Journal of Clinical Pharmacy and Therapeutics

Cover image for Vol. 39 Issue 1

February 2014

Volume 39, Issue 1

Pages 1–105

  1. Commentaries

    1. Top of page
    2. Commentaries
    3. Review Articles
    4. Original Articles
    5. Pharmacogenetics
    6. Pharmacokinetics
    7. Case Report
    1. You have free access to this content
      Cardiac toxicity of the echinocandins: chance or cause and effect association? (pages 1–3)

      K. R. Stover, S. T. King and J. D. Cleary

      Version of Record online: 19 NOV 2013 | DOI: 10.1111/jcpt.12108

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      The objective of this commentary is to review the cardiac toxicity of the echinocandin antifungals in light of recent evidence and published case reports. Three case reports detail cardiac decompensation following the initiation of anidulafungin and caspofungin and corroborate ex vivo laboratory results, in which rat hearts exposed to anidulafungin and caspofungin had significantly decreased cardiac contractility. Our hypothesized mechanism of toxicity of anidulafungin and caspofungin is mitochondrial toxicity. The clinical corroboration of the ex vivo work presented above highly suggests that the cardiac toxicity seen with some of the echinocandin antifungals is a cause and effect pattern, not a chance finding.

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      A modern analgesics pain ‘pyramid’ (pages 4–6)

      R. B. Raffa and J. V. Pergolizzi Jr

      Version of Record online: 19 NOV 2013 | DOI: 10.1111/jcpt.12110

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      The initial 1986 WHO analgesics guidance ‘ladder’ was set forth in 1986. We suggest that more modern best practice is an analgesic ‘pyramid’. This update reflects advances made in understanding the (patho)physiology of pain, provides clinical flexibility and a patient-individualized care strategy to achieve better pain management.

  2. Review Articles

    1. Top of page
    2. Commentaries
    3. Review Articles
    4. Original Articles
    5. Pharmacogenetics
    6. Pharmacokinetics
    7. Case Report
    1. You have free access to this content
      The cardiovascular effects of glucagon-like peptide-1 receptor agonists: a trial sequential analysis of randomized controlled trials (pages 7–13)

      S. Wu, F. Sun, Y. Zhang, Z. Yang, T. Hong, Y. Chen and S. Zhan

      Version of Record online: 16 OCT 2013 | DOI: 10.1111/jcpt.12102

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      The purpose of this study is to systematically assess the robustness of the available evidence on the adverse cardiovascular effects of GLP-1 receptor agonists in patients with type 2 diabetes. Randomized controlled trials (RCTs) were selected if they compared GLP-1 receptor agonists with placebo or other drugs with a duration ≥12 weeks. Mantel–Haenszel odds ratio (MH-OR) of cardiovascular events with 95% confidence interval (CI) was estimated using a random effects model. Overall, the OR for cardiovascular events with GLP-1 receptor agonists was 0·52 (95% CI: 0·27–0·99) compared with placebo and 0·84 (95% CI: 0·52–1·36) with active controls. GLP-1 receptor agonists do not seem to show any increased risk of cardiovascular events. However, the available data from RCTs remain insufficient to confirm an absence of detrimental effect. More long-term trials and population-based studies are required to provide the necessary reassurance on the cardiovascular safety of GLP-1 receptor agonists.

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      Efficacy and safety of telaprevir and boceprevir in patients with hepatitis C genotype 1: a meta-analysis (pages 14–24)

