• Title/Summary/Keyword: drug-drug interactions

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Albumin-Mediated Hepatic Uptake of Drugs (약물의 간내 이행기전과 알부민의 역할)

  • Han, Yong-Hae;Shim, Chang-Koo
    • Journal of Pharmaceutical Investigation
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    • v.20 no.4
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    • pp.179-191
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    • 1990
  • A central dogma of pharmacology is that only unbound drug is capable of translocation across biological membrane. Thus, hepatic uptake is assumed to be solely determined by the unbound concentration of the diffusible moiety at the surface of the liver cell. However, an increasing number of experimental observations with xenobiotics that are normally very extensively bound to plasma proteins (>99%) appear to be inconsistent with these assumptions. This suggested that in addition to progressive spontaneous dissociation within the liver sinusoids and space of Disse, direct interactions of the albumin-drug complex at the plasma membrane may facilitate dissociation of the complex. To explain this phenomena. called albumin-mediated uptake, 4 mechanisms have been suggested. The validity of such hypotheses needs to be examined by the further study. Because albumin-mediated uptake has also been observed to occur in other plasma proteins, protein-mediated uptake rather than albumin-mediated uptake seems to be acceptable.

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Investigation of Binding Modes of the Verapamil and Curcumin into Human P-glycoprotein (P-gp)

  • Gadhe, Changdev G.;Cho, Seung Joo
    • Journal of Integrative Natural Science
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    • v.6 no.4
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    • pp.205-210
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    • 2013
  • Human P-gp is a protein responsible for the multidrug resistance (MDR) and causes failure of cancer chemotherapy. Till date no X-ray crystal structure is reported for this membrane protein, which hampers active research in the field. We performed homology modeling to develop three dimensional (3D) model of P-gp, and docking studies of the verapamil and curcumin have been performed to gain insight into the interaction mechanism between inhibitors and P-gp. It was identified that the inhibitors docked into the upper part of P-gp and interacted through the hydrophobic interactions.

Pharmacological potential of ginseng and its major component ginsenosides

  • Ratan, Zubair Ahmed;Haidere, Mohammad Faisal;Hong, Yo Han;Park, Sang Hee;Lee, Jeong-Oog;Lee, Jongsung;Cho, Jae Youl
    • Journal of Ginseng Research
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    • v.45 no.2
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    • pp.199-210
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    • 2021
  • Ginseng has been used as a traditional herb in Asian countries for thousands of years. It contains a large number of active ingredients including steroidal saponins, protopanaxadiols, and protopanaxatriols, collectively known as ginsenosides. In the last few decades, the antioxidative and anticancer effects of ginseng, in addition to its effects on improving immunity, energy and sexuality, and combating cardiovascular diseases, diabetes mellitus, and neurological diseases, have been studied in both basic and clinical research. Ginseng could be a valuable resource for future drug development; however, further higher quality evidence is required. Moreover, ginseng may have drug interactions although the available evidence suggests it is a relatively safe product. This article reviews the bioactive compounds, global distribution, and therapeutic potential of plants in the genus Panax.

Two Cases of Obesity Treatment Using Liraglutide 3 mg with Intensive Behavioral Changes in Morbidly Obese Patients with Major Depressive Disorder (주요우울증을 동반한 고도비만 환자에 대한 행동요법을 병행한 리라글루티드 치료의 2예)

  • Ko, Hae-Jin
    • Archives of Obesity and Metabolism
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    • v.1 no.1
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    • pp.39-42
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    • 2022
  • Obesity is a chronic disease associated with severe complications. A major complication of obesity is depression, which can worsen obesity and vice versa. In addition, most antidepressants or antipsychotics cause weight gain, and the relationship between obesity and depression is clinically critical. However, treatment of obese patients with major depressive disorder is complicated. Bariatric physicians should provide appropriate behavioral interventions alongside pharmacological treatment, considering psychiatric symptoms, drug side effects, and drug interactions. Two successful cases of moderate-to-severe obese patients with major depressive disorder who had been treated for obesity using behavioral intervention therapy along with liraglutide will be discussed. This report highlights the safety and efficacy of liraglutide treatment of obesity in patients with depression who take antidepressants and antipsychotics.

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.