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Drug interactions with local anaesthetic preparations used by primary care dental practitioners.

UNLABELLED: A number of drug interactions that may potentially occur with local anaesthetic preparations are listed in the British National Formulary (BNF) and Summaries of Product Characteristics (SmPC). Many are theoretical or are associated with higher doses of local anaesthetic preparations than those used for dental procedures in primary care. Reports of serious interactions between medicines and local anaesthetic preparations occurring in dental practice are exceedingly rare. Practitioners can minimize the risk of interactions by using an aspirating syringe, which reduces the likelihood …

Concomitant device and drug therapy: current trends, potential benefits, and adverse interactions.

Antiarrhythmic drug therapy in patients with implantable cardioverter defibrillators (ICDs) has decreased over the last 10 years. This trend, primarily seen with class I agents, has occurred mainly in patients with a cardiac arrest. However, despite this overall decrease, antiarrhythmic drug therapy remains an important adjuvant to ICD therapy. In addition to primary prevention of ventricular tachycardia and supraventricular tachycardia, antiarrhythmic drug therapy may potentiate tachycardia rate slowing and make ventricular tachycardia more tolerated hemodynamically and possibly more amendabl

Review article: drug interactions with agents used to treat acid-related diseases.

Patients with acid-related diseases often need to take multiple medications. Treatment of Helicobacter pylori infection often includes eithe … y other diseases. Thus, it is important to understand the potential for clinically significant drug-drug interactions in this setting. H2-receptor antagonists and proton pump inhibitors can influence the pharmacokinetic profiles of other commonly administered medications by elevating intragastric pH, which can alter drug absorption, and by interacting with the cyto …

Pharmacogenetic determination of the effects of codeine and prediction of drug interactions.

To define the differences in codeine pharmacodynamics in extensive (EMs) and poor (PMs) metabolizers of debrisoquin and to determine whether the inhibition of codeine's metabolism by quinidine produces phenotypically dependent pharmacodynamic changes, we studied 16 healthy nonsmoking males, 10 EMs and 6 PMs of debrisoquin. The subjects received in random double-blind fashion 120 mg of codeine plus placebo, 120 mg of codeine plus 100 mg of quinidine and 100 mg of quinidine plus placebo. Blood was obtained over 24 hr and urine was collected for 48 hr. Respiratory, psychomotor and pupillary effec

[Main drug interactions at a hospital emergency department. Analysis of 100 cases].

We prospectively reviewed clinical charts of 100 consecutive patients that were admitted during the first trimester 1991 to the Emergency De … clinical interactions of cimetidine with other medications are analyzed. Our results indicate that drug interactions are a permanent risk in our hospitals. We suggest to use a computer program on drug interactions or an updated chart of medications in the emergency rooms of our hospitals.

Drug use survey to identify significant drug-drug interactions and assess clinical importance in the outpatient setting of a tertiary care hospital.

OBJECTIVES: Drug-drug interactions (DDIs) are a common problem in pharmacotherapy, particularly in situations where multiple disorders must be treated at the same time. We conducted a drug use survey in the general medicine outpatient department of a tertiary care hospital with the objective of assessing the potential for DDI in individual prescriptions for adult patients. MATERIALS AND METHODS: Drugs prescribed in the current physician-patient encounter were considered in conjunction with medicines already being received by the patient as well as those discontinued in the past 1 month. Free …

Mechanisms and Clinical Significance of Pharmacokinetic-Based Drug-Drug Interactions with Drugs Approved by the U.S. Food and Drug Administration in 2017.

Pharmacokinetic-based drug-drug interaction (DDI) data for drugs approved by the U.S. Food and Drug Administration in 2017 (N = 34) were analyzed using the University of Washington Drug Interaction Database. The mechanisms and clinical relevance of these interactions were characterized based on information from new drug application reviews. CYP3A inhibition and induction explained most of the observed drug interactions (new drugs as victims or as perpetrators), and transporters mediated about half of all DDIs, alone or with enzymes. Organic anion transporting polypeptide (OATP)1B1/1B3 played a…

Metabolic profile of thiopental and cytochrome P450-mediated drug interactions in rats.

1. Pentobarbital (PTB) is metabolised by cytochrome P450 (CYP) enzymes, being a model compound for evaluating CYP-mediated drug-drug interactions, has become difficult to obtain for animal studies in Japan. The metabolic pathway of thiopental (TP), a barbiturate with similar pharmacological properties, remains insufficiently characterised. This study investigated TP metabolic profile, with emphasis on CYP modulator-induced drug-drug interactions.2. TP was administered intraperitoneally to either phenobarbital (PB), chloramphenicol (CP)-pretreated, or untreated rats. Plasma TP concentrations we…

Population pharmacokinetic modeling of amisulpride drug interactions and a transporter binding analysis.

PURPOSE: The combination of amisulpride and metformin is common in schizophrenia, but their potential drug-drug interaction has been largely overlooked, despite both drugs being prototypical substrates for renal elimination and potentially subject to transport by OCT2 and MATE1. METHODS: In this study, we employed population pharmacokinetic modeling to quantify the impact of renal function and metformin on amisulpride pharmacokinetics, and complemented it with molecular docking to predict binding modes on key renal transporters, thereby exploring potential transporters mediating the interacti

Maternal gut microbiota-psychotropic drug interactions and their impact on offspring neurodevelopment.

