普瑞巴林与先天性畸形和长期神经发育结果的风险增加有关,而暴露于加巴喷丁与子痫前期、早产和胎龄小的风险增加有关。需要进行更大规模的研究来确认这些数据并探讨其他结果。综合本系统综述和动物实验的证据,我们对孕期使用加巴喷丁类药物的安全性表示担忧。当妊娠期间无法避免使用这些药物时,必须仔细评估母亲和胎儿/婴儿的获益与风险之间的平衡。
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引用次数: 0
Characteristics of patients who are initiated on long-acting buprenorphine (Buvidal®) in France: A retrospective cross-sectional study. 法国开始使用长效丁丙诺啡(Buvidal®)的患者特征:回顾性横断面研究。
IF 2.2 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-10-05 DOI: 10.1016/j.therap.2024.09.003
Alice Deschenau, Benoit Trojak, Georges Brousse, Lisa Blecha, Julien Azuar, Mathieu Chappuy, Benjamin Touchon, Margaux Kosim, Benjamin Rolland

Aim: The long-acting buprenorphine Buvidal® is a recent type of opioid agonist treatment (OAT) used for opioid use disorder (OUD). It was initially suggested to preferentially use Buvidal® for specific OUD populations, including people in prison, or patients in recovery and on sublingual buprenorphine. We conducted a national study to examine whether the profile of patients treated with Buvidal® in France matched these initial recommendations.

Methods: A retrospective cross-sectional study was conducted in 13 national addiction centers (outside prison), using the individual medical records of patients initiated on Buvidal®. Baseline characteristics were collected and described, including sociodemographic features, comorbid medical conditions, concurrent substance use and prescription drug misuse, and OAT features before Buvidal® initiation, respectively.

Results: In total 101 patients (72.3% males, mean age 43.9±11.3years) were identified, which corresponded to one sixth of all patients treated with Buvidal® in France at the time of the study. Of them, 36 (36.4%) of them were professionally active, 35 (35.4%) were durably inactive, and the rest in an intermediary situation. Furthermore, 90 (90.0%) patients had at least one medical comorbidity (all types), and 83 (83.0%) at least one psychiatric comorbidity. Most frequent non-psychiatric comorbidities were chronic pain (n=20, 20.0%) and chronic viral infection (n=16, 17.8%). Current use of psychoactive substances included cocaine and crack (n=43, 42.6%), heroin (n=19, 18.8%), but also misuse of prescription drugs (n=20, 20%), mainly opioid analgesics. Moreover, 99 (98.0%) patients had an OAT before Buvidal® initiation, including 7 (8.1%) patients on methadone.

Conclusion: The profile of patients initiated on Buvidal® in France was extremely similar to that of patients treated for OUD in France, either in terms of social or clinical features. While initial recommendations essentially underlined the interest of Buvidal® for some niche populations, the on-the-ground practice reveals a more widespread use, including for unrecovered patients, or patients treated with methadone.

