Browsing by Subject "Pharmacotherapy"

Now showing 1 - 8 of 8
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    Current Management Guidelines on Hyperlipidemia: The Silent Killer
    (Hindawi, 2021-07-31) Su, Lilly; Mittal, Rea; Ramgobin, Devyani; Jain, Rahul; Jain, Rohit; Medicine, School of Medicine
    Given the high incidence of cardiovascular events in the United States, strict control of modifiable risk factors is important. Pharmacotherapy is helpful in maintaining control of modifiable risk factors such as elevated lipids or hypercholesterolemia. Hypercholesterolemia can lead to atherosclerotic disease which may increase the risk of acute coronary events. Statin therapy has long been a mainstay in the treatment of hypercholesterolemia, but while highly regarded, statin therapy also has side effects that may lead to patient noncompliance. Therefore, various medicines are being developed to manage hypercholesterolemia. This paper will discuss the role that lipids play in the pathophysiology of atherosclerotic disease, review the current lipid management guidelines, and discuss new treatment options that are alternatives to statin therapy.
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    Differential drug response in pulmonary arterial hypertension: The potential for precision medicine
    (Wiley, 2023-11-02) Miller, Elise; Sampson, Chinwuwanuju Ugo‐Obi; Desai, Ankit A.; Karnes, Jason H.; Medicine, School of Medicine
    Pulmonary arterial hypertension (PAH) is a rare, complex, and deadly cardiopulmonary disease. It is characterized by changes in endothelial cell function and smooth muscle cell proliferation in the pulmonary arteries, causing persistent vasoconstriction, resulting in right heart hypertrophy and failure. There are multiple drug classes specific to PAH treatment, but variation between patients may impact treatment response. A small subset of patients is responsive to pulmonary vasodilators and can be treated with calcium channel blockers, which would be deleterious if prescribed to a typical PAH patient. Little is known about the underlying cause of this important difference in vasoresponsive PAH patients. Sex, race/ethnicity, and pharmacogenomics may also factor into efficacy and safety of PAH-specific drugs. Research has indicated that endothelin receptor antagonists may be more effective in women and there have been some minor differences found in certain races and ethnicities, but these findings are muddled by the impact of socioeconomic factors and a lack of representation of non-White patients in clinical trials. Genetic variants in genes such as CYP3A5, CYP2C9, PTGIS, PTGIR, GNG2, CHST3, and CHST13 may influence the efficacy and safety of certain PAH-specific drugs. PAH research faces many challenges, but there is potential for new methodologies to glean new insights into PAH development and treatment.
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    Disparities in Prescription Patterns of Cardioprotective Medications in Postacute Myocardial Infarction Patients in Indiana
    (Elsevier, 2024-09-06) Gunderman, David; Kumar, Ashish; Munguia-Vazquez, Raymundo; Vora, Keyur P.; Shah, Chirag D.; Dharmakumar, Rohan; Kalra, Ankur; Medicine, School of Medicine
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    Hypertension Pharmacological Treatment in Adults: A World Health Organization Guideline Executive Summary
    (Wolters Kluwer, 2022) Al-Makki, Akram; DiPette, Donald; Whelton, Paul K.; Murad, M. Hassan; Mustafa, Reem A.; Acharya, Shrish; Beheiry, Hind Mamoun; Champagne, Beatriz; Connell, Kenneth; Cooney, Marie Therese; Ezeigwe, Nnenna; Gaziano, Thomas Andrew; Gidio, Agaba; Lopez-Jaramillo, Patricio; Khan, Unab I.; Kumarapeli, Vindya; Moran, Andrew E.; Silwimba, Margaret Mswema; Rayner, Brian; Sukonthasan, Apichard; Yu, Jing; Saraffzadegan, Nizal; Reddy, K. Srinath; Khan, Taskeen; Medicine, School of Medicine
    Hypertension is a major cause of cardiovascular disease and deaths worldwide especially in low- and middle-income countries. Despite the availability of safe, well-tolerated, and cost-effective blood pressure (BP)-lowering therapies, <14% of adults with hypertension have BP controlled to a systolic/diastolic BP <140/90 mm Hg. We report new hypertension treatment guidelines, developed in accordance with the World Health Organization Handbook for Guideline Development. Overviews of reviews of the evidence were conducted and summary tables were developed according to the Grading of Recommendations, Assessment, Development, and Evaluations approach. In these guidelines, the World Health Organization provides the most current and relevant evidence-based guidance for the pharmacological treatment of nonpregnant adults with hypertension. The recommendations pertain to adults with an accurate diagnosis of hypertension who have already received lifestyle modification counseling. The guidelines recommend BP threshold to initiate pharmacological therapy, BP treatment targets, intervals for follow-up visits, and best use of health care workers in the management of hypertension. The guidelines provide guidance for choice of monotherapy or dual therapy, treatment with single pill combination medications, and use of treatment algorithms for hypertension management. Strength of the recommendations was guided by the quality of the underlying evidence; the tradeoffs between desirable and undesirable effects; patient’s values, resource considerations and cost-effectiveness; health equity; acceptability, and feasibility consideration of different treatment options. The goal of the guideline is to facilitate standard approaches to pharmacological treatment and management of hypertension which, if widely implemented, will increase the hypertension control rate world-wide.