Pregnancy is associated with a unique and dynamic gut microbiota profile that supports fetal growth and neurodevelopment. Psychotropic drug-gut microbiota interactions are documented in the general population, yet less well described in pregnant women. Research has independently linked both perinatal psychotropic exposure and alterations to the maternal gut microbiome with potential changes to offspring neurodevelopment; therefore, it is plausible that similar interactions occur during pregnancy where they may influence maternal-fetal signaling pathways relevant to brain development. The aim o

Drug-controlled CAR T cells through the regulation of cell-cell interactions.

Chimeric antigen receptor (CAR) T cell therapy is constrained by on-target, off-tumor toxicities and cellular exhaustion because of chronic antigen exposure. CARs incorporating small-molecule controlled on- and off-switches can enhance both safety and therapeutic efficacy but their design is limited by the scarcity of nonimmunogenic protein elements responsive to nonimmunosuppressive, clinically approved drugs with favorable pharmacodynamics. Here we combine rational design and library-based optimization of a protein-protein interaction (PPI) of human origin to develop venetoclax-controlled dr

TACTIC: A transfer learning framework to predict drug interactions in emerging pathogens.

Machine learning (ML) is necessary to efficiently identify potent drug combinations within a large candidate space to combat drug resistance. However, existing ML approaches cannot be applied to emerging and understudied pathogens with limited training data. Hence, we developed a computational framework (TACTIC [transfer-learning and cross-species training to infer combination therapies]) to train ML models on data from multiple model bacteria. TACTIC was built using 2,965 drug interactions from 12 bacterial strains and outperformed traditional ML models in predicting drug interaction outcomes…

Фармакомикробиомика: От взаимодействия хост-микробиома-наркотики к клиническому переводу в докторскую медицину.

Заметная межиндивидуальная изменчивость реакции на наркотики по-прежнему является серьезной проблемой в области клинической фармакологии и не может быть в полной мере объяснена только генетикой принимающей страны. Растущие данные свидетельствуют о том, что кишечная микробиота является дополнительным фактором, определяющим эффективность и токсичность наркотиков посредством двустороннего взаимодействия с фармакологической терапией. Это признание привело к появлению фармакомикробиомики - области, которая изучает, как микробные сообщества влияют на утилизацию наркотиков и реагирование на них, и ка

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Marked interindividual variability in drug response remains a major challenge in clinical pharmacology and cannot be fully explained by host … omicrobiomics into precision medicine. This review summarises current evidence regarding microbiome-drug interactions, the mechanisms underlying microbiome-mediated modulation of pharmacokinetics and pharmacodynamics, emerging therapeutic strategies, and the challenges that remain before pharmacomicrobiomics can be implemented in clinical practice.

Gut microbiota in anxiety and depression: mechanisms, drug interactions, and therapeutic implications.

Anxiety and depressive disorders constitute a public health concern with a high negative impact on patients' quality of life. These disorders are among the prevalent neuropsychiatric conditions significantly contributing to the global burden. Although the precise mechanisms underlying the development of anxiety- and depressive-like behaviors remain incompletely understood, increasing evidence indicates that these disorders arise from complex and multifactorial processes involving dysfunction across multiple body organs. The gut microbiota (GM) seem to play certain role in developing of these c

Exploring gene-drug interactions for personalized treatment of post-traumatic stress disorder.

INTRODUCTION: Post-Traumatic Stress Disorder (PTSD) is a mental disorder that can develop after experiencing traumatic events. The aim of this work is to explore the role of genes and genetic variations in the development and progression of PTSD. METHODS: Through three methodological approaches, 122 genes and 184 Single Nucleotide Polymorphisms (SNPs) associated with PTSD were compiled into a single gene repository for PTSD. Using PharmGKB and DrugTargetor, 323 drug candidates were identified to target these 122 genes. The top 17 drug candidates were selected based on the statistical signific

Use of herbal medication in the perioperative period: Potential adverse drug interactions.

Use of herbal medications and supplements has experienced immense growth over the last two decades, with retail sales in the USA exceeding $ … nesthesiologists should inquire about the use of herbal medications to anticipate potential adverse drug interactions during the perioperative period.

Modulation of engineered nanomaterial interactions with organ barriers for enhanced drug transport.

The biomedical use of nanoparticles (NPs) has been the focus of intense research for over a decade. As most NPs are explored as carriers to alter the biodistribution, pharmacokinetics and bioavailability of associated drugs, the delivery of these NPs to the tissues of interest remains an important topic. To date, the majority of NP delivery studies have used tumor models as their tool of interest, and the limitations concerning tumor targeting of systemically administered NPs have been well studied. In recent years, the focus has also shifted to other organs, each presenting their own unique d

An Update on Drug-Nutrient Interactions and Dental Decay in Older Adults.

In recent decades, the global demographic landscape has undergone a discernible shift that has been characterised by a progressive increase … e challenge of maintaining an optimal nutritional status. This scenario increases the likelihood of drug interactions, both between medications and with nutrients and the microbiome, triggering complications such as dental decay and other pathologies. Since the drug industry is evolving and new types of food, supplements, and nutrients are being designed, there is …

Population-based signals of benzodiazepine drug interactions associated with unintentional traumatic injury.

Benzodiazepine receptor agonists and related medications, such as Z-drugs and dual orexin receptor antagonists (BZDs), have been associated with unintentional traumatic injury due to their central nervous system (CNS)-depressant effects. Drug-drug interactions (DDIs) may contribute to the known relationship between BZD use and unintentional traumatic injury, yet evidence is still lacking. We conducted high-throughput pharmacoepidemiologic screening using the self-controlled case series design in a large US commercial health insurance database to identify potentially clinically relevant DDI sig…