      C. Park, S. Jiang and K. A. Lawson

      Version of Record online: 16 NOV 2013 | DOI: 10.1111/jcpt.12106

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      A total of 4421 patients from ten evaluated articles were included in the meta-analysis. This figure summarizes the effects of triple therapy (telaprevir or boceprevir + peg-interferon+ribavirin) on sustained virologic response (SVR) when compared with dual therapy (peg-interferon+ribavirin). Overall, triple therapy was significantly associated with a higher achievement of SVR than dual therapy, regardless of NS3/4A protease inhibitors (PIs) type and patients' treatment experience: (i) telaprevir-based triple therapy in treatment-naïve patients [relative risk (RR) = 1.62; 95% CI, 1.47–1.78; I2 = 0%]; (ii) telaprevir-based triple therapy in treatment-experienced patients (RR = 3.85; 95% CI, 3.03–4.90; I2 = 0%); (iii) boceprevir-based triple therapy in treatment-naïve patients (RR = 1.70; 95% CI, 1.56–1.86; I2 = 0%); and (iv) boceprevir-based triple therapy in treatment-experienced patients (RR = 2.98; 95% CI, 2.29–3.87; I2 = 0%).

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      Potential novel targets for Alzheimer pharmacotherapy: II. Update on secretase inhibitors and related approaches (pages 25–37)

      J. A. Mikulca, V. Nguyen, D. A. Gajdosik, S. G. Teklu, E. A. Giunta, E. A. Lessa, C. H. Tran, E. C. Terak and R. B. Raffa

      Version of Record online: 8 DEC 2013 | DOI: 10.1111/jcpt.12112

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      Since Aβ is formed from the sequential splicing of amyloid precursor protein catalyzed by ‘secretase’ enzymes, clinical trials of secretase inhibitors will either result in beneficial pharmacotherapy or, if negative, cast doubt on the role of Aβ in AD.

  3. Original Articles

    1. Top of page
    2. Commentaries
    3. Review Articles
    4. Original Articles
    5. Pharmacogenetics
    6. Pharmacokinetics
    7. Case Report
    1. Risk of death associated with the use of conventional vs. atypical antipsychotic medications: evaluating the use of the Emilia-Romagna Region database for pharmacoepidemiological studies (pages 38–44)

      S. Sikirica, M. Marino, J. J. Gagne, R. De Palma and V. Maio

      Version of Record online: 16 SEP 2013 | DOI: 10.1111/jcpt.12099

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      The present study sought to explore the feasibility of using the Emilia-Romagna region (RER) database for comparative safety analyses by replicating and refining risk estimates of this well-known drug safety example through meta-analysis. We compared 180-day mortality using Cox proportional hazards models adjusted for risk factors for death, use of other medications, and measures of health services utilization intensity, all measured before antipsychotic initiation. We conducted a meta-analysis of studies with similar methods against which to compare our results. Our results support the use of the RER database for pharmacoepidemiology studies and provide an up-to-date and pooled estimate of the magnitude of the association between mortality and conventional versus atypical antipsychotics.

    2. Comparing patient dissatisfaction and rational judgment in intentional medication non-adherence versus unintentional non-adherence (pages 45–52)

      N. Iihara, T. Nishio, M. Okura, H. Anzai, M. Kagawa, H. Houchi and Y. Kirino

      Version of Record online: 25 SEP 2013 | DOI: 10.1111/jcpt.12100

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      Among both hospitalized patients and online survey respondents, intentionally non-adherent patients demonstrated significantly higher mean Dissatisfaction scores than adherent patients. Compared to the adherent group of participants in the online survey, the mean differential scores for Willingness-Dissatisfaction and Willingness-Barrier were significantly lower in the intentional non-adherent group.

    3. Analysis of patients' narratives posted on social media websites on benfluorex's (Mediator®) withdrawal in France (pages 53–55)

      M. Abou Taam, C. Rossard, L. Cantaloube, N. Bouscaren, G. Roche, L. Pochard, F. Montastruc, A. Herxheimer, J. L. Montastruc and H. Bagheri

      Version of Record online: 21 OCT 2013 | DOI: 10.1111/jcpt.12103

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      The drastic changes occurred mainly following media coverage, 1 year after the drug's withdrawal. The most requests of consumer concerned the efficacy before the withdrawal of Mediator® and its ADRs after the withdrawal and media coverage.

