Clinical pharmacology and therapeutics
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Clin. Pharmacol. Ther. · Apr 2014
Review Practice GuidelineClinical Pharmacogenetics Implementation Consortium guidelines for cytochrome P450 2D6 genotype and codeine therapy: 2014 update.
Codeine is bioactivated to morphine, a strong opioid agonist, by the hepatic cytochrome P450 2D6 (CYP2D6); hence, the efficacy and safety of codeine are governed by CYP2D6 activity. Polymorphisms are a major cause of CYP2D6 variability. We summarize evidence from the literature supporting this association and provide therapeutic recommendations for codeine based on CYP2D6 genotype. This document is an update to the 2012 Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for CYP2D6 genotype and codeine therapy.
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Clin. Pharmacol. Ther. · Apr 2014
"It's the economy, stupid": strategies for improved cost containment in cancer treatment.
The advent of numerous novel antitumor compounds has improved the prognosis of many cancer patients but has also substantially increased the costs of cancer care and put more pressure on health-care budgets. This situation increasingly raises questions such as the extent to which these drugs offer value sufficient to justify their cost and how to accommodate the increasing costs of cancer care. Here I look at the various aspects that affect cancer care economics and offer potential solutions.