scholarly journals Variant Interpretation in Current Pharmacogenetic Testing

2020 ◽  
Vol 10 (4) ◽  
pp. 204
Author(s):  
Sally Luvsantseren ◽  
Michelle Whirl-Carrillo ◽  
Katrin Sangkuhl ◽  
Nancy Shin ◽  
Alice Wen ◽  
...  
Keyword(s):  
Case Report ◽  
Drug Interactions ◽  
Variant Interpretation ◽  
Pharmacogenetic Testing ◽  
Phenotype Analysis ◽  
Reporting Discrepancies

In the current marketplace, there are now more than a dozen commercial companies providing pharmacogenetic tests. Each company varies in the panel of genes they test and the variants they are able to screen for. The reports generated by these companies provide phenotypic interpretations of pharmacogenes and clinically actionable gene–drug interactions based on internally curated data and proprietary algorithms. The freedom to choose the types of evidence to include versus exclude in interpreting genomics has created reporting discrepancies in the industry. The case report presented here reveals the discordant phenotype analysis provided by two pharmacogenetic testing companies. The uncertainty and unnecessary distress experienced by the patient highlights the need for consensus in phenotype reporting within the industry.

scholarly journals Herb–Drug Interactions: Worlds Intersect with the Patient at the Center

Medicines ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 44
Author(s):  
Mary Beth Babos ◽  
Michelle Heinan ◽  
Linda Redmond ◽  
Fareeha Moiz ◽  
Joao Victor Souza-Peres ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Case Report ◽  
Drug Interactions ◽  
Clinical Studies ◽  
Drug Information ◽  
Case Reports ◽  
Full Information ◽  
Information Need ◽  
Herbal Products ◽  
Reduce Risk

This review examines three bodies of literature related to herb–drug interactions: case reports, clinical studies, evaluations found in six drug interaction checking resources. The aim of the study is to examine the congruity of resources and to assess the degree to which case reports signal for further study. A qualitative review of case reports seeks to determine needs and perspectives of case report authors. Methods: Systematic search of Medline identified clinical studies and case reports of interacting herb–drug combinations. Interacting herb–drug pairs were searched in six drug interaction resources. Case reports were analyzed qualitatively for completeness and to identify underlying themes. Results: Ninety-nine case-report documents detailed 107 cases. Sixty-five clinical studies evaluated 93 mechanisms of interaction relevant to herbs reported in case studies, involving 30 different herbal products; 52.7% of these investigations offered evidence supporting reported reactions. Cohen’s kappa found no agreement between any interaction checker and case report corpus. Case reports often lacked full information. Need for further information, attitudes about herbs and herb use, and strategies to reduce risk from interaction were three primary themes in the case report corpus. Conclusions: Reliable herb–drug information is needed, including open and respectful discussion with patients.

Multiple drug interactions - induced serotonin syndrome: a case report

2009 ◽  
Vol 34 (4) ◽  
pp. 485-487 ◽  
Author(s):  
E. Montané ◽  
A. Barriocanal ◽  
I. Isern ◽  
T. Parajon ◽  
J. Costa
Keyword(s):  
Case Report ◽  
Drug Interactions ◽  
Serotonin Syndrome ◽  
Multiple Drug

Farmacogenetische tests in de Belgische zorg: (hoe) beginnen we eraan?

2021 ◽  
Author(s):  
A. DE PAUW ◽  
W. MARTINET ◽  
D. THEUNS ◽  
K. VANDEVEN ◽  
H. DE LOOF
Keyword(s):  
Drug Interactions ◽  
Information Needs ◽  
Scientific Evidence ◽  
Scientific Information ◽  
Implementation Process ◽  
Local Context ◽  
Pharmacogenetic Testing ◽  
Average Patient ◽  
Current List ◽  
A Current

Pharmacogenetic tests in Belgian care: (how) do we get started? Personalized medicine attempts to take all the information about an individual into account, and this also includes characteristics that differ from the presumed ‘average patient’. This approach includes pharmacogenetics, where the influence of genetic variation in various biomolecules on drug response is studied. By performing preemptive pharmacogenetic testing, drug therapies can be optimized, and serious side effects can be avoided. In order to implement pharmacogenetic testing in practice, some hurdles still need to be overcome. For example, scientific information needs to be translated into practical clinical guidelines that are applicable in the local context and reimbursement issues also need to be resolved. In this paper, a current list of gene-drug interactions is presented that could be prioritized during the implementation process in Belgium. The list only contains clinically relevant interactions for which there is sufficient scientific evidence. In addition, a tool is described that takes into account the drug consumption in a specific healthcare environment, to prioritize the most interesting gene-drug interactions. International implementation initiatives show that the obstacles are surmountable. It is therefore time to start a dialogue on accelerating the implementation of pharmacogenetic testing in Belgium. We hope that this prioritized list, together with a discussion of some hurdles that need to be overcome, can inform this debate.

scholarly journals Therapeutic drug monitoring of voriconazole: a case report of multiple drug interactions in a patient with an increased CYP2C19 activity