    4. A practical approach to minimize the interaction of dietary vitamin K with warfarin (pages 56–60)

      C.-H. Chang, Y.-W. Wang, P.-Y. Yeh Liu and Y.-H. Kao Yang

      Version of Record online: 28 OCT 2013 | DOI: 10.1111/jcpt.12104

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      Twenty-three vitamin K-rich vegetables commonly seen in Taiwanese meals were identified and classified into seven score grades according to their relative vitamin K content per serving. The scores were based on published vitamin K content of different foods. The vitamin K score was equivalent to 5 points for spinach and garland chrysanthemum per bowel. We suggest a novel approach to patient counseling on warfarin to maintain consistent dietary vitamin K intake and achieve a more stable anticoagulation response. A prospective randomized controlled trial to validate this pragmatic approach would be useful.

    5. Onset time of hyperkalaemia after angiotensin receptor blocker initiation: when should we start serum potassium monitoring? (pages 61–68)

      I.-W. Park, S. S. Sheen, D. Yoon, S.-H. Lee, G.-T. Shin, H. Kim and R. W. Park

      Version of Record online: 22 NOV 2013 | DOI: 10.1111/jcpt.12109

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      The present study was performed to examine the onset time of hyperkalemia after angiotensin receptor blockers (ARBs) therapy. We carried out a retrospective analysis to determine the onset time of hyperkalemia (serum potassium >5·5 mm) among hospitalized patients newly starting ARB therapy between 2004 and 2012, in a tertiary teaching hospital. Predefined possible risk factors and concomitant medications were evaluated. The highest frequency of hyperkalemia occurred on the first day after initiation of ARBs. Hyperkalemia occurred earlier in patients with a high baseline serum potassium level, reduced GFR, diabetes, and in those without heart failure. Monitoring of serum potassium and estimated GFR after initiation of ARBs should be started within a few days or not later than 1 week, especially in patients with risk factors.

    6. Clopidogrel cessation triggers aspirin rebound in patients with coronary stent (pages 69–72)

      N. Djukanovic, Z. Todorovic, S. Obradovic, S. Njegomirovic, D. Zamaklar-Trifunovic, D. Protić and M. Ostojic

      Version of Record online: 29 NOV 2013 | DOI: 10.1111/jcpt.12111

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      Recent studies indicate that even discontinuation of long-term use of clopidogrel may be associated with multiple adverse outcomes, i.e. rebound phenomenon whose mechanism is not definitely clear. The aim of the study was to examine the effect of clopidogrel withdrawal in those on combined aspirin and clopidogrel therapy. Our findings show that cessation of clopidogrel causes loss of antiplatelet synergism with aspirin, leading to a weakening of the response to aspirin, which may be one explanation for the rebound after the clopidogrel cessation.

    7. Baking soda misuse as a home remedy: case experience of the California Poison Control System (pages 73–77)

      S. A. Al-Abri and T. Kearney

      Version of Record online: 8 DEC 2013 | DOI: 10.1111/jcpt.12113

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      Characterizing the patterns and outcomes from the misuse of baking soda as a home remedy can guide the clinical assessment and preventative counseling of patients at risk for use of this product. Those patients at highest risk of toxicity may include: chronic use as an antacid, method to ‘beat’ urine drug screens, pregnancy, and young children. Self-treatment with baking soda as a home remedy may also mask or delay medical care thereby complicating or exacerbating an existing medical problem. We suggest that healthcare providers counsel high risk patients about the potential complications of misuse of baking soda as a home remedy.

    8. Evidence of frequent dosing errors in paediatrics and intervention to reduce such prescribing errors (pages 78–83)

      R. Bolt, J. M. Yates, J. Mahon and I. Bakri

      Version of Record online: 3 JAN 2014 | DOI: 10.1111/jcpt.12114

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      The objective was to determine the degree of error seen in paediatric drug prescribing for patients admitted under the care of oral and maxillofacial surgery and to explore practical and accessible methods through which error can be reduced. The study also examined the distribution and variability of weight-adjusted dose prescribing in an attempt to set targets for auditing improvements following the implementation of changes. Our study demonstrates a clear bias towards under-prescribing weight-adjusted doses which may be contributing to reduced efficacy of analgesia, among other drugs. Simple methods can be implemented on a specialty basis to improve the accuracy of both drug chart completion and weight-adjusted dosing.