目的:长效丁丙诺啡 Buvidal® 是最近用于治疗阿片类药物使用障碍(OUD)的一种阿片类药物激动剂治疗(OAT)。最初有人建议将 Buvidal® 优先用于特定的阿片类药物使用障碍人群,包括监狱服刑人员、康复期患者和舌下含服丁丙诺啡的患者。我们开展了一项全国性研究,以考察法国接受 Buvidal® 治疗的患者情况是否符合这些最初的建议:我们在 13 个国家戒毒中心(监狱外)进行了一项回顾性横断面研究,使用了开始使用 Buvidal® 的患者的个人医疗记录。研究收集并描述了基线特征,包括社会人口学特征、合并症、并发药物使用和处方药滥用,以及开始使用 Buvidal® 前的 OAT 特征:共发现101名患者(72.3%为男性,平均年龄(43.9±11.3)岁),占研究期间法国所有接受Buvidal®治疗患者的六分之一。其中,36 人(36.4%)职业活跃,35 人(35.4%)长期不活跃,其余处于中间状态。此外,90(90.0%)名患者至少患有一种内科合并症(所有类型),83(83.0%)名患者至少患有一种精神科合并症。最常见的非精神病合并症是慢性疼痛(20 人,20.0%)和慢性病毒感染(16 人,17.8%)。目前使用的精神活性物质包括可卡因和快克(43 人,占 42.6%)、海洛因(19 人,占 18.8%),还包括滥用处方药(20 人,占 20%),主要是阿片类镇痛药。此外,99 名(98.0%)患者在开始使用 Buvidal® 前曾服用过 OAT,其中包括 7 名(8.1%)服用美沙酮的患者:法国开始使用 Buvidal® 的患者在社会或临床特征方面与法国接受 OUD 治疗的患者极为相似。虽然最初的建议主要强调了Buvidal®对某些特殊人群的意义,但实际使用情况表明,Buvidal®的使用更为广泛,包括未康复患者或接受美沙酮治疗的患者。
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引用次数: 0
Ischemic cardiopathy induced by capecitabine in gastric cancer: The role of dihydropyrimidine dehydrogenase metabolites. 胃癌患者卡培他滨诱发的缺血性心肌病:二氢嘧啶脱氢酶代谢物的作用。
IF 2.2 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-10-05 DOI: 10.1016/j.therap.2024.09.001
Joaquim Verdaguer, Laurent Chouchana, Marion Robert, Sandrine Bergeron, François Montastruc, Romain Barus

Objectives: Fluoropyrimidine-based therapies, 5-fluorouracil (5-FU) and its oral prodrugs, capecitabine and tegafur/oteracil/gimeracil (S-1), are pivotal drugs to treat gastric cancer. Fluoropyrimidines are associated with cardiotoxicity including ischemic cardiopathy. The mechanisms of ischemic cardiopathy are considered to be multifactorial, potentially involving metabolites of 5-FU generated by the dihydropyrimidine dehydrogenase (DPD). By using Vigibase®, the World Health Organization pharmacovigilance database, we aimed to investigate the implication of the 5-FU metabolites induced by DPD in the occurrence of ischemic cardiopathy in patients with gastric cancer using capecitabine.

Methods: In Vigibase®, we included serious reports of ischemic cardiopathy with capecitabine and S-1 from January 1st, 2013, to September 16th, 2023. Among patients with gastric cancer, we calculated the reporting odds ratio (ROR) of ischemic cardiopathy to compare capecitabine (a prodrug without DPD antagonist) with S-1 (a prodrug associated with a DPD antagonist). The ROR was also calculated regardless of the drug indication. An ancillary analysis based on the French pharmacovigilance database was also performed. We evaluated the ROR of serious cardiac disorders induced by 5-FU intravenous infusion according to the DPD status (no deficiency versus complete or partial deficiency).

Results: In gastric cancer, 1843 reports (including 23 ischemic cardiopathy) for capecitabine and 2225 reports (including 17 ischemic cardiopathy) for S-1 were included. Median time-to-onset was 7 (3-26) days for capecitabine and 22 (13.25-30) days for S-1. Capecitabine was associated with an increased ROR of ischemic cardiopathy compared with S-1 in gastric cancer (ROR=1.6; [95% CI=1.5-1.8]) and regardless of the indication (7.3; [95% CI=6.6-8.0]). In the ancillary analysis, among 5-FU users, the lack of DPD deficiency increased the ROR for cardiac disorders (2.1; [95% CI=1.9-2.3]) compared to the DPD deficiency.

Conclusion: This work supports the role of toxic 5-FU metabolites generated by dihydropyrimidine dehydrogenase in the occurrence of ischemic cardiopathy among patients with gastric cancer using capecitabine.

