Enhancing drug-drug Interaction Prediction by Integrating Physiologically-Based Pharmacokinetic Model with Fraction Metabolized by CYP3A4

Expert Opinion on Drug Metabolism & Toxicology, Journal Year: 2023, Volume and Issue: 19(10), P. 721 - 731

Published: Sept. 25, 2023

Enhancing the precision of drug-drug interaction (DDI) prediction is essential for improving drug safety and efficacy. The aim to identify most effective fraction metabolized by CY3A4 (fm) DDI using physiologically based pharmacokinetic (PBPK) models.The fm values were determined 33 approved drugs a human liver microsome in vitro measurements ADMET Predictor software silico predictions. Subsequently, these integrated into PBPK models GastroPlus platform. models, combined with ketoconazole model, utilized predict AUCR (AUCcombo ketoconazole/AUCdosing alone), accuracy predictions was evaluated comparison observed AUCR.The integration method demonstrates superior performance compared 100% method. Under Guest-limits criteria, achieves an 76%, while methods achieve accuracies 67% 58%, respectively.Our study highlights importance data improve predicting DDIs promising potential DDIs.

Language: Английский

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Prescribing Renally Inappropriate Medication to Hospitalized Geriatric Patients in Makkah, Saudi Arabia

International Journal of General Medicine, Journal Year: 2024, Volume and Issue: Volume 17, P. 1755 - 1764

Published: May 1, 2024

Introduction:As a result of the physiological decline in renal function that comes with age and common failure to recognise insufficiency, older adults aged 65 above are at increased risk receiving medications inappropriate for their level which turn lead adverse effects.Little is known about how many receive function.This study aimed determine prevalence renally elderly by reviewing patient files evaluating appropriateness medication doses relative patients ≥ years inpatient healthcare departments.Methods: A retrospective cross-sectional was conducted, covering cases from 2015 2021.Patient's medical records were reviewed, lists evaluated, determined whether they had been prescribed least one based on drug-dosing recommendations different degrees function.Results: total 317 inpatients included, 10% whom received function.Glomerular filtration rate associated dosing this study.Of CKD stage 5, 36.8% drug administered an dose, while figure 6.5% among 1; difference statistically significant (p = 0.001). Conclusion:A notable portion may be effects due related function.Further studies large samples, use analyses comprehensive geriatric references prioritisation actual outcomes over potential needed further adults' exposure drugs.

Language: Английский

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Exploring Polypharmacy and Drug Interactions in Geriatric Patients: A Cross-Sectional Study from India

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: July 16, 2024

Background Polypharmacy and potential drug-drug interactions (pDDIs) present challenges in managing elderly individuals with multiple comorbidities. Understanding their prevalence associated factors is vital for enhancing medication safety therapeutic outcomes. Objective This study aimed to assess the of polypharmacy pDDIs among aged 60 years above at Yenepoya Medical College Hospital. Methods A prospective observational was conducted hospital's in-patient out-patient wards following ethics committee approval. Patient records were reviewed, prescriptions screened using Medscape UpToDate. SPSS 26.0 analyzed data identify patterns characterize pDDIs. Results Predominantly older adults participated (mean age approximately 70.25 years), notable prevalence, especially in-patients. Gender disparities evident, females receiving more medications on average (p = 0.036). Moderate (50%) most common various severity levels. Age correlated positively (r 0.897) prescribed medications, but categories showed no significant association drug > 0.05). However, a relationship existed between quantity interaction 4.77e-05). Conclusion The highlights individuals, emphasizing management. We found polypharmacy, particularly complex health conditions, observed pervasive nature moderate interactions.

Language: Английский

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Clinical Significance and Patterns of Potential Drug–Drug Interactions in Cardiovascular Patients: Focus on Low-Dose Aspirin and Angiotensin-Converting Enzyme Inhibitors

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(15), P. 4289 - 4289

Published: July 23, 2024

Objective: This study assessed the patterns and clinical significance of potential drug–drug interactions (pDDIs) in patients with diseases cardiovascular system. Methods: Electronic health records (EHRs), established 2018–2023, were selected using probability serial nested sampling method (n = 1030). Patients aged 27 to 95 years (65.0% men). Primary diagnosis COVID-19 was present 17 EHRs (1.7%). Medscape Drug Interaction Checker used characterize pDDIs. The Mann–Whitney U test chi-square for statistical analysis. Results: numbers per record ranged from 1 23 T-List 20 P-List. In T-List, 567 drug combinations resulted 3781 P-List, 584 5185 Polypharmacy detected 39.0% versus 65.9% P-List (p-value < 0.05). rates serious monitor-closely pDDIs due ‘aspirin + captopril’ significantly higher than enalapril’ lisinopril’ lower compared corresponding Serious administration aspirin fosinopril, perindopril, ramipril less frequently Conclusions: Obtained data may suggest better patient adherence combinations, which are potentially superior ramipril. An abundance high-order real-world practice warrants development a decision support system aimed at reducing pharmacotherapy-associated risks while integrating pharmacokinetic, pharmacodynamic, pharmacogenetic information.

