• Title/Summary/Keyword: drug interactions

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Physiologically-based pharmacokinetic predictions of intestinal BCRP-mediated drug interactions of rosuvastatin in Koreans

  • Bae, Soo Hyeon;Park, Wan-Su;Han, Seunghoon;Park, Gab-jin;Lee, Jongtae;Hong, Taegon;Jeon, Sangil;Yim, Dong-Seok
    • The Korean Journal of Physiology and Pharmacology
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    • v.22 no.3
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    • pp.321-329
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    • 2018
  • It was recently reported that the $C_{max}$ and AUC of rosuvastatin increases when it is coadministered with telmisartan and cyclosporine. Rosuvastatin is known to be a substrate of OATP1B1, OATP1B3, NTCP, and BCRP transporters. The aim of this study was to explore the mechanism of the interactions between rosuvastatin and two perpetrators, telmisartan and cyclosporine. Published (cyclosporine) or newly developed (telmisartan) PBPK models were used to this end. The rosuvastatin model in Simcyp (version 15)'s drug library was modified to reflect racial differences in rosuvastatin exposure. In the telmisartan-rosuvastatin case, simulated rosuvastatin $C_{maxI}/C_{max}$ and $AUC_I/AUC$ (with/without telmisartan) ratios were 1.92 and 1.14, respectively, and the $T_{max}$ changed from 3.35 h to 1.40 h with coadministration of telmisartan, which were consistent with the aforementioned report ($C_{maxI}/C_{max}$: 2.01, $AUC_I/AUC$:1.18, $T_{max}:5h{\rightarrow}0.75h$). In the next case of cyclosporine-rosuvastatin, the simulated rosuvastatin $C_{maxI}/C_{max}$ and $AUC_I/AUC$ (with/without cyclosporine) ratios were 3.29 and 1.30, respectively. The decrease in the $CL_{int,BCRP,intestine}$ of rosuvastatin by telmisartan and cyclosporine in the PBPK model was pivotal to reproducing this finding in Simcyp. Our PBPK model demonstrated that the major causes of increase in rosuvastatin exposure are mediated by intestinal BCRP (rosuvastatin-telmisartan interaction) or by both of BCRP and OATP1B1/3 (rosuvastatin-cyclosporine interaction).

Computational Evaluation on the Interactions of an Opaque-Phase ABC Transporter Associated with Fluconazole Resistance in Candida albicans, by the Psidium guajava Bio-Active Compounds

  • Mithil Vora;Smiline Girija Aseervatham Selvi;Shoba Gunasekaran;Vijayashree Priyadharsini Jayaseelan
    • Journal of Pharmacopuncture
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    • v.27 no.2
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    • pp.91-100
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    • 2024
  • Objectives: Candida albicans is an opportunistic pathogen that occurs as harmless commensals in the intestine, urogenital tract, and skin. It has been influenced by a variety of host conditions and has now evolved as a resistant strain. The aim of this study was thus detect the fluconazole resistant C. albicans from the root caries specimens and to computationally evaluate the interactions of an opaque-phase ABC transporter protein with the Psidium guajava bio-active compounds. Methods: 20 carious scrapings were collected from patients with root caries and processed for the isolation of C. albicans and was screened for fluconazole resistance. Genomic DNA was extracted and molecular characterization of Cdrp1 and Cdrp2 was done by PCR amplification. P. guajava methanolic extract was checked for the antifungal efficacy against the resistant strain of C. albicans. Further in-silico docking involves retrieval of ABC transporter protein and ligand optimization, molinspiration assessment on drug likeness, docking simulations and visualizations. Results: 65% of the samples showed the presence of C.albicans and 2 strains were fluconazole resistant. Crude methanolic extract of P. guajava was found to be promising against the fluconazole resistant strains of C. albicans. In-silico docking analysis showed that Myricetin was a promising candidate with a high docking score and other drug ligand interaction scores. Conclusion: The current study emphasizes that bioactive compounds from Psidium guajava to be a promising candidate for treating candidiasis in fluconazole resistant strains of C. albicans However, further in-vivo studies have to be implemented for the experimental validation of the same in improving the oral health and hygiene.

