The potential role of pharmacogenomics in the prevention of serious adverse drug reactions in multiple sclerosis

Multiple sclerosis (MS) is dened as one chronic disease of central nervous system with neurodegenerative and inammatory components, where most of the patients shown a relapsingremitting course dened by the acute inception of focal neurologic decits and consistent focal inammatory changes visible on MRI. The causal factor of this complicated autoimmune and neurodegenerative disease is still unknown. Mitochondrial dysfunction is the key contributor to the neurodegenerative process of this disease. The current review signies the possible potential role of mitochondria in MS and the different dietary approach as a disease modier with the special emphasis on mitochondrial function and neurodegenerations.Research regarding therapeutic implementation of different diet in MS is advancing day by day; but currently remains with limited data. Few studies have been intended with meticulously collected observations, and the very few clinical trials that have been executed with insufcient sample size or length to adequately assess efcacy. More epidemiological and observational studies on dietary implementations were required

Download Full-text

Adverse Drug Reactions Among Patients Enrolled in an Outpatient Parenteral Antimicrobial Therapy (OPAT) Program 2015–2016 at UNC Medical Center

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.813 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S341-S341

Author(s):

Vahini Chundi ◽

Anh Eichholz ◽

Onyeka Nwankwo ◽

Alan Kinlaw ◽

Wesley Kufel ◽

...

Keyword(s):

Adverse Drug Reactions ◽

Medical Center ◽

Critical Role ◽

Drug Reactions ◽

Health Records ◽

Outpatient Parenteral Antimicrobial Therapy ◽

Initial Cohort ◽

Recorded Data ◽

Antimicrobial Regimen

Abstract Background The UNC Medical Center OPAT program was started in 2015 to provide multidisciplinary monitoring and management of patients discharged on parenteral antimicrobials. We examined characteristics of incident adverse drug reactions (ADRs) observed in our initial cohort of OPAT patients. Methods We abstracted electronic health records for the first 250 patients enrolled in the OPAT program. 223 patients with sufficient recorded data for entire OPAT course were included in the analysis. ADRs meeting criteria as detailed in Table 1 were collected and further stratified by antimicrobial regimen. Results 57 patients (26%) experienced at least one ADR during OPAT therapy. The frequency of specific ADRs associated with OPAT therapies are provided in Figure 1. Β-lactam regimens were most frequently associated with liver dysfunction, while combinations of β-lactams and vancomycin were associated with kidney dysfunction. Median days on OPAT regimen was 19 days (IQR: 10–29) for patients who experienced an ADR compared with 39 (IQR: 30–44) for patients who did not experience an ADR. Conclusion ADRs were most commonly observed within the first three weeks of therapy, particularly for patients receiving vancomycin and a β-lactam antimicrobial in combination. These results underscore the critical role of a multidisciplinary team in providing laboratory monitoring and response to abnormal results for OPAT patients. In addition, closer monitoring within the first three weeks of therapy may provide opportunities for regimen changes or dose adjustment to avoid toxicities. Disclosures All authors: No reported disclosures.

Download Full-text