    9. An improved dosage regimen of sertraline hydrochloride in the treatment for premature ejaculation: an 8-week, single-blind, randomized controlled study followed by a 4-week, open-label extension study (pages 84–90)

      G. Xu, H.-W. Jiang, J. Fang, H. Wen, B. Gu, J. Liu, L.-M. Zhang, Q. Ding and Y.-F. Zhang

      Version of Record online: 9 DEC 2013 | DOI: 10.1111/jcpt.12115

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      The study is aimed at evaluating the safety and efficacy of an improved dosage regimen of sertraline in patients with premature ejaculation (PE) and to examine whether the Premature Ejaculation Diagnostic Tool (PEDT) can be used as a measure of treatment response in these patients. Main outcome measures include intravaginal ejaculatory latency time (IELT), PEDT score and Clinical Global Impression of Change (CGIC) score. The findings suggest that PE patients not responding to an 8-week treatment with sertraline 50 mg can benefit from an additional 4-week treatment with sertraline 100 mg and that the PEDT may be a valid measure of treatment response in PE patients.

  4. Pharmacogenetics

    1. Top of page
    2. Commentaries
    3. Review Articles
    4. Original Articles
    5. Pharmacogenetics
    6. Pharmacokinetics
    7. Case Report
  5. Pharmacokinetics

    1. Top of page
    2. Commentaries
    3. Review Articles
    4. Original Articles
    5. Pharmacogenetics
    6. Pharmacokinetics
    7. Case Report
    1. The pharmacokinetics and safety profiles of belimumab after single subcutaneous and intravenous doses in healthy Japanese volunteers (pages 97–101)

      Y. Shida, N. Takahashi, T. Sakamoto, H. Ino, A. Endo and T. Hirama

      Version of Record online: 5 OCT 2013 | DOI: 10.1111/jcpt.12101

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      Each subject received a single intravenous infusion or a subcutaneous injection of 200 mg belimumab. The pharmacokinetic parameters and safety parameters including local tolerance (injection site), biomarkers, immunogenicity and adverse events were evaluated up to 70 days post dosing. After a single intravenous or a subcutaneous administration of 200 mg belimumab, all 16 subjects completed the study. There were no serious adverse events or adverse events related to injection site reactions. A favorable absolute bioavailability in healthy Japanese subjects was seen following a subcutaneous injection of 200 mg belimumab. Considerating the inter-subject variability, exposures were consistent with those previously observed in healthy non-Japanese subjects. Safety and biomarker data were also consistent with previous non-Japanese clinical studies.

  6. Case Report

    1. Top of page
    2. Commentaries
    3. Review Articles
    4. Original Articles
    5. Pharmacogenetics
    6. Pharmacokinetics
    7. Case Report
    1. Simultaneous manifestation of pleural effusion and acute renal failure associated with dasatinib: a case report (pages 102–105)

      G. Kaiafa, N. Kakaletsis, C. Savopoulos, V. Perifanis, A. Giannouli, N. Papadopoulos, S. Zisekas and A.I. Hatzitolios

      Version of Record online: 5 NOV 2013 | DOI: 10.1111/jcpt.12107

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      Dasatinib is a novel second-generation inhibitor of multiple tyrosine kinases, indicated for the treatment of Philadelphia chromosome-positive (Ph+) chronic myeloid leukaemia (CML), acute lymphoblastic leukaemia (ALL) and lymphoid blast CML with resistance or intolerance to prior therapy. We report the first case of a patient with imatinib-resistant CML who developed PE and acute renal failure (ARF) simultaneously, after being placed on dasatinib therapy. In conclusion, here we describe the first case of simultaneous manifestation of PE and ARF associated with dasatinib. Thus, in patients treated with tyrosine kinase inhibitors, especially those with predisposing nephrological or haematological factors, serum creatinine levels should be monitored routinely.

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