PET-Based Molecular Nuclear Neuro-Imaging

  • Kim, Jong-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.2
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    • pp.161-170
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    • 2004
  • Molecular Nuclear Neuro-Imaging in "CNS" drug discovery and development tan be divided into four categories that are clearly inter-related.(1) Neuroreceptor mapping to examine the involvement of specific neurotransmitter system in CNS diseases, drug occupancy characteristics and perhaps examine mechanisms of action;(2) Structural and spectroscopic imaging to examine morphological changes and their consequences;(3) Metabolic mapping to provide evidence of central activity and "CNS fingerprinting" the neuroanatomy of drug effects;(4) Functional mapping to examing disease-drug interactions. In addition, targeted delivery of therapeutic agents could be achieved by modifying stem cells to release specific drugs at the site of transplantation('stem cell pharmacology'). Future exploitation of stem cell biology, including enhanced release of therapeutic factors through genetic stem cell engineering, might thus constitute promising pharmaceutical approaches to treating diseases of the nervous system. With continued improvements in instrumentation, identification of better imaging probes by innovative chemistry, molecular nuclear neuro-imaging promise to play increasingly important roles in disease diagnosis and therapy.

Rivaroxaban in Patients Undergoing Hip Arthroplasty in Korean Patients: Implications in Clinical Practice (고관절치환술 후의 Rivaroxaban의 국내임상적용)

  • Liu, Yu Li;La, Hyen O;Rhie, Sandy Jeong
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.1
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    • pp.1-8
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    • 2014
  • Objective: Currently, rivaroxaban is widely used clinically for thromboprophylaxis after surgery. However, there are concerns on effectiveness and safety of rivaroxaban for its proper use. We aimed to evaluate the effectiveness and safety of rivaroxaban in orthopaedic patients after total hip replacement surgery in a large medical centre after the preferred formulary was switched from enoxaparin to rivaroxaban. Methods: The study was conducted on the patients who underwent hip arthroplasty surgery at the department of Orthopaedic Surgery at Seoul St. Mary's Hospital, South Korea. Electronic medical records were retrospectively reviewed to identify patients treated with rivaroxaban following total hip replacement between February 2011 and March 2012. Evaluation criteria included indications for use, dose, initiation and duration of therapy, drug interactions, adverse reactions, and status of health care reimbursement. The patients who were on enoxaparin were also reviewed as a reference. Results: We identified 57 patients who received rivaroxaban and 50 who received enoxaparin. All patients were prescribed the drugs for Korean Food and Drug Administration-approved indications. No thromboembolic or bleeding events were observed in either group. However, only 5.3% of rivaroxaban- treated patients had an appropriate length of prophylaxis and only 3.5% began rivaroxaban treatment at the recommended time. Surprisingly, 47.4% of rivaroxaban-treated patients received rivaroxaban despite being ineligible for reimbursement benefits. Conclusion: Rivaroxaban was generally well tolerated clinically. However, the duration of treatment, the time of initiation and patient eligibility for reimbursement require improvements, emphasising the need for education which indicates the area of pharmacists' involvement.

Current Status of Herb-Drug Interaction Information and Information Database in Korea (국내 한약-양약 상호작용 연구논문 분석을 통한 상호작용 정보 현황파악 및 제공방안에 대한 연구)

  • Park, Soo-Jin;Kwon, Young-Kyu;Shin, Jae-Gook
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.4
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    • pp.543-552
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    • 2010
  • The objectives of this study are to examine the current status and problems of herb-drug interaction (HDI) information and information database in Korea and suggest the better way to establish useful HDI database. We collected HDI studies that published in Korea and analyzed according to objective, methods, selection criteria of herbs, number of study, correlation between study subject and frequently used herbal medicine (HM). Then we selected representative HM database on the internet made by Korea Food and Drug Administration (KFDA) among the several databases and analyzed its contents related to HDI. Several HDI studies were carried out from laboratory based research to clinical trials and HM databases have been developed for providing information about different aspects of traditional Korean medicine. But the information of HDI and information database are still far from practical applications because there are no coherence to select study subjects and methods among researchers. So, it is necessary to build up HDI database led by the government for providing systematic HDI information. HDI information database is expected to be able to provide useful evidence for health professionals in prescription and consultation to reduce the chance of adverse effects and improve the quality of medical care.

