Article
Emergency Medicine
Z. Blok, M. L. Ridderikhof, H. Goddijn, M. Berendsen, M. W. Hollmann
Summary: This study evaluated the opioid requirement in Emergency Department patients with painful conditions who received intravenous acetaminophen, showing no significant decrease in opioid requirement during the Emergency Department stay with additional intravenous acetaminophen use, but a trend towards decreased opioid requirement after discharge.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Review
Health Care Sciences & Services
Belinda Butcher, Elizabeth Hutchings, Belinda Fazekas, Katherine Clark, Debra Rowett, David Currow
Summary: Despite heterogeneity in the results, ketorolac may have a certain effect in sparing opioids; there is insufficient data to analyze the frequency of opioid use or the need for rescue medication.
PALLIATIVE MEDICINE
(2022)
Review
Health Care Sciences & Services
Premalatha Balachandran, Mahmoud Elsohly, Kevin P. Hill
Summary: CBD, a non-intoxicating phytocannabinoid, has therapeutic effects and has been approved by the FDA for the treatment of two severe forms of pediatric epilepsy. Despite its widespread use for various indications, it can interact with common medications and substances such as acetaminophen and alcohol.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2021)
Article
Medicine, General & Internal
Natasa Gisev, Luke Buizen, Ria E. Hopkins, Andrea L. Schaffer, Benjamin Daniels, Chrianna Bharat, Timothy Dobbins, Sarah Larney, Fiona Blyth, David C. Currow, Andrew Wilson, Sallie-Anne Pearson, Louisa Degenhardt
Summary: The objective of this population-based cohort study was to identify 5-year trajectories of prescription opioid use and examine the characteristics of each trajectory group. The results suggest that most individuals initiating treatment with prescription opioids had relatively low and time-limited exposure over a 5-year period. A small proportion of individuals had sustained or increasing use, and they were typically older with more comorbidities and higher use of psychotropic and other analgesic drugs.
Article
Anesthesiology
Catherine Chanfreau-Coffinier, Sony Tuteja, Leland E. Hull, Sally MacDonald, Olga Efimova, Jill Bates, Deepak Voora, David W. Oslin, Scott L. DuVall, Julie A. Lynch
Summary: The response to analgesic therapy is influenced by various factors, including genetics and drug interactions. This study aimed to evaluate the potential impact of pharmacogenetic (PGx) testing on the care of Veterans with noncancer pain who were prescribed opioids metabolized by the CYP2D6 gene. The results showed that a significant proportion of patients were at an elevated risk for undesirable responses to their opioid medication based on predicted phenotypes and drug-drug interactions. However, CYP2D6 testing was infrequently used, and the results were mainly utilized to optimize antidepressant treatments rather than pain medications. The findings suggest that utilizing PGx testing along with consideration of phenoconversion may enhance the precision medicine approach to pain management in Veterans.
Article
Pharmacology & Pharmacy
Song Ren, Karthick Vishwanathan, Mireille Cantarini, Paul Frewer, Indira Hara, Graeme Scarfe, Wendy Burke, Stein Schalkwijk, Yan Li, David Han, Ronald Goldwater
Summary: Co-dosing of rifampicin significantly reduces exposure to savolitinib, while co-dosing of itraconazole or midazolam with savolitinib has no clinically significant effect on PK. Co-dosing of famotidine with savolitinib reduces exposure to savolitinib, although this is not considered clinically meaningful. No new savolitinib-related safety findings were observed.
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
(2022)
Article
Oncology
Soraira Pacheco, Linh M. T. Nguyen, John M. Halphen, Nikitha N. Samy, Nathaniel R. Wilson, Gregory Sattler, Shane E. Wing, Christine Feng, Rex A. D. Paulino, Pulin Shah, Supriyanka Addimulam, Riddhi Patel, Curtis J. Wray, Joseph A. Arthur, David Hui
Summary: Patient prescriber agreements (PPAs) are recommended as a strategy for mitigating non-medical opioid use (NMOU) in cancer patients. Our study found that 54% of patients had a PPA, and 10% were not adherent. PPAs were associated with younger age and alcohol use, while non-adherence was associated with males, being single, tobacco and alcohol use, contact with persons involved in criminal activity, opioid use for non-cancer pain, and higher pain score.
Review
Critical Care Medicine
Sheryl Wu, Heather B. Hoang, Jenny Z. Yang, Demosthenes G. Papamatheakis, David S. Poch, Mona Alotaibi, Sandra Lombardi, Cynthia Rodriguez, Nick H. Kim, Timothy M. Fernandes
Summary: The management of pulmonary arterial hypertension has become more complex due to increased pharmacotherapy options and longer patient survival. This review provides an overview of pharmaceutical metabolism and discusses important drug-drug interactions for approved medications in different pathways. Understanding these interactions is crucial for effective treatment.
