The latest medical research on Clinical Pharmacology

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about clinical pharmacology gathered by our medical AI research bot.

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A nonhuman primate model of human non-suicidal self-injury: serotonin-transporter genotype-mediated typologies.

Neuropsychopharmacology

While non-suicidal self-injury (NSSI) occurs in the general population at a surprisingly high rate, with higher rates among certain clinical  popul...

The integral role of the clinical pharmacist in drug-assisted intubation at a newly established children's major trauma center.

International Journal of Epidemiology

This commentary outlines how the clinical pharmacist can support the safe administration of emergency medications in trauma anesthesia for seriousl...

Multidisciplinary telephone conferences about medication therapy after discharge of older inpatients: a feasibility study.

International Journal of Epidemiology

Background Studies have shown poor post-discharge implementation by the general practitioner of changes made to patients' medication during admissi...

Evaluation of Anti-Xa Apixaban and Rivaroxaban Levels With Respect to Known Doses in Relation to Major Bleeding Events.

Journal of Pharmacy and Pharmacology

Although not routinely recommended, anti-Xa level monitoring for apixaban or rivaroxaban may be useful in certain clinical scenarios. There are currently no laboratory standards, therapeutic ranges, or proven correlation between anti-Xa levels and clinical outcomes.

This study describes the utilization, application, and association of anti-Xa levels with clinical outcomes in patients receiving apixaban or rivaroxaban.

This retrospective, descriptive study included adult inpatients within the Houston Methodist System on apixaban or rivaroxaban with at least one anti-Xa level ordered subsequent to administered doses. The primary endpoint was major bleeding according to International Society on Thrombosis and Haemostasis criteria. Secondary endpoints included reasons for anti-Xa level ordering, anti-Xa levels at different time intervals post-dose, and thrombotic events. Pre-specified subgroup analyses were performed to further evaluate the primary endpoint.

The study population consisted of 169 patients and 234 anti-Xa levels. Twenty-nine levels were obtained in context of major bleeding. The majority of levels were not drawn as peak levels 2-4 hours post-dose, however remained quantifiable above typical observed levels within this timeframe and well beyond 24 hours post-dose. Patient characteristics with major bleeding included elderly age, acute renal impairment, and low body weight. At least 14 unique reasons for anti-Xa level ordering were identified. Twenty-nine levels were associated with thrombotic events.

Anti-Xa levels may be useful for assessment of current drug concentrations, immediate safety of therapy, and guidance for possible clinical interventions. Dose titration and reversal therapies based on anti-Xa level results in major bleeding warrant further research.

Review of COVID-19 mRNA Vaccines: BNT162b2 and mRNA-1273.

Journal of Pharmacy and Pharmacology

The United States Food and Drug Administration recently issued emergency use authorization for 2 mRNA vaccines for preventing COVID-19 disease caus...

Evaluation of a Pharmacist-Led Diabetes Collaborative Drug Therapy Management Service.

Journal of Pharmacy and Pharmacology

To evaluate the pharmacist-led diabetes collaborative drug therapy management services in a family medicine and internal medicine clinic.

Mixed methods of evaluation based on the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.

Reach: 71.3% of patients who were independently consulted (n = 184/258) and 1.6% (n = 11/680) of patients who triggered a best practice advisory (BPA) were enrolled. Effectiveness: 27.7% of patients (n = 54/195) enrolled were lost to follow-up. Adoption: 55% of eligible providers (n = 77/140) have placed a consult. Implementation: Providers independently choose to refer patients and are also prompted to place consults by a BPA that triggers for patients with an HbA1c ≥ 9%. Common reasons providers did not place a consult include: alignment with workflow, patient refusal, and patients followed by other services. Regarding patient perceptions, patients valued the service. Patients reported increased accountability with disease state maintenance and increased self-efficacy. Regarding how to improve the service, patients wanted more information on expectations before engaging with the pharmacist. Patients suggested to replicate this service for pain, cancer, and blood pressure management. Maintenance: 96.7% of providers (n = 30/31) reported they were very likely/likely to place a consult in the future and 60% of providers (n = 18/30) reported they were very likely/likely to place a consult when prompted by the BPA.

These results can be utilized to make improvements to the pharmacist-led diabetes collaborative drug therapy management service to ensure sustainability. This study also provides lessons learned and strategies for future adoption, implementation, and maintenance of similar services for other disease states.

Treatment modification after second-line failure among people living with HIV in the Asia-Pacific.

Antiviral Therapy

The World Health Organisation recommends continuation with the failing second-line regimen if third-line option is not available. We investigated treatment outcomes among people living with HIV in Asia who continued with failing second-line regimens compared to those who had treatment modifications after failure.

Treatment modification was defined as a change of two antiretrovirals, a drug class change, or treatment interruption (TI), all for >14 days. We assessed factors associated with CD4 changes and undetectable viral load (UVL <1000 copies/mL) at one year after second-line failure using linear and logistic regression, respectively. Survival time was analysed using competing risk regression.

Of the 328 patients who failed second-line ART in our cohorts, 208 (63%) had a subsequent treatment modification. Compared to those who continued the failing regimen, the average CD4 cell increase was higher in patients who had a modification without TI (difference=77.5, 95%CI 35.3-119.7) while no difference was observed among those with TI (difference=-5.3, 95%CI -67.3-56.8). Compared to those who continued the failing regimen, the odds of achieving UVL was lower in patients with TI (OR=0.18, 95%CI 0.06-0.60) and similar among those who had a modification without TI (OR=1.97, 95%CI 0.95-4.10), with proportions of UVL 60%, 22% and 75%, respectively. Survival time was not affected by treatment modifications.

CD4 cell improvements were observed in those who had treatment modification without TI compared to those on the failing regimen. When no other options are available, maintaining the same failing ART combination provided better VL control than interrupting treatment.

Dysregulation of threat neurociruitry during fear extinction: the role of anhedonia.

Neuropsychopharmacology

Dimensional models of anxiety and depression highlight common and distinct symptom clusters that are thought to reflect disruptions in underlying f...

Economic choice between remifentanil and food in squirrel monkeys.

Neuropsychopharmacology

Traditional approaches for evaluating if compounds are reinforcing, and thus a risk for abuse, include preclinical self-administration procedures c...

The association of matrix metalloproteinase 9 (MMP9) with hippocampal volume in schizophrenia: a preliminary MRI study.

Neuropsychopharmacology

Matrix metalloproteinases 9 (MMP9) are enzymes involved in regulating neuroplasticity in the hippocampus. This, combined with evidence for disrupte...

Psychotropic medicine beliefs, side effects and adherence in schizophrenia: a patient-caregiver dyad perspective.

International Journal of Epidemiology

Background Medication adherence is essential in the management of schizophrenia. Yet poor treatment uptake has negative consequences on patients an...