目的:基于氟嘧啶的疗法、5-氟尿嘧啶(5-FU)及其口服原药、卡培他滨和替加氟/奥替拉嘧啶/吉莫拉嘧啶(S-1)是治疗胃癌的关键药物。氟嘧啶类药物与心脏毒性有关,包括缺血性心脏病。缺血性心脏病的发病机制被认为是多因素的,可能涉及二氢嘧啶脱氢酶(DPD)产生的 5-FU 代谢物。通过使用世界卫生组织药物警戒数据库 Vigibase®,我们旨在研究 DPD 诱导的 5-FU 代谢物对使用卡培他滨的胃癌患者发生缺血性心肌病的影响:在 Vigibase® 中,我们收录了自 2013 年 1 月 1 日至 2023 年 9 月 16 日期间卡培他滨和 S-1 引起缺血性心肌病的严重报告。在胃癌患者中,我们计算了缺血性心肌病的报告几率(ROR),以比较卡培他滨(一种不含DPD拮抗剂的原研药)和S-1(一种与DPD拮抗剂相关的原研药)。此外,无论药物适应症如何,都计算了 ROR。我们还根据法国药物警戒数据库进行了辅助分析。我们根据 DPD 状态(无缺失与完全或部分缺失)评估了 5-FU 静脉注射诱发严重心脏疾病的 ROR:结果:在胃癌患者中,卡培他滨有 1843 例报告(包括 23 例缺血性心肌病),S-1 有 2225 例报告(包括 17 例缺血性心肌病)。卡培他滨的中位发病时间为 7(3-26)天,S-1 的中位发病时间为 22(13.25-30)天。与S-1相比,卡培他滨与胃癌缺血性心肌病的ROR增加有关(ROR=1.6;[95% CI=1.5-1.8]),与适应症无关(7.3;[95% CI=6.6-8.0])。在辅助分析中,在5-FU使用者中,缺乏DPD与缺乏DPD相比,增加了心脏疾病的ROR(2.1;[95% CI=1.9-2.3]):这项研究支持二氢嘧啶脱氢酶产生的毒性5-FU代谢物在使用卡培他滨的胃癌患者发生缺血性心肌病中的作用。
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引用次数: 0
Translation of the REMEDI[e]S (Review of potentially inappropriate MEDIcation pr[e]scribing in Seniors) explicit criteria into seminatural language for use in prescription support systems: A multidisciplinary consensus. 将 REMEDI[e]S(审查老年人潜在的不当医疗行为)的明确标准翻译成半自然语言,用于处方支持系统:多学科共识。
IF 2.2 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-10-05 DOI: 10.1016/j.therap.2024.09.002
Romane Freppel, Anaïs Barbier, Mathilde Dambrine, Laurine Robert, Chloé Rousselière, Estel Cuneo, Pascal Odou, Sophie Gautier, Jean-Baptiste Beuscart, Marie-Laure Laroche, Bertrand Décaudin

Background: By recovering data in an ordered manner and at the right time, clinical decision support systems (CDSSs) are designed to help healthcare professionals make decisions that improve patient care.

Objectives: The aim of the present study was to translate the REMEDI[e]s tool's explicit criteria, France's first reference list of potentially inappropriate drugs for the elderly, into seminatural language, in order to implement these criteria as alert rules and then enable their computer coding in a CDSS.

Methods: This work was carried out at Lille University Hospital by a team of clinical pharmacists with expertise in the use of pharmaceutical decision support systems, in collaboration with the authors of the REMEDI[e]s tool. A total of 3 multi-professional consensus meetings were required to discuss the construction of each rule in seminatural language and the coding choices.

Results: All REMEDIES criteria (n=104) were translated into seminatural language. This study is the first to have translated the 104 REMEDI[e]s explicit criteria into seminatural language.

Conclusions: One of the study's strengths relates to the close collaboration between the authors of the REMEDI[e]s tool and experts in CDSS programming rules; this ensured the exactitude of the seminatural language translations and limited (mis)interpretations.