Article
Biochemistry & Molecular Biology
Ilia G. Denisov, Yelena V. Grinkova, Mark A. McLean, Tyler Camp, Stephen G. Sligar
Summary: Human cytochrome P450 CYP3A4 plays a significant role in the metabolism of more than 35% of pharmaceuticals, leading to drug-drug interactions. This study evaluated the use of midazolam as a probe substrate to detect and predict the involvement of new drug candidates in CYP3A4-mediated drug-drug interactions. The results suggest that the changes in the shape and volume of the substrate-binding pocket explain the occurrence of drug interactions.
Article
Health Care Sciences & Services
Sebastiano Mercadante
Summary: Spinal analgesia may be effective for specific populations, but its application in comprehensive palliative care requires high expertise in managing opioids, different routes, particularly intrathecal, and providing comprehensive palliative care.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2023)
Article
Microbiology
Shawn Flanagan, Helen Walker, Voon Ong, Taylor Sandison
Summary: Rezafungin, a newly approved once-weekly echinocandin, has been shown to be free of severe drug-drug interactions (DDIs) according to extensive testing, making it a potential treatment for Candida infections and prevention of various infections.
MICROBIOLOGY SPECTRUM
(2023)
Article
Pharmacology & Pharmacy
Naoki Katayama, Keiichi Odagiri, Akio Hakamata, Chiaki Kamiya, Shinya Uchida, Shimako Tanaka, Naoki Inui, Noriyuki Namiki, Koichiro Tatsumi, Hiroshi Watanabe
Summary: This study investigated the impact of clopidogrel on the pharmacokinetics of selexipag and its active metabolite in 14 healthy Japanese volunteers. The results showed that co-administration of clopidogrel with selexipag did not affect selexipag's pharmacokinetics, but significantly increased the AUC(0-infinity) of ACT-333679. Furthermore, even when selexipag was administered 1 day after discontinuation of clopidogrel, there was still an increase in the AUC(0-infinity) of ACT-333679, indicating a persistent inhibitory effect of clopidogrel on CYP2C8.
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
(2021)
Review
Biochemistry & Molecular Biology
Kornel Kiraly, David A. Karadi, Ferenc Zador, Amir Mohammadzadeh, Anna Rita Galambos, Mihaly Balogh, Pal Riba, Tamas Tabi, Zoltan S. Zadori, Eva Szoko, Susanna Furst, Mahmoud Al-Khrasani
Summary: There is ongoing debate on the effectiveness of opioids in the management of neuropathic pain, with dose escalation required to maintain analgesia leading to increased side effects. Literature suggests that angiotensin and its receptors may have an impact on pain transmission. The interaction between MOR and angiotensin receptors remains understudied in chronic pain, particularly neuropathy.
Article
Oncology
Aaron K. K. Wong, Andrew A. Somogyi, Justin Rubio, Tien Dung Pham, Brian Le, Pal Klepstad, Jennifer Philip
Summary: This study aimed to compare the pain and adverse event outcomes between opioid switching and a control group in patients with advanced cancer pain. The findings showed that opioid switching reduced pain, controlled breakthrough pain, and reduced psychological distress, demonstrating its effectiveness in managing pain and adverse effects in advanced cancer patients.
Article
Anesthesiology
Tak Kyu Oh, Hyeong Geun Kim, In-Ae Song
Summary: Among preoperative opioid-naive patients in South Korea, 6.1% became new long-term opioid users after lung cancer surgery. Older age, male sex, wider surgical extent, open thoracotomy, increased Charlson Comorbidity Index score, neoadjuvant or adjuvant chemotherapy, preoperative anxiety disorder and insomnia disorder were potential risk factors for new long-term opioid use. The new long-term opioid user group had a 40% higher risk of 2-year all-cause mortality.
REGIONAL ANESTHESIA AND PAIN MEDICINE
(2022)
Article
Clinical Neurology
Jan Gaertner, Karin Jaroslawski, Gerhild Becker, Christopher Boehlke
FRONTIERS IN NEUROLOGY
(2019)
Review
Health Care Sciences & Services
Jan Gaertner, Steffen Eychmueller, Thomas Leyhe, Daniel Bueche, Egemen Savaskan, Mathias Schlogl
ANNALS OF PALLIATIVE MEDICINE
(2019)
Review
Health Care Sciences & Services
Jan Gaertner, Christopher Boehlke, Charles B. Simone, David Hui
ANNALS OF PALLIATIVE MEDICINE
(2019)
Article
Pharmacology & Pharmacy
Xia Li, Sebastian Frechen, Daniel Moj, Thorsten Lehr, Max Taubert, Chih-hsuan Hsin, Gerd Mikus, Pertti J. Neuvonen, Klaus T. Olkkola, Teijo Saari, Uwe Fuhr
CLINICAL PHARMACOKINETICS
(2020)
Article
Oncology
Waldemar Siemens, Christopher Boehlke, Michael I. Bennett, Klaus Offner, Gerhild Becker, Jan Gaertner
SUPPORTIVE CARE IN CANCER
(2020)
Article
Pharmacology & Pharmacy