Language: Английский

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An Agenda for Spectrum Thinking and Technological Assistance Derived From the Research of the Late Dr. Dur Muhammad Lashari

Advances in medical technologies and clinical practice book series, Journal Year: 2024, Volume and Issue: unknown, P. 85 - 108

Published: Aug. 26, 2024

Dental research explores herbal treatments, such as EGCG, for treating gingivitis. This study introduces a mucoadhesive gingival patch loaded with EGCG and gel. highlights green tea's potential oral health. With 3D animation, we can provide an interactive experience people to understand better how treat gingivitis its application, journey. It will also explain use the gel, making it easier start using treatment. further delight education through why safe treatments should be ensured technology help make acceptance possible. The gel used periodontitis treatment, offering cost-effective, health-promoting, time-effective solutions. aims address dental health issues low risk cost more information, technological acceptance, self-understanding, practical solutions, potentially eradicating antibacterial medicine shifting toward medicine.

Language: Английский

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Healthcare provider-related perceptions toward deprescribing inappropriate medications among older adult outpatients

PLoS ONE, Journal Year: 2024, Volume and Issue: 19(11), P. e0312762 - e0312762

Published: Nov. 12, 2024

Objectives To examine healthcare provider-related perceptions toward deprescribing inappropriate medications among older adults. Methods A cross-sectional, correlational study used a convenience sample of outpatient adults to measure their perception using Patient’s Perceptions Deprescribing (PPoD), which include 57 multiple-choice questions related patients’ sociodemographic data, health, medicines, providers, and experience care provided by the clinic. Data were collected graduate nursing student from one pharmacy in public hospital, five days per week, via in-person interviews. Results analyzed for 200 participants. The level patient collaboration with primary providers (PCPs) is linked trust PCPs, beliefs about medication use, PCP knowledge, concerns (p < .0001). Patient involvement decision-making also associated PCPs willingness stop Additionally, decision-making, general receiving conflicting information medicine = .010). Lastly, knowledge views on importance concerns, seeking help interactions clinical pharmacists, being advised pharmacist discontinue Conclusions found that adults’ PCP, deprescribing, are medicine-related factors. Therefore, should discuss benefits prevent long-term side effects. Future studies focus effectiveness evidence-based protocols

Language: Английский

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Statins’ effect on quality of life and functioning in older stroke patients: Systematic review and meta-analysis

Journal of Clinical Neuroscience, Journal Year: 2024, Volume and Issue: 132, P. 110989 - 110989

Published: Dec. 17, 2024

Limited evidence exists on the efficacy and safety of statins in older ischemic stroke or transient attack patients, particularly frail individuals. Studies often exclude limiting insights optimal treatments for entire population. This review aims to evaluate effect secondary prevention quality life functioning patients following an attack, as these outcomes are aligned with treatment goals this patient

Language: Английский

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Prescribed-vs.-Taken Polypharmacy and Drug-Drug Interactions in Older Cardiovascular Patients: Observational Cross-Sectional Analytical Study

Published: June 28, 2023

The study aimed to identify clinical pharmacology patterns of prescribed and taken medications in older cardiovascular patients using electronic health records (EHRs) (n = 704) (2019–2022). Medscape Drug Interaction Checker was used pairwise drug-drug interactions (DDIs). Prevalence rates DDIs were 73.5% 68.5% among drugs, respectively. However, total number significantly higher compared with the list drugs (p &lt; 0.05). Serious comprised 16% 7% all medications, correspondingly Median DDI numbers between versus Me 2, IQR 0-7 3, per record, polypharmacy Women taking more had No sex-related differences observed medications. ICD code U07.1 (COVID-19, virus identified) associated highest median record. Further research is warranted improve EHR structure, patient engagement reporting adverse drug reactions, genetic profiling avoid potentially serious DDIs.

Language: Английский

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Investigating Frailty, Polypharmacy, Malnutrition, Chronic Conditions, and Quality of Life in Older Adults: Large Population-Based Study (Preprint)

Published: July 6, 2023

Aging, a significant public health issue, is associated with multiple concurrent chronic diseases and aging-related conditions (geriatric syndromes). This study aims to investigate the impact of age on geriatric syndromes intercorrelations between quality life (QoL) in older adults (aged ≥65 years) at population level. A large representative sample was randomly selected from county China, Feidong, 17 towns 811,867 residents. Multiple conditions, (frailty, polypharmacy, malnutrition), QoL were assessed compared. Associations demographic information using multivariable-adjusted logistic regression. Intercorrelations age, syndromes, investigated both correlation analysis restricted cubic splines–based dose-response analysis. Older comprised 43.42% (3668/8447) entire population. The prevalence frailty, premalnutrition or malnutrition, impaired (median 73, IQR 69-78 years; 1871/3668, 51% men) 8.26% (303/3668), 15.59% (572/3668), 3.22% (118/3668), 10.8% (396/3668), respectively. Different sex subgroups mostly had similar (except that frailty occurred more often age). Premalnutrition malnutrition lower frequency obesity higher constipation, polypharmacy diabetes constipation hernia, hypertension, diabetes, physical disability, constipation. Mini Nutritional Assessment–Short Form, Groningen Frailty Indicator, EQ-5D-5L scores, as well number medications used, predicted each other QoL. Impaired polypharmacy. At 1.5-year follow-up, linked baseline, baseline. Causal mediation analyses showed mediated link worse In this population-based adults, ≥1 syndromes. Geriatric intercorrelated with, predictive of, QoL; causal relationships existed QoL, being mediators. findings might be biased by residual confounding factors. It important perform personalized syndrome assessments stratified condition; active prevention intervention for, any help reduce others improve

Language: Английский

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