Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2C9 and Nonsteroidal Anti-inflammatory Drugs.

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Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used analgesics due to their lack of addictive potential. However, NSAIDs have the potential to cause serious gastrointestinal, renal, and cardiovascular […]

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Evaluating Adherence to Guideline-Directed C Difficile Infection Management Pre- and Postimplementation of an Electronic Order Set.

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After publication of the Clostridioides difficile infection (CDI) guidelines by the Infectious Disease Society of America (IDSA) in early 2018, we identified that many prescribers at our institution continued to […]

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Evaluation of current regulation and guidelines of pharmacogenomic drug labels; opportunities for improvements.

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Pharmacogenomic drug labels in summary of product characteristics (SmPCs) provide an instrument for clinical implementation of pharmacogenomics. We compared pharmacogenomic guidance by CPIC, DPWG, FDA, and by the European agencies […]

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Dose-Dependent Inhibition of OATP1B by Rifampicin in Healthy Volunteers: Comprehensive Evaluation of Candidate Biomarkers and OATP1B Probe Drugs.

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Abstract: To address the most appropriate endogenous biomarker for drug-drug interaction risk assessment, eight healthy subjects received an organic anion transporting polypeptide 1B (OATP1B) inhibitor (rifampicin, 150, 300 and 600 […]

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Evaluation of Therapeutics for Severely-Debilitating or Life Threatening Diseases or Conditions: Defining Scope to Enable Global Guidance Development.

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Abstract: A significant regulatory gap exists to facilitate global development of therapeutics for non-oncology severely-debilitating or life threatening diseases or conditions (SDLTs). In a 2017 publication, a streamlined approach to […]

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Detecting unstable plaques in humans using cardiac CT Can it guide treatments?

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Abstract: Advances in imaging technology have driven the rapid expansion in the use of computed tomography in the assessment of coronary atherosclerotic plaque. Current guidelines recommend coronary CT angiography as […]

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Detecting unstable plaques in humans using cardiac CT Can it guide treatments?

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Abstract: Advances in imaging technology have driven the rapid expansion in the use of computed tomography in the assessment of coronary atherosclerotic plaque. Current guidelines recommend coronary CT angiography as […]

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Repurposing of diagnostic whole exome sequencing data of 1,583 individuals for clinical pharmacogenetics.

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Abstract: For approximately 80 drugs, widely recognized pharmacogenetics dosing guidelines are available. However, the use of these guidelines in clinical practice remains limited as only a fraction of patients is […]

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The Promise and the Reality of Genomics to Guide Precision Medicine in Pediatric Oncology: The Decade Ahead.

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Abstract: Much has been written about the promise of “precision medicine”, especially in oncology, where somatic mutations can influence the response of cancer cells to “targeted therapy”. There have been […]

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The Clinical Pharmacogenetics Implementation Consortium: 10 Years Later.

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Abstract: In 2009, the Clinical Pharmacogenetics Implementation Consortium (CPIC; www.cpicpgx.org), a shared project between Pharmacogenomics Knowledge Base (PharmGKB, http://www.pharmgkb.org/) and the National Institutes of Health (NIH), was created to provide […]

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A Pilot Study Embedding Clinical Pharmacists Within an Interprofessional Nephrology Clinic for the Initiation and Monitoring of Empagliflozin in Diabetic Kidney Disease.

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Abstract: The American Diabetes Association (ADA) recommends sodium-glucose cotransporter-2 (SGLT2) inhibitors as the second medication to be started, after metformin, for patients with chronic kidney disease (CKD). Sodium-glucose cotransporter-2 inhibitors […]

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Secondary stroke prevention: a population-based cohort study on anticoagulation and antiplatelet treatments, and the risk of death or recurrence.

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Abstract: Using claims databases of a public healthcare program (Quebec) for the years 2010 – 2013, we conducted a cohort study of acute ischemic stroke (AIS) patients to describe secondary […]

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Silicon nanomembrane-based near infrared phototransistor with positive and negative photodetections.

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Abstract: Surface plasmon polariton induces hot carrier injection that enables near infrared photodetection in Si nanomembranes and is of great significance for Si photonics integrated circuits. In this study, near […]

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Considerations for improved performance of competition association assays analysed with the Motulsky-Mahan’s “kinetics of competitive binding” model.

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Abstract: Target engagement dynamics can influence drugs’ pharmacological effects. The kinetic parameters for drug:target interactions are often quantified by evaluating competition association experiments – measuring simultaneous protein binding of labelled […]

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Evaluating Pharmacist Impact on Guideline-Directed Medical Therapy in Patients With Reduced Ejection Fraction Heart Failure.

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Abstract: Limited literature exists evaluating the ability of a pharmacist to quickly and effectively initiate and manage dose titrations of guideline-directed medication therapy (GDMT) in an outpatient setting.This pilot study […]

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National Trends in Statin Medication Prescribing in Patients With a History of Stroke or Transient Ischemic Attack.

