Abstract:
BACKGROUND AND OBJECTIVE:Enteric-coated, delayed-release divalproex sodium requires multiple daily administrations and high adherence rate to prevent breakthrough seizures and control adverse effects. We evaluated the effect of missing one or two doses of divalproex for up to 24 h, followed by replacement and resumption of scheduled therapy, on plasma valproic acid (VPA) concentrations. METHODS:Comprehensive simulations using well-established VPA pharmacokinetic parameters were performed for two distinct populations on every-12-h divalproex therapy: monotherapy patients and polytherapy patients on hepatic enzyme-inducing antiepileptics. RESULTS:In polytherapy patients on c. 32.1 mg/kg/day, steady-state (no missed doses) mean VPA minimum (C(min)) and maximum (C(max)) concentrations were 67 and 98 mg/L, respectively. When dose(s) were missed for 12, 18 and 24 h, mean C(min) fell to 37, 28 and 20 mg/L, respectively, below the threshold 50 mg/L VPA concentration generally required to maintain efficacy. Replacing, then resuming the next regularly scheduled divalproex dose increased mean C(max) to 113, 117 and 129 mg/L upon replacement at 12, 18 and 24 h, respectively; a mean increment of 31 mg/L for replacement at 24 h. Less pronounced changes in VPA concentrations occurred in monotherapy patients (enzyme-uninduced) on approximately 16.1 mg/kg/day. CONCLUSIONS:These simulations predict that the risk of high VPA concentrations which may lead to clinical toxicity is low for patients not concurrently taking enzyme-inducing antiepileptic drugs (uninduced), even when divalproex doses are replaced at 24 h(effectively tripling the dose at that time). However, the same action in induced patients may result in drug levels leading to transient clinical toxicity; the optimal regimen for replacing a missed enteric-coated divalproex dose beyond 12 h remains to be determined.
journal_name
J Clin Pharm Therjournal_title
Journal of clinical pharmacy and therapeuticsauthors
Dutta S,Reed RCdoi
10.1111/j.1365-2710.2006.00739.xsubject
Has Abstractpub_date
2006-08-01 00:00:00pages
321-9issue
4eissn
0269-4727issn
1365-2710pii
JCP739journal_volume
31pub_type
杂志文章abstract:WHAT IS KNOWN AND OBJECTIVE:Every prescriber knows that patients often do not take their medicines as prescribed. Hippocrates, the wise man of Kos, knew over two millennia ago. Our objective is to comment on the types of studies aimed at understanding and optimizing drug usage and to draw attention to the need to seek ...
journal_title:Journal of clinical pharmacy and therapeutics
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pub_type: 杂志文章,多中心研究
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journal_title:Journal of clinical pharmacy and therapeutics
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abstract:WHAT IS KNOWN AND OBJECTIVE:There is increasing evidence that epigenetics plays a major role in the pathogenesis of the idiopathic mental disorders. This article comments on the role of epigenetics in the pharmacotherapy, psychotherapy and nutritional management of these disorders. COMMENT:There are two classes of epi...
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abstract:WHAT IS KNOWN AND OBJECTIVE:Pain management for complex regional pain syndrome (CRPS) is challenging. When added to local anaesthetics, dexmedetomidine prolongs the duration of the block and improves analgesia. The effect of long-term dexmedetomidine use in the brachial plexus block (BPB) for CRPS is unknown. CASE DES...
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pub_type: 杂志文章,meta分析,评审
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journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.1994.tb00697.x
更新日期:1994-12-01 00:00:00
abstract::Enalapril was shown to have no effect on the serum potassium of patients (n = 16) already taking Frusemide and Amiloride. Furthermore, there was no difference in serum potassium levels of the group taking a combination of Enalapril, Frusemide and Amiloride when compared to a similar group of patients taking Frusemide ...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.1987.tb00543.x
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abstract:WHAT IS KNOWN AND OBJECTIVES:Little is known about the ability of community pharmacists who are inexperienced in medication review to identify drug-related problems (DRPs). The objective of our study was to investigate the completeness of DRPs in terms of number, type and clinical relevance identified by community phar...
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pub_type: 杂志文章,随机对照试验
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更新日期:2014-06-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Clinical pharmacokinetic profiles of clarithromycin and telithromycin in bronchopulmonary sites have not been fully characterized. This study aimed to describe in more detail the pharmacokinetics of the two macrolides in epithelial lining fluid (ELF) of human bronchi and to evaluate their ph...
journal_title:Journal of clinical pharmacy and therapeutics
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更新日期:2014-08-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Imatinib is a specific BCR/ABL inhibitor, commonly used for the treatment of chronic myeloid leukaemia (CML), a hematological malignancy resulting from a chromosomal translocation that generates the BCR/ABL fusion protein. Recent studies showed that the imatinib has cytotoxic and apoptotic e...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2010.01224.x
更新日期:2011-12-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Obsessive-compulsive disorder (OCD) is a chronic neuropsychiatric disorder. Selective serotonin reuptake inhibitors (SSRIs) are the first line of medication for OCD treatment; however, 40%-60% of patients with OCD do not respond to SSRIs adequately. There are growing pieces of evidence which...
