European journal of clinical pharmacology
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Eur. J. Clin. Pharmacol. · Sep 2010
Meta AnalysisHaemodynamics of intravenous paracetamol in neonates.
Reports on the haemodynamics of intravenous (iv) paracetamol in adult intensive care were recently published. We therefore wanted to explore the haemodynamics of iv paracetamol in neonates. ⋯ In a setting of open label administration to alleviate (procedural) pain, haemodynamic effects of iv paracetamol in neonates remained modest. We suggest considering impaired haemodynamics to be a relative contra-indication for iv paracetamol in neonates.
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Eur. J. Clin. Pharmacol. · Sep 2010
A signal for an abuse liability for pregabalin--results from the Swedish spontaneous adverse drug reaction reporting system.
Pregabalin is a gamma-aminobutyric acid (GABA) analogue approved for the treatment of epilepsy, neuropathic pain and generalised anxiety disorder. As a GABA analogue, there has been some concern about an abuse liability. We aimed to investigate the possible abuse liability of pregabalin. ⋯ Based on the signal from the present study, we conclude that pregabalin is likely to be associated with an abuse potential.
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Eur. J. Clin. Pharmacol. · Aug 2010
ReviewPharmacogenetic testing and therapeutic drug monitoring are complementary tools for optimal individualization of drug therapy.
Genetic factors contribute to the phenotype of drug response, but the translation of pharmacogenetic outcomes into drug discovery, drug development or clinical practice has proved to be surprisingly disappointing. Despite significant progress in pharmacogenetic research, only a few drugs, such as cetuximab, dasatinib, maraviroc and trastuzumab, require a pharmacogenetic test before being prescribed. There are several gaps that limit the application of pharmacogenetics based upon the complex nature of the drug response itself. ⋯ Third, the use of a pharmacogenetic test as a standard of care for drug therapy has to overcome significant scientific, economic, commercial, political and educational barriers, among others, in order for clinically useful information to be effectively communicated to practitioners and patients. Meanwhile, the lack of efficacy is in this process is quite as costly as drug toxicity, especially for very expensive drugs, and there is a widespread need for clinically and commercially robust pharmacogenetic testing to be applied. In this complex scenario, therapeutic drug monitoring of parent drugs and/or metabolites, alone or combined with available pharmacogenetic tests, may be an alternative or complementary approach when attempts are made to individualize dosing regimen, maximize drug efficacy and enhance drug safety with certain drugs and populations (e.g. antidepressants in older people).
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Eur. J. Clin. Pharmacol. · Aug 2010
Case Reports Comparative StudyPancytopenia due to proguanil toxicity in a returning traveller with fever.
A patient known to have renal insufficiency was admitted to the hospital with fever and pancytopenia after returning from a trip to Mali. Pancytopenia was not caused by a tropical infection but was a side effect of atovaquone/proguanil used as malaria chemoprophylaxis. High and prolonged detectable proguanil serum levels can result in bone marrow suppression in patients with renal insufficiency. This should be taken into account in a returning traveller with fever and pancytopenia.
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Eur. J. Clin. Pharmacol. · Jul 2010
Randomized Controlled TrialTwo separate dose-dependent effects of paroxetine: mydriasis and inhibition of tramadol's O-demethylation via CYP2D6.
To investigate paroxetine's putative dose-dependent impact on pupil reaction and inhibition of the O-demethylation of tramadol. ⋯ Paroxetine is a dose-dependent dilator of the pupil and as expected a dose-dependent inhibitor of (+)-tramadol's O-demethylation.