In vitro Assessment of Cytochrome P450 Inhibition by Red Ginseng Ginsenosides (홍삼 Ginsenoside의 Cytochrome P450 저해 활성 평가)

  • Ryu, Chang Seon;Shin, Jang Hyun;Shin, Byoung Chan;Sim, Jae Han;Yang, Hyeon Dong;Lee, Sung Woo;Kim, Bong-Hee
    • YAKHAK HOEJI
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    • v.59 no.2
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    • pp.49-54
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    • 2015
  • In the present study we evaluated comparative herb-drug interaction potential of red ginseng total powder, ginsenoside Rg1, and Rb1 by inhibition of CYP isoforms including CYP1A2, CYP2A6, CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP2E1 and CYP3A4 using pooled human liver microsomes (HLMs). As measured by liquid chromatography-electrospray ionization tandem mass spectrometry, red ginseng total powder inhibited significantly activities of CYP1A2, CYP2A6, CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP2E1 and testosterone 6-beta hydroxylation by CYP3A4, but the $IC_{50}$ values were higher than $556{\mu}g/ml$. Activities of CYP2B6, CYP2C9, CYP2D6 and CYP3A4 were inhibited by ginsenoside Rb1. Also, activities of CYP1A2, CYP2A6, CYP2B6, CYP2C9, CYP2C19, CYP2D6 and testosterone 6-beta hydroxylation by CYP3A4 were inhibited by ginsenoside Rg1. The $IC_{50}$ values of ginsenoside Rb1 and Rg1 were higher than $200{\mu}g/ml$. Based on $IC_{50}$ values against CYP isoforms, ginsenosides-drug interactions by CYP inhibition may be very low in clinical situations.

One-year experience of oral substrate reduction therapy in three patients with Gaucher disease type I

  • Sohn, Young Bae;Kim, Yewon;Moon, Ji Eun
    • Journal of Genetic Medicine
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    • v.17 no.2
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    • pp.62-67
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    • 2020
  • Purpose: Eliglustat is an oral substrate reduction therapy (SRT) approved for adults with Gaucher disease type I (GD1) who are extensive, intermediate, or poor CYP2D6 metabolizers. Here we report one-year experience of eliglustat switch therapy from long-term enzyme replacement therapy (ERT) in three adult patients with GD1. Materials and Methods: Medical history, clinical (hemoglobin concentration, platelet count, and bone mineral density) and biochemical parameters (angiotensin converting enzyme, total acid phosphatase, and lyso-gb1) of the patients were collected and evaluated by retrospective review of medical records at every 3, 6, or 12 month after switch to SRT. Results: Patient 1 was a 43-year old female diagnosed GD1 and her clinical and biochemical parameters were stabilized for more than 20 years by ERT. Due to the burden of regular hospital visit, she switched to SRT. During one-year of SRT, clinical parameters and biomarkers were maintained stable. However, after suffering acute febrile illness during SRT, she decided to re-switch to ERT due to concerns about drug interaction. Patient 2 was 41-year old male, younger brother of patient 1 and Patient 3 was 31-year old male. They switched to SRT in clinically stable condition with long-term ERT. The one-year SRT was tolerable without specific safety issue and the clinical parameters were maintained stable. Conclusion: One-year eliglustat therapy in three adult patients with GDI was generally tolerable and effective for maintaining the clinical parameters and biomarkers. However, the drug compliance, concurrent drug interactions, and long-term safety of eliglustat should be carefully monitored.

Transitional care for high-risk elderly patients pre/post discharge by collaboration between general hospital and community pharmacy: a pilot study

  • Park, Mi Seon;Lee, Ji Hee;Lee, Heung Bum;Kim, Ju Sin;Choi, Eun Joo
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.1
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    • pp.27-36
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    • 2022
  • Background: Medication-related problems (MRPs) frequently occur during the discharge period. Elderly patients, particularly, are at high risk for these problems due to polypharmacy and the use of potentially inappropriate medications. The purpose of this study was to build and implement collaboration between general hospital and community pharmacies to address MRPs among high-risk elderly patients before/after discharge. Methods: This retrospective study was conducted between June and December of 2020. The inclusion criteria were patients with aged ≥65 years; residents of Jeonju; discharged from Jeonbuk National University hospital; either on medication of exceeding 10 medications (or high-risk medications) after hospitalization through the emergency room, or having severe illness. Patients received medication reconciliation and counselling by hospital pharmacists before discharge and home-visit pharmaceutical care as follow-up by community pharmacists after discharge. Results: Twenty-two patients agreed to home-visit pharmaceutical services. Fifteen and 11 patients completed the first and second home-visit pharmaceutical care service, respectively. Forty-two MRPs were identified in 15 patients. The types of high-frequency MRPs were incorrect administration of drug, adverse drug reactions, medication non-compliance, drug-drug interactions, lifestyle modifications, and expired medication disposal. After consultation with the pharmacist, 34 out of 42 MRPs were resolved. Conclusions: Transitional care for high-risk elderly patients before and after discharge was successfully built and implemented through a collaboration between general hospital and community pharmacies. This study suggests that home-visit pharmaceutical services may have positive effects on the safe use of drugs during the transition period; however, additional research is needed to expand on these findings.