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pub_type: 杂志文章
doi:10.1111/jcpt.12766
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:A pain relief score 50% of the maximum is often used as a clinically meaningful outcome in meta-analyses of analgesic trials. This arbitrary value requires validation. OBJECTIVE:To determine the optimum pain relief score for predicting pain relief sufficient to obviate the need for analgesic remedication in...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,meta分析
doi:10.1111/j.1365-2710.2006.00719.x
更新日期:2006-04-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity and mortality, and frequent exacerbations are associated with an increased risk of death, deterioration in lung function and reduced quality of life. Current Australian guidelines developed by the Lung Foun...
journal_title:Journal of clinical pharmacy and therapeutics
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更新日期:2019-02-01 00:00:00
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pub_type:
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doi:10.1111/j.1365-2710.2007.00833.x
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abstract:WHAT IS KNOWN AND OBJECTIVE:Pulmonary sarcomatoid carcinoma (PSC) is characterized by dismal prognosis and resistance to platinum-based chemotherapy. The immune checkpoint inhibitors showed promising efficacy in the treatment of PSC. Camrelizumab is a programmed cell death protein 1 inhibitor; however, current evidence...
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journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.1991.tb00306.x
更新日期:1991-06-01 00:00:00
abstract::Caffeine elimination was studied in 73 patients admitted to an intensive care unit, 33 of whom had liver disease. Mean plasma clearance of caffeine in patients with no liver disease (1.30 +/- 0.79 ml/kg/min) was significantly higher than in patients with liver disease (0.39 +/- 0.23 ml/kg/min). Mean half-life of caffe...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 临床试验,杂志文章
doi:10.1111/j.1365-2710.1995.tb00621.x
更新日期:1995-02-01 00:00:00
abstract:PURPOSE:Empirical use of intravenous (IV) itraconazole (ITZ) for febrile neutropenic patients has recently been introduced in Korea. This study was designed to investigate the population pharmacokinetics (PK) of IV-ITZ. METHODS:Sparse PK data were collected from febrile neutropenic patients undergoing empirical ITZ th...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2008.00999.x
更新日期:2009-06-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Long non-coding RNAs (lncRNAs) have been proved to regulate. LncRNA TUG1 is well characterized in cancer biology. This study was carried out to investigate the molecular function of lncRNA TUG1 in myocardial infarction. METHODS:This study enrolled 58 MI patients and 52 healthy volunteers, a...
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更新日期:2020-12-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Two NS3/4A protease inhibitors (PIs), telaprevir and boceprevir, were recently approved in the United States. The primary objective was to compare the efficacy and safety of triple therapies including either PI to dual therapy in patients with chronic hepatitis C genotype 1; the secondary ob...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,meta分析,评审
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更新日期:2014-02-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Admixtures of levobupivacaine, fentanyl and epinephrine are increasingly used in epidural pain management. Neither the compatibility nor the stability of levobupivacaine with fentanyl and epinephrine is known and therefore we examined the chemical, physical and microbiological stability of l...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12035
更新日期:2013-04-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Mebendazole (MBZ) is a broad-spectrum antihelminthic agent of the benzimidazole type. Although MBZ has been reported to cause hepatic injury, case reports of severe hepatic injury are very rare. We report a case of severe hepatitis after administration of MBZ in a patient with Gilbert's synd...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type:
doi:10.1111/jcpt.13033
更新日期:2019-12-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Although the risk of major bleeding with non-vitamin K antagonist oral anticoagulant (NOAC) is low, life-threatening bleeding can occur. CASE SUMMARY:We report a case of an 81-year-old female with deep vein thrombosis who developed bilateral spontaneous haemothorax and haemopericardium afte...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type:
doi:10.1111/jcpt.13116
更新日期:2020-10-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVES:Subjects of different ethnic groups may respond differently to drugs. The present study was conducted to compare the oral pharmacokinetics of midazolam among healthy volunteers from five different ethnic groups in China: Han, Mongolian, Uygur, Hui and Korean. METHODS:Healthy volunteers (10...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 临床试验,杂志文章
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更新日期:2011-06-01 00:00:00