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    Rat animal models for screening medications to treat alcohol use disorders
    (Elsevier, 2017-08-01) Bell, Richard L.; Hauser, Sheketha R.; Liang, Tiebing; Sari, Youssef; Maldonado-Devincci, Antoniette; Rodd, Zachary A.; Psychiatry, School of Medicine
    The purpose of this review is to present animal research models that can be used to screen and/or repurpose medications for the treatment of alcohol abuse and dependence. The focus will be on rats and in particular selectively bred rats. Brief introductions discuss various aspects of the clinical picture, which provide characteristics of individuals with alcohol use disorders (AUDs) to model in animals. Following this, multiple selectively bred rat lines will be described and evaluated in the context of animal models used to screen medications to treat AUDs. Next, common behavioral tests for drug efficacy will be discussed particularly as they relate to stages in the addiction cycle. Tables highlighting studies that have tested the effects of compounds using the respective techniques are included. Wherever possible the Tables are organized chronologically in ascending order to describe changes in the focus of research on AUDs over time. In general, high ethanol-consuming selectively bred rats have been used to test a wide range of compounds. Older studies usually followed neurobiological findings in the selected lines that supported an association with a propensity for high ethanol intake. Most of these tests evaluated the compound's effects on the maintenance of ethanol drinking. Very few compounds have been tested during ethanol-seeking and/or relapse and fewer still have assessed their effects during the acquisition of AUDs. Overall, while a substantial number of neurotransmitter and neuromodulatory system targets have been assessed; the roles of sex- and age-of-animal, as well as the acquisition of AUDs, ethanol-seeking and relapse continue to be factors and behaviors needing further study. This article is part of the Special Issue entitled "Alcoholism".
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    Staying InformED: Top emergency Medicine pharmacotherapy articles of 2020
    (Elsevier, 2021-11) Zimmerman, David E.; Sarangarm, Preeyaporn; Brown, Caitlin S.; Faine, Brett; Flack, Tara; Gilbert, Brian W.; Howington, Gavin T.; Kelly, Gregory; Laub, Jessica; Porter, Blake A.; Slocum, Giles W.; Rech, Megan A.; Pharmacology and Toxicology, School of Medicine
    The year 2020 was not easy for Emergency Medicine (EM) clinicians with the burden of tackling a pandemic. A large focus, rightfully so, was placed on the evolving diagnosis and management of patients with COVID-19 and, as such, the ability of clinicians to remain up to date on key EM pharmacotherapy literature may have been compromised. This article reviews the most important EM pharmacotherapy publications indexed in 2020. A modified Delphi approach was utilized for selected journals to identify the most impactful EM pharmacotherapy studies. A total of fifteen articles, eleven trials and four meta-analyses, were identified. This review provides a summary of each study, along with a commentary on the impact to the EM literature and EM clinician.
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    The MPRINT Hub Data, Model, Knowledge and Research Coordination Center: Bridging the gap in maternal-pediatric therapeutics research through data integration and pharmacometrics
    (Wiley, 2023) Quinney, Sara K.; Bies, Robert R.; Grannis, Shaun J.; Bartlett, Christopher W.; Mendonca, Eneida; Rogerson, Colin M.; Backes, Carl H.; Shah, Dhaval K.; Tillman, Emma M.; Costantine, Maged M.; Aruldhas, Blessed W.; Allam, Reva; Grant, Amelia; Abbasi, Mohammed Yaseen; Kandasamy, Murugesh; Zang, Yong; Wang, Lei; Shendre, Aditi; Li, Lang; Obstetrics and Gynecology, School of Medicine
    