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Guidelines support statin therapy post-stroke or transient ischemic attack (TIA); however, previously reported utilization rates are suboptimal.This study investigates the incidence of statin usage in patients with a documented stroke or TIA while identifying predictors of statin use.A retrospective, cross-sectional study utilizing data from the National Ambulatory Medical Care Survey.A total of 2963 unweighted visits were included in the analysis, representing a total of 52 645 000 office visits when weighted. Statin therapy was initiated or continued in 35.7% (95% confidence interval [CI]: 32.4-39.0%) of office visits. Upon multivariate analysis, positive predictors of statin therapy included a diagnosis of hyperlipidemia (odds ratio [OR]: 3.60; 95% CI: 2.40-5.41), angiotensin-converting enzyme inhibitor (ACE-I) therapy (OR: 2.52; 95% CI: 1.69-3.76), aspirin therapy (OR: 2.02; 95% CI: 1.40-2.93), and clopidogrel therapy (OR: 2.60; 95% CI: 1.69-4.02). Negative predictors of statin therapy included office visits with neurologists when compared to visits with primary care practitioners (OR: 0.55; 95% CI: 0.33-0.90) and office visits in rural areas when compared to office visits in urban areas (OR: 0.64; 95% CI: 0.41-0.99).Various factors impact statin therapy use with overall utilization being suboptimal, highlighting an opportunity for medication optimization.

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Pharmacogenomics Clinical Annotation Tool (PharmCAT).

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Pharmacogenomics (PGx) decision support and return of results is an active area of precision medicine. One challenge of implementing PGx is extracting genomic variants and assigning haplotypes in order to apply prescribing recommendations and information from CPIC, FDA, PharmGKB, etc. PharmCAT (1) extracts variants specified in guidelines from a genetic dataset derived from sequencing or genotyping technologies; (2) infers haplotypes and diplotypes; and (3) generates a report containing genotype/diplotype-based annotations and guideline recommendations. We describe PharmCAT and a pilot validation project comparing results for 1000 Genomes sequences of Coriell samples with corresponding Genetic Testing Reference Materials Coordination Program (GeT-RM) sample characterization. PharmCAT was highly concordant with the GeT-RM data. PharmCAT is available in GitHub to evaluate, test and report results back to the community. As precision medicine becomes more prevalent, our ability to consistently, accurately, and clearly define and report PGx annotations and prescribing recommendations is critical. This article is protected by copyright. All rights reserved.

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Clinical Pearls in Medical Toxicology: Updates Ranging From Decontamination to Elimination.

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Such as any field of medicine, it is imperative to stay current with the latest advances and treatment modalities in toxicology. With the absence of rigorous randomized controlled trials, many updated guidelines are created by expert consensus and/or case reports and clinical experience. Over the past 10 years, there have been several changes in the management of drug overdoses in light of new data available. Although this is not a comprehensive review of all available antidotes, this article will focus on several important interventions including the use of gastrointestinal decontamination, hyperinsulinemic-euglycemic therapy, methylene blue, intravenous lipid emulsion, hemodialysis, and extracorporeal membrane oxygenation.

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Pharmacists’ Role in the Management of Acute and Recurrent Pericarditis: Inpatient and Outpatient Perspectives.

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Abstract: Pharmacists are qualified to provide valued care to patients inflicted with cardiovascular-related disorders. Although the role of pharmacists regarding the care of patients with cardiovascular disease has been previously […]

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Ambulatory Care Pharmacists’ Perception of Prediabetes.

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Abstract: Eighty-four million patients in the United States have prediabetes yet evidence-based interventions to prevent diabetes are infrequently used. The concept of prediabetes is contentious, although preventive interventions are guideline […]

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Low-Dose Alteplase for the Treatment of Submassive Pulmonary Embolism: A Case Series.

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Abstract: Pulmonary embolism (PE) can lead to significant morbidity and mortality. Thrombolytics are currently approved for the treatment of massive PE; however, the CHEST guidelines recommend against systemic thrombolytic use […]

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Racial/ethnic-specific differences in the effects of inhaled corticosteroid use on bronchodilator response in patients with asthma.

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Abstract: American Thoracic Society guidelines recommend inhaled corticosteroids (ICS) therapy, plus a short-acting bronchodilator, in patients with persistent asthma. However, few prior studies have examined the efficacy of this combination […]

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Towards a Consensus on Applying Quantitative LC-MS/MS Proteomics in Translational Pharmacology Research: A White Paper.

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Abstract: Quantitative translation of information on drug absorption, disposition, receptor engagement and drug-drug interactions from bench to bedside requires models informed by physiological parameters that link in vitro studies to […]

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