背景:临床决策支持系统(CDSS)以有序的方式在适当的时间恢复数据,旨在帮助医疗保健专业人员做出改善患者护理的决策:本研究的目的是将REMEDI[e]s工具的明确标准--法国第一份老年人潜在不适当药物参考清单--翻译成半自然语言,以便将这些标准作为警报规则实施,然后将其编码到CDSS中:这项工作由里尔大学医院的一个临床药剂师团队与 REMEDI[e]s 工具的作者合作完成,该团队拥有使用药物决策支持系统的专业知识。共召开了 3 次多专业共识会议,讨论如何用半自然语言构建每条规则以及编码选择:所有 REMEDIES 标准(n=104)均已翻译成半自然语言。本研究是首次将104条REMEDI[e]s明确标准翻译成半自然语言:本研究的优势之一在于 REMEDI[e]s 工具的作者与 CDSS 编程规则专家之间的密切合作;这确保了半自然语言翻译的准确性和有限的(错误)解释。
{"title":"Translation of the REMEDI[e]S (Review of potentially inappropriate MEDIcation pr[e]scribing in Seniors) explicit criteria into seminatural language for use in prescription support systems: A multidisciplinary consensus.","authors":"Romane Freppel, Anaïs Barbier, Mathilde Dambrine, Laurine Robert, Chloé Rousselière, Estel Cuneo, Pascal Odou, Sophie Gautier, Jean-Baptiste Beuscart, Marie-Laure Laroche, Bertrand Décaudin","doi":"10.1016/j.therap.2024.09.002","DOIUrl":"https://doi.org/10.1016/j.therap.2024.09.002","url":null,"abstract":"<p><strong>Background: </strong>By recovering data in an ordered manner and at the right time, clinical decision support systems (CDSSs) are designed to help healthcare professionals make decisions that improve patient care.</p><p><strong>Objectives: </strong>The aim of the present study was to translate the REMEDI[e]s tool's explicit criteria, France's first reference list of potentially inappropriate drugs for the elderly, into seminatural language, in order to implement these criteria as alert rules and then enable their computer coding in a CDSS.</p><p><strong>Methods: </strong>This work was carried out at Lille University Hospital by a team of clinical pharmacists with expertise in the use of pharmaceutical decision support systems, in collaboration with the authors of the REMEDI[e]s tool. A total of 3 multi-professional consensus meetings were required to discuss the construction of each rule in seminatural language and the coding choices.</p><p><strong>Results: </strong>All REMEDIES criteria (n=104) were translated into seminatural language. This study is the first to have translated the 104 REMEDI[e]s explicit criteria into seminatural language.</p><p><strong>Conclusions: </strong>One of the study's strengths relates to the close collaboration between the authors of the REMEDI[e]s tool and experts in CDSS programming rules; this ensured the exactitude of the seminatural language translations and limited (mis)interpretations.</p>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Elexacaftor/tezacaftor/ivacaftor induced liver enzymes abnormalities in breastfed infants: A series of 3 cases. 依来卡夫托/替扎卡夫托/依瓦卡夫托诱发母乳喂养婴儿肝酶异常:3例系列病例。
IF 2.2 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-10 DOI: 10.1016/j.therap.2024.08.001
Sandrine Bergeron, Camille Audousset, Gurvan Bourdon, Charles Garabedian, Sophie Gautier
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引用次数: 0
Retinal vascular occlusion after COVID-19 vaccination: Analysis of the French pharmacovigilance database. 接种 COVID-19 疫苗后视网膜血管闭塞:法国药物警戒数据库分析。
IF 2.2 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-10 DOI: 10.1016/j.therap.2024.08.002
Mathilde Beurrier, Jean-Bapiste Conart, Marie Lauren Antoine, Anthony Facile, Haleh Bagheri, Valérie Gras-Champel, Nadine Petitpain