2014 ◽  
Vol 11 (1) ◽  
pp. 25 ◽  
Author(s):  
Yassine Bouatou ◽  
Caroline Samer ◽  
Kuntheavy Ing Lorenzini ◽  
Youssef Daali ◽  
Samira Daou ◽  
...  
Keyword(s):  
Case Report ◽  
Therapeutic Drug Monitoring ◽  
Drug Interactions ◽  
Drug Monitoring ◽  
Therapeutic Drug ◽  
Multiple Drug

Evaluation of Drug Interaction Document Citation in Nine On-Line Bibliographic Databases

1997 ◽  
Vol 31 (1) ◽  
pp. 45-49 ◽  
Author(s):  
Marine J Barillot ◽  
Bernard Sarrut ◽  
Christian G Doreau
Keyword(s):  
Case Report ◽  
Drug Interactions ◽  
The Other ◽  
Second Step ◽  
Bibliographic Databases ◽  
Specific Drug ◽  
Outcomes Measures ◽  
Significant Difference ◽  
Relevant Reference ◽  
On Line

OBJECTTVE: To compare nine on-line bibliographic databases to obtain bibliographic references on specific drug interactions. DESIGN: Seven bibliographic databases were selected for their ability to provide information concerning drug interactions: EMBASE, MEDLINE, TOXLINE, BIOSIS, Chemical Abstracts (CAS), PHARMLINE, and International Pharmaceutical Abstracts (IPA). Two French on-line bibliographic databases (i.e., PASCAL, BIBLIOGRAPHIF) were also tested to compare them with the other international databases. Twenty drug interactions were selected randomly using the journal Reactions Weekly 1993. MAIN OUTCOMES MEASURES: The total number of references, the number of potentially relevant references, the number of case report references, the number of unique references in the total number of references, and the number of unique references between potentially relevant references were analyzed by using the Friedman two-way ANOVA by ranks. For each database, relevance and relative recall were calculated. RESULTS: For the total number of references, EMBASE was significantly more comprehensive than all other databases (p < 0.05). EMBASE had a significantly greater number of potentially relevant references than IPA, PHARMLINE, CAS, and BIBLIOGRAPHIF (p < 0.05). For the total number of case report references, only one significant difference, between EMBASE and BIBLIOGRAPHIF (p < 0.05), was observed. MEDLINE and TOXLINE had the lowest cost per potentially relevant reference. CONCLUSIONS: To obtain bibliographic references on drug interactions, the first step should be to search MEDLINE or TOXLINE; the second step, for completeness, should be to search EMBASE.

Advantages of everolimus therapeutic drug monitoring in oncology when drug–drug interaction is suspected: A case report

2020 ◽  
Vol 26 (7) ◽  
pp. 1743-1749 ◽  
Author(s):  
Geoffrey Strobbe ◽  
Diane Pannier ◽  
Ilyes Sakji ◽  
Alexandre Villain ◽  
Frédéric Feutry ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Case Report ◽  
Therapeutic Drug Monitoring ◽  
Drug Interactions ◽  
Drug Monitoring ◽  
Plasma Concentrations ◽  
Response To Treatment ◽  
Therapeutic Drug ◽  
High Doses

Introduction Drug interactions involving everolimus are fairly well known because of its common use, primarily as an immunosuppressant. Several recommendations regarding therapeutic drug monitoring are also available for the use of everolimus-based immunosuppression regimens. However, everolimus use in oncology differs substantially, particularly because of the high doses involved. Therapeutic drug monitoring, although sometimes necessary, is not recommended as a routine in oncology. Thus, it was deemed inapplicable due to the lack of clear recommendations. Case report Here, we present a case where a patient was prescribed everolimus for renal cell carcinoma. The patient benefitted from a pharmaceutical consultation prior to treatment initiation, and a drug interaction with verapamil was suspected. Management and outcome: Therapeutic drug monitoring of everolimus was proposed. Based on the everolimus values reported in the literature, trough plasma concentration in the patient was greatly increased. The patient was then diagnosed with grade 4 oral mucositis, thereby requiring temporary suspension of everolimus treatment. Management of adverse effects was performed through multiple medicated mouthwashes. Discussion Therapeutic drug monitoring for everolimus is important for potential drug interactions or the occurrence of severe adverse events. In such cases, dose adjustments should be managed according to everolimus plasma concentrations. Clear oncological recommendations regarding plasma everolimus thresholds are required for a successful follow-up of the patient’s condition and to ensure adequate response to treatment.

scholarly journals Clozapine, HIV and neutropenia: a case report

2018 ◽  
Vol 8 (12) ◽  
pp. 365-369 ◽  
Author(s):  
Eromona Whiskey ◽  
David O’Flynn ◽  
David Taylor
Keyword(s):  
Case Report ◽  
Drug Interactions ◽  
Multidisciplinary Approach ◽  
Optimal Outcome ◽  
Clozapine Treatment ◽  
Complex Patients

There is paucity of information on the use of clozapine in patients with HIV. Ethnicity, co-prescribed medications and possible drug-drug interactions are important considerations in evaluating risk of blood dyscrasias during clozapine treatment. Individuals with HIV should not be denied access to the most effective antipsychotic, but a multidisciplinary approach is essential for optimal outcome in such complex patients.

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