Xia Li, Lisa Junge, Max Taubert, Anabelle von Georg, Dominik Dahlinger, Chris Starke, Sebastian Frechen, Christoph Stelzer, Martina Kinzig, Fritz Soergel, Ulrich Jaehde, Ulrich Toex, Tobias Goeser, Uwe Fuhr
JOURNAL OF CLINICAL PHARMACOLOGY
(2020)
Article
Oncology
Waldemar Siemens, Stefan S. Schoensteiner, Claudia Lorena Orellana-Rios, Ulrike Schaekel, Jens Kessler, Corinna Eschbach, Maren Viehrig, Regine Mayer-Steinacker, Gerhild Becker, Jan Gaertner
SUPPORTIVE CARE IN CANCER
(2020)
Article
Oncology
Lucia Nogova, Christian Mattonet, Matthias Scheffler, Max Taubert, Masyar Gardizi, Martin L. Sos, Sebastian Michels, Rieke N. Fischer, Meike Limburg, Diana S. Y. Abdulla, Thorsten Persigehl, Carsten Kobe, Sabine Merkelbach-Bruse, Jeremy Franklin, Heiko Backes, Roland Schnell, Dirk Behringer, Britta Kaminsky, Martina Eichstaedt, Christoph Stelzer, Martina Kinzig, Fritz Soergel, Yingying Tian, Lisa Junge, Ahmed A. Suleiman, Sebastian Frechen, Dennis Rokitta, Dongsheng Ouyang, Uwe Fuhr, Reinhard Buettner, Juergen Wolf
Article
Pharmacology & Pharmacy
Ibrahim Ince, Andre Dallmann, Sebastian Frechen, Katrin Coboeken, Christoph Niederalt, Thomas Wendl, Michael Block, Michaela Meyer, Thomas Eissing, Rolf Burghaus, Jorg Lippert, Stefan Willmann, Jan-Frederik Schlender
Summary: Physiology-based pharmacokinetic (PBPK) modeling has been used to support the development and guidance of dosing schemes in children for many years. By accounting for physiological differences, PBPK models can be translated from adults to children, demonstrating successful prediction of the pharmacokinetics of small-molecule compounds across different pediatric age groups.
JOURNAL OF CLINICAL PHARMACOLOGY
(2021)
Article
Pharmacology & Pharmacy
Sebastian Frechen, Juri Solodenko, Thomas Wendl, Andre Dallmann, Ibrahim Ince, Thorsten Lehr, Jorg Lippert, Rolf Burghaus
Summary: The success of physiologically-based pharmacokinetic (PBPK) modeling in drug development has led regulatory agencies to demand rigorous demonstration of the predictive capability of specific PBPK platforms. Utilizing an agile and sustainable technical framework for automatic PBPK platform qualification, PK-Sim(R) has shown effectiveness in predicting CYP3A4-mediated drug-drug interactions (DDIs).
CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY
(2021)
Article
Pharmacology & Pharmacy
Thomas Wendl, Sebastian Frechen, Michael Gerisch, Roland Heinig, Thomas Eissing
Summary: This study developed a physiologically-based pharmacokinetic (PBPK) model for finerenone and used it to predict its performance as a victim drug in CYP3A4-mediated drug interactions. The model accurately predicted interactions with erythromycin and verapamil and also successfully predicted interactions with other CYP3A4 modulators.
CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY
(2022)
Article
Chemistry, Multidisciplinary
Sebastian Frechen, Amin Rostami-Hodjegan
Summary: Modeling and simulation are essential tools in drug development, with mechanistic modeling being the fastest growing field and physiologically based pharmacokinetic (PBPK) modeling being recommended for specific applications by regulatory agencies. Ensuring the credibility of PBPK tools, software platforms, and related models is a crucial discussion point, with many questions remaining on how to ensure credibility. This study provides guidance on quality assurance of PBPK platforms and executing PBPK studies.
PHARMACEUTICAL RESEARCH
(2022)
Review
Cardiac & Cardiovascular Systems
Jan Gaertner, Tanja Fusi-Schmidhauser, Stephanie Stock, Waldemar Siemens, Vera Vennedey
Summary: For the treatment of breathlessness in heart failure, opioids are commonly recommended but lack strong evidence. This systematic review of randomized controlled trials suggests that opioids have limited efficacy and may cause adverse effects. Therefore, opioids should be considered as a last resort and only used when other treatments have failed or in emergencies.
Article
Pharmacology & Pharmacy
Sebastian Frechen, Ibrahim Ince, Andre Dallmann, Michael Gerisch, Natalia A. Jungmann, Corina Becker, Maximilian Lobmeyer, Maria E. Trujillo, Shiyao Xu, Rolf Burghaus, Michaela Meyer
Summary: This study assesses the drug-drug interaction (DDI) risk between Vericiguat and UGT1A1 inhibitors using a physiologically-based pharmacokinetic (PBPK) model and in vitro DDI study, and reveals no clinically relevant interaction. The impact of genetic polymorphisms of UGT1A1 and UGT1A9 on drug exposure was also evaluated.
CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY
(2023)
Review
Oncology
Jan Gartner, Marion Daun, Juergen Wolf, Michael von Bergwelt-Baildon, Michael Hallek
ONCOLOGY RESEARCH AND TREATMENT
(2019)