Retinal vein occlusions and central retinal artery occlusions have been reported with coronavirus disease 2019 (COVID-19) vaccines. We aim to provide a descriptive analysis of cases reported in France until mid-2023, and recorded in the French pharmacovigilance database. An independent ophthalmologist reviewed all cases. We analyzed 290 cases (228 retinal vein occlusions, 58 central retinal artery occlusions, and four combinations). Retinal vein occlusions occurred with mRNA vaccines (68.0%) and adenovirus-vectored vaccines (32%), with an 11-day median onset delay. Almost half of the patients had retinal vein occlusion risk factors, mainly hypertension, and five had a positive rechallenge. Considering the lower adenovirus-vectored vaccines exposure in France, their proportion of retinal vein occlusions appears high. Among the 58 central retinal artery occlusion cases, most occurred with mRNA vaccines in patients with retinal artery occlusion risk factors (mainly hypertension), with a 17-day median onset delay. In conclusion, there was a temporal association in almost half of cases, but few cases with positive rechallenge, and many cases were confounded by risk factors (e.g., cardiovascular disorders, diabetes), which are also COVID-19 risk factors. Therefore, the risk of retinal vascular occlusion does not challenge the benefit-risk ratio of the vaccination, especially for mRNA vaccines.

有报告称,2019年冠状病毒病(COVID-19)疫苗导致视网膜静脉闭塞和视网膜中央动脉闭塞。我们旨在对法国药物警戒数据库中记录的截至 2023 年年中的法国报告病例进行描述性分析。一位独立的眼科医生对所有病例进行了审查。我们分析了 290 例病例(228 例视网膜静脉闭塞、58 例视网膜中央动脉闭塞和 4 例合并病例)。视网膜静脉闭塞发生于 mRNA 疫苗(68.0%)和腺病毒载体疫苗(32%),中位发病延迟时间为 11 天。近一半的患者有视网膜静脉闭塞的危险因素,主要是高血压,其中五名患者的再挑战呈阳性。考虑到法国的腺病毒疫苗接种率较低,其视网膜静脉闭塞的比例似乎较高。在 58 例视网膜中央动脉闭塞病例中,大多数是在有视网膜动脉闭塞危险因素(主要是高血压)的患者中接种 mRNA 疫苗后发生的,中位发病延迟时间为 17 天。总之,近一半的病例存在时间上的关联性,但很少有阳性再挑战的病例,许多病例受到危险因素(如心血管疾病、糖尿病)的干扰,而这些危险因素也是 COVID-19 的危险因素。因此,视网膜血管闭塞的风险并不影响疫苗接种的收益风险比,尤其是 mRNA 疫苗。
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引用次数: 0
Ipomoea species, glorious but dangerous plants: A case-series 苕子--光荣而危险的植物:一个案例系列
IF 2.2 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-01 DOI: 10.1016/j.therap.2024.01.005
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引用次数: 0
Chirurgie bariatrique et médicaments : revue de la littérature et analyse des effets indésirables dans la banque nationale de pharmacovigilance [减肥手术与药物:文献综述和法国国家药物警戒数据库中的药物不良反应分析]。
IF 2.2 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-01 DOI: 10.1016/j.therap.2024.02.003
<div><h3>Introduction</h3><div>La chirurgie bariatrique est le seul traitement de l’obésité sévère (IMC<!--> <!-->><!--> <!-->35<!--> <!-->kg/m<sup>2</sup>) actuellement reconnu comme efficace à la fois sur la perte pondérale de façon tangible et durable et l’amélioration, voire la rémission des comorbidités liées à l’obésité, telles que le diabète de type 2, l’hypertension artérielle, et les complications cardiovasculaires. La chirurgie bariatrique, comme toute autre chirurgie du tractus digestif, peut avoir des retentissements sur l’absorption des nutriments mais également des médicaments. Les publications étudiant la prise en charge médicamenteuse des patients opérés concernent essentiellement des cas rapportés ou des études rétrospectives incluant un petit nombre de patients. On ne dispose pas de références officielles.