Fundamental & clinical pharmacology
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Fundam Clin Pharmacol · Aug 2007
Comparative StudyPatterns and frequency of atypical antipsychotic prescribing in psychiatric medical centers: a cross-sectional national survey.
Studies describing atypical antipsychotics when compared with conventional antipsychotic drugs are few in France. This study aimed to describe the frequency and characteristics of atypical antipsychotic prescribing. A cross-sectional national survey was conducted from February to June 2003 in a random sample of 100 volunteer French psychiatrists practicing in public psychiatric medical centers. ⋯ Seventy percent of patients were treated with single-drug atypical antipsychotics. Compared with conventional antipsychotics with immediate action, atypical antipsychotics were less likely to be prescribed to patients over 35 years of age [odds ratio (OR) 0.4; 95% confidence interval (CI) 0.3-0.6], with duration of illness >10 years (OR 0.5; 95% CI 0.3-0.7), and were less likely to be used with concomitant corrector agents for neurological side effects (OR 0.4; 95% CI 0.3-0.6). This study shows the important use of atypical antipsychotic drugs especially in schizophrenic patients and younger patients.
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Fundam Clin Pharmacol · Aug 2007
Tacrolimus pharmacokinetics and pharmacogenetics: influence of adenosine triphosphate-binding cassette B1 (ABCB1) and cytochrome (CYP) 3A polymorphisms.
Tacrolimus, an immunosuppressant used after organ transplantation, has a narrow therapeutic range and its pharmacokinetic variability complicates its daily dose assessment. P-glycoprotein (P-gp), encoded by the adenosine triphosphate-binding cassette B1 (ABCB1) and the cytochrome (CYP) 3A4 and 3A5 enzymes appears to play a role in the tacrolimus metabolism. In the present study, two different renal transplant recipient groups were used to examine the influence of ABCB1 and CYP3A polymorphisms on the daily tacrolimus dose and several pharmacokinetic parameters. ⋯ Neither the individual ABCB1 polymorphisms nor the ABCB1 haplotypes were associated with any pharmacokinetic parameter. We noticed that patients carrying a CYP3A5*1 allele require a twofold higher tacrolimus dose compared with homozygous carriers of the CYP3A5*3 variant allele to maintain the target dnAUC(0-12). Therefore, genotyping for the CYP3A5*3 variant allele can contribute to a better and more individualized immunosuppressive therapy in transplant patients.