Identification of novel potential drugs and miRNAs biomarkers in lung cancer based on gene co-expression network analysis

  • Sara Hajipour;Sayed Mostafa Hosseini;Shiva Irani;Mahmood Tavallaie
    • Genomics & Informatics
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    • v.21 no.3
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    • pp.38.1-38.8
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    • 2023
  • Non-small cell lung cancer (NSCLC) is an important cause of cancer-associated deaths worldwide. Therefore, the exact molecular mechanisms of NSCLC are unidentified. The present investigation aims to identify the miRNAs with predictive value in NSCLC. The two datasets were downloaded from the Gene Expression Omnibus (GEO) database. Differentially expressed miRNAs (DEmiRNA) and mRNAs (DEmRNA) were selected from the normalized data. Next, miRNA-mRNA interactions were determined. Then, co-expression network analysis was completed using the WGCNA package in R software. The co-expression network between DEmiRNAs and DEmRNAs was calculated to prioritize the miRNAs. Next, the enrichment analysis was performed for DEmiRNA and DEmRNA. Finally, the drug-gene interaction network was constructed by importing the gene list to dgidb database. A total of 3,033 differentially expressed genes and 58 DEmiRNA were recognized from two datasets. The co-expression network analysis was utilized to build a gene co- expression network. Next, four modules were selected based on the Zsummary score. In the next step, a bipartite miRNA-gene network was constructed and hub miRNAs (let-7a-2-3p, let-7d-5p, let-7b-5p, let-7a-5p, and let-7b-3p) were selected. Finally, a drug-gene network was constructed while SUNITINIB, MEDROXYPROGESTERONE ACETATE, DOFETILIDE, HALOPERIDOL, and CALCITRIOL drugs were recognized as a beneficial drug in NSCLC. The hub miRNAs and repurposed drugs may act a vital role in NSCLC progression and treatment, respectively; however, these results must validate in further clinical and experimental assessments.

Identification of Selective STAT1 Inhibitors by Computational Approach

  • Veena Jaganivasan;Dona Samuel Karen;Bavya Chandrasekhar
    • Journal of Integrative Natural Science
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    • v.16 no.3
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    • pp.81-95
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    • 2023
  • Colorectal cancer is one of the most common types of cancer worldwide, ranking third after lung and breast cancer in terms of global prevalence. With an expected 1.93 million new cases and 935,000 deaths in 2020, it is more prevalent in males than in women. Evidence has shown that during the later stages of colon cancer, STAT1 promotes tumor progression by promoting cell survival and resistance to chemotherapy. Recent studies have shown that inhibiting STAT1 pathway leads to a reduction in tumor cell proliferation and growth, and can also promote apoptosis in colon cancer cells. One of the recent approaches in the field of drug discovery is drug repurposing. In drug repurposing approach we have virtually screened FDA database against STAT1 protein and their interactions have been studied through Molecular docking. Cross docking was performed with the top 10 compounds to be more specific with STAT1 comparing the affinity with STAT2, STAT3, STAT4, STAT5a, STAT5b and STAT6. The drugs that showed higher affinity were subjected to Conceptual - Density functional theory. Besides, the Molecular dynamic simulation was also carried out for the selected leads. We also validated in-vitro against colon cancer cell lines. The results showed mainly Acetyldigitoxin has shown better binding to the target. From this study, we can predict that the drug Acetyldigitoxin has shown noticeable inhibitory efficiency against STAT1, which in turn can also lead to the reduction of tumor cell growth in colon cancer.