</div></div><div><h3>Méthodes</h3><div>Nous avons réalisé une recherche des données de la littérature sur les conséquences de la chirurgie bariatrique au niveau de la biodisponibilité et/ou de l’effet du médicament. La base de données Medline® (PubMed) a été interrogée en utilisant les mots clés suivants : « <em>bariatric surgery</em> », « <em>bioavailability</em> », « <em>gastric bypass</em> », et « <em>obesity</em> ». Nous avons complété cette revue par une analyse des notifications d’effets indésirables (EIs) chez les patients en post-chirurgie bariatrique pour obésité enregistrées dans la banque nationale de pharmacovigilance (BNPV). Nous avons sélectionné tous les cas avec la mention chirurgie bariatrique et/ou gastrectomie comme « antécédent ». Après lecture des cas, nous avons exclu les cas où le patient a bénéficié d’une chirurgie pour une autre indication que l’obésité, où la voie d’administration était autre que la voie orale et les cas dont les EIs résultaient de surdosage volontaire, tentative de suicide, d’allergie, du passage au Lévothyrox® nouvelle formule, du méningiome sous progestatif, d’une inefficacité liée à une substitution par un générique et d’une erreur médicamenteuse.</div></div><div><h3>Résultats</h3><div>La recherche de la littérature a permis d’identifier essentiellement des publications type « <em>case report</em> » sur l’impact de la chirurgie bariatrique sur les médicaments dits à « fenêtre thérapeutique étroite ». L’interrogation de la BNPV a permis d’identifier 66 cas informatifs sur un total de 565 cas sélectionnés (11 %). Néanmoins, les informations ne permettent pas souvent d’établir un lien évident entre la survenue de l’effet indésirable et l’influence de la chirurgie bariatrique.</div></div><div><h3>Conclusion</h3><div>On note un manque d’informations officielles et/ou recommandations sur la prise des médicaments chez les sujets ayant subi une chirurgie bariatrique. En dehors de la sous-notification, les déclarations des effets indésirables restent peu informatives. Une sensibilisation des professionnels de santé et des patients sur la déclaration des effets indésirables chez cette pop
导言:减肥手术是目前公认的治疗重度肥胖(体重指数大于 35kg/m2)的唯一有效方法,既能达到明显而持久的减肥效果,又能改善与肥胖相关的并发症,如 2 型糖尿病、高血压和心血管并发症。减肥手术与其他消化道手术一样,会影响营养吸收和药物吸收。有关减肥手术患者药物管理的文献主要是涉及少数患者的病例报告和回顾性研究。目前尚无官方指南:我们对减肥手术在药物生物利用度和/或效果方面的影响进行了文献检索。我们使用以下关键词在 Medline® (PubMed) 数据库中进行了搜索:"减肥手术"、"生物利用度"、"胃旁路术 "和 "肥胖症"。最后,我们对国家药物警戒数据库(PVDB)中登记的减肥手术后肥胖症患者的药物不良反应(ADRs)报告进行了分析。我们选择了所有在 "病史 "中提及 "减肥手术和/或胃切除术 "的病例。阅读病例后,我们排除了患者因肥胖以外的适应症而接受手术的病例、给药途径为口服以外的病例,以及因自愿过量、自杀未遂、过敏、改用左旋甲状腺素®新制剂、孕激素药物导致脑膜瘤、非专利药替代品无效和用药错误而导致ADR的病例:文献检索主要发现了减肥手术对所谓 "窄治疗窗 "药物影响的 "病例报告"。在 PVDB 选取的 565 个病例中,我们发现了 66 个有参考价值的病例(占 11%)。尽管如此,这些信息仍无法明确 ADR 的发生与减肥手术的影响之间的关系:结论:目前缺乏关于减肥手术患者用药的官方信息和/或建议。除了报告不足外,ADRs 报告在很大程度上仍然缺乏信息。保健专业人员和患者应从定量和定性两方面提高对这一人群药物不良反应的报告。
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引用次数: 0
Questionnaire about therapeutic drug monitoring (TDM) of psychotropics for a panel of French psychiatrists 针对法国精神科医生小组的精神药物治疗监测(TDM)问卷调查。
IF 2.2 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-01 DOI: 10.1016/j.therap.2024.01.004
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引用次数: 0
Syndrome de Stevens-Johnson induit par la lymécycline chez un adolescent de 17 ans : cas clinique et revue de la littérature 莱美环素诱发一名 17 岁青少年史蒂文斯-约翰逊综合征:病例报告和文献综述
IF 2.2 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-01 DOI: 10.1016/j.therap.2024.04.004
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引用次数: 0
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Therapie
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