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Tacrolimus Level Increase During Nirmatrelvir-Ritonavir Treatment. 尼马瑞韦-利托那韦治疗期间他克莫司水平升高
IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 DOI: 10.1097/MJT.0000000000001668
Yinhua Gong, Yue Li, Ling Xue, Jie Gao
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引用次数: 0
Tislelizumab-Induced Toxic Epidermal Necrolysis-Like Cutaneous Adverse Reaction: Rare Complication of Immune Checkpoint Inhibitor Therapy. Tislelizumab诱发的中毒性表皮坏死溶解症样皮肤不良反应:免疫检查点抑制剂治疗的罕见并发症。
IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 DOI: 10.1097/MJT.0000000000001682
Xiaoqin Yang, Shunming Xu
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引用次数: 0
Taurolidine and Heparin as Catheter Lock Solution for Central Venous Catheters in Hemodialysis. 血液透析中心静脉导管的滔罗尼定和肝素导管锁定液
IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 Epub Date: 2024-05-07 DOI: 10.1097/MJT.0000000000001736
Timothy Nguyen, Bernard C Camins, David A Butler

Background: Chronic kidney disease can lead to end-stage renal disease, and the prevalence is increasing. Many patients starting hemodialysis require central venous catheters (CVCs). Catheter-related bloodstream infections (CRBSIs) are a common complication and lead to significant morbidity and mortality. Interventions to prevent CRBSI include antimicrobial lock therapy but concern for the development of antimicrobial resistance and adverse effects. Nonantimicrobial antiseptics as catheter lock solutions have also been used. Taurolidine and heparin catheter lock solution is first approved by the Food and Drug Administration for the prevention of CRBSI in patients on hemodialysis. Taurolidine has a unique mechanism of action and favorable safety profile.

Mechanism of action, pharmacodynamics, and pharmacokinetics: Taurolidine and heparin catheter lock solution have both antimicrobial and anticoagulant properties. Taurolidine is derivative of the amino acid taurine, and heparin is derived from porcine intestinal mucosa. Taurolidine not only damages microbial cell walls but also prevents the adherence of microorganisms to biological surfaces, preventing biofilm formation. Taurolidine and heparin catheter lock solution is intended to be used intraluminally within the catheter and should be aspirated. Because it is used locally, limited pharmacokinetic and pharmacodynamic data are available.

Clinical trials: The LOCK-IT-100 trial is a randomized, double-blind, phase 3 study, which included 795 end-stage renal disease patients on hemodialysis with CVC. Taurolidine and heparin was compared with the control heparin alone. The results of the study showed a 71% risk reduction in CRBSI for taurolidine and heparin arm (95% confident interval, 38%-86%, P = 0.0006). Other studies have also shown that taurolidine lock solution leads to decreased CRBSI episodes. Several systematic reviews and meta-analysis consisted of taurolidine in adult, and pediatric populations also showed reduction in the incidence of CRBSIs.

Therapeutic advance: Taurolidine and heparin lock solution represents a novel preventive strategy for those undergoing hemodialysis through a CVC by reducing the risk of CRBSI. This is significant progress because there are no other similar options available for patients for whom catheters are the only options for their life-saving treatment.

背景:慢性肾病可导致终末期肾病,而且发病率正在上升。许多开始血液透析的患者需要使用中心静脉导管(CVC)。导管相关血流感染(CRBSI)是一种常见的并发症,可导致严重的发病率和死亡率。预防 CRBSI 的干预措施包括抗菌素锁定疗法,但抗菌素耐药性的产生和不良反应令人担忧。非抗菌消毒剂也被用作导管锁定溶液。滔罗立定和肝素导管锁定溶液首次获得美国食品和药物管理局批准,用于预防血液透析患者的 CRBSI。滔罗立定具有独特的作用机制和良好的安全性:滔罗立定和肝素导管锁溶液具有抗菌和抗凝特性。滔罗立定是氨基酸牛磺酸的衍生物,肝素则来自猪肠粘膜。滔罗匹定不仅能破坏微生物细胞壁,还能阻止微生物附着在生物表面,防止生物膜的形成。滔罗立定和肝素导管锁溶液用于导管内腔,应吸入导管。由于是局部使用,因此药代动力学和药效学数据有限:LOCK-IT-100 试验是一项随机、双盲、三期研究,共纳入了 795 名使用 CVC 进行血液透析的终末期肾病患者。牛磺必利和肝素与单独使用肝素的对照组进行了比较。研究结果显示,滔罗尼定和肝素组的 CRBSI 风险降低了 71%(95% 置信区间:38%-86%,P = 0.0006)。其他研究也表明,滔罗立定锁定溶液可减少 CRBSI 的发生。在成人和儿童人群中使用滔罗尼定的几项系统回顾和荟萃分析也显示,CRBSI 的发生率有所下降:滔罗尼定和肝素锁溶液为通过 CVC 进行血液透析的患者提供了一种新型预防策略,可降低 CRBSI 风险。这是一项重大进展,因为对于导管是唯一救命治疗选择的患者来说,目前还没有其他类似的选择。
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引用次数: 0
Prasugrel-Associated Drug Fever. 普拉苏格雷相关药物热。
IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 DOI: 10.1097/MJT.0000000000001739
Wan Man Chan, Ta-Wei Wu, Tzu-Rong Peng
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引用次数: 0
Brexpiprazole Can Be Used to Treat Behavioral and Psychological Symptoms of Lewy Body Dementia Without Exacerbating the Risk of Falls. 布雷克吡唑可用于治疗路易体痴呆症的行为和心理症状,而不会加剧跌倒风险。
IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 DOI: 10.1097/MJT.0000000000001703
Hsun Ou, Yi-Wei Yeh
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引用次数: 0
Investigation Into Potentially Inappropriate Prescribing Patterns of Loop Diuretics in a Nationally Representative Outpatient Population. 对全国代表性门诊人群中潜在不适当的环状利尿药处方模式的调查。
IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 Epub Date: 2023-10-11 DOI: 10.1097/MJT.0000000000001644
Steven Fosnight, Mate Michael Soric, Jacob Smearman, Emily Graves, Melvin Vazquez, Zachary Herrington, Carl Palladino, Matthew Costello, Abby Knauss

Background: Loop diuretic therapy effectively treats edema related to heart failure, chronic kidney disease, and liver impairment; however, evidence supporting other indications is lacking. For indications such as hypertension or dependent edema or treatment of adverse events associated with other medications, the benefits likely do not outweigh the risks, putting patients at an unacceptably high risk of poor outcomes.

Study question: What is the proportion of loop diuretic prescribing that occurs in the absence of a diagnosis of heart failure, chronic kidney disease, liver impairment, or other evidence-based indications?

Study design: This was a national, retrospective, cross-sectional investigation conducted using the National Ambulatory Care Survey from 2013 to 2016. Outpatient visits for patients aged 18 years or older prescribed with loop diuretics were included.

Measures and outcomes: The primary end point was the frequency of potentially inappropriate loop diuretic prescribing. The secondary end point was a multivariable regression model that identified predictors of potentially inappropriate loop diuretic utilization.

Results: This analysis identified 5261 outpatient visits conducted during the study period in which loop diuretics were prescribed. Of these, 3648 visits (65.8% of weighted visits) were of patients without a history of heart failure, chronic kidney disease, or liver impairment. Positive predictors included age older than 65 years (odds ratio [OR] 1.71; 95% confidence interval [CI] 1.38-2.13), concomitant calcium channel blocker (OR 1.42; 95% CI, 1.09-1.84), sodium-containing medication use (OR 2.78; 95% CI, 1.23-6.25), and office visit with a cardiology specialist (OR 2.84; 95% CI, 2.31-3.50).

Conclusions: This analysis identified that loop diuretics are prescribed in the absence of evidence-based indications more frequently than they are prescribed for them. This prescribing pattern creates a unique opportunity for clinicians to optimize patient care. Further study of the outcomes associated with this prescribing pattern is warranted.

背景:环状利尿疗法能有效治疗心力衰竭、慢性肾脏疾病和肝损伤引起的水肿;然而,缺乏支持其他迹象的证据。对于高血压或依赖性水肿等适应症,或与其他药物相关的不良事件的治疗,其益处可能不会超过风险,使患者面临无法接受的不良后果高风险。研究问题:在没有诊断为心力衰竭、慢性肾脏疾病、肝损伤或其他循证指征的情况下,环路利尿剂处方的比例是多少?研究设计:这是一项全国性、回顾性、横断面调查,使用2013年至2016年的全国门诊护理调查进行。包括对18岁或18岁以上服用环管利尿剂的患者的门诊就诊。措施和结果:主要终点是潜在的不适当的环路利尿剂处方的频率。次要终点是一个多变量回归模型,该模型确定了潜在的环路利尿剂使用不当的预测因素。结果:该分析确定了在研究期间进行的5261次门诊就诊,其中开了环状利尿剂。其中,3648次就诊(占加权就诊的65.8%)是没有心力衰竭、慢性肾脏疾病或肝损伤史的患者。阳性预测因素包括65岁以上的年龄(比值比[OR]1.71;95%置信区间[CI]1.38-2.13)、伴用钙通道阻滞剂(比值比1.42;95%可信区间,1.09-1.84)、含钠药物使用(比值比2.78;95%可信范围,1.23-6.25),以及心脏病专家的办公室访问(OR 2.84;95%CI,2.31-3.50)。这种处方模式为临床医生优化患者护理创造了一个独特的机会。有必要进一步研究与这种处方模式相关的结果。
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引用次数: 0
Comparative Meta-Analysis of Retatrutide Versus Placebo and Dulaglutide for Weight Loss and Diabetes Management: Insights From Clinical Trials. 雷特鲁肽与安慰剂和度拉鲁肽在减轻体重和糖尿病管理方面的对比分析:临床试验的启示。
IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 DOI: 10.1097/MJT.0000000000001743
Hazem Ayesh, Suhail Ayesh, Kevin Niswender
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引用次数: 0
Mung Bean (Vigna radiata L.) Soup Decreases Tacrolimus Blood Trough Level. 绿豆汤可降低他克莫司血药浓度
IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 DOI: 10.1097/MJT.0000000000001696
Lei Hu, Jianmin Liu, Qiuyu Fan, Shaohui Zhang
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引用次数: 0
Disulfiram-Associated Generalized Tonic-Clonic Seizures. 双硫仑相关的全身强直-阵挛性发作。
IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 Epub Date: 2023-04-04 DOI: 10.1097/MJT.0000000000001625
Sivapriya Vaidyanathan, Sudharshan Raghunathan, Suma T Udupa, Ravindra Neelakanthappa Munoli, Malkonahalli Srikanta Manjushree, Samir Kumar Praharaj
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引用次数: 0
Polypharmacy-Associated Tardive Dystonia Responding to Clozapine Optimization. 对氯氮平优化治疗的多重药理作用相关迟发性肌张力障碍。
IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 Epub Date: 2024-01-17 DOI: 10.1097/MJT.0000000000001656
N A Uvais, Shamsudeen Moideen
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引用次数: 0
期刊
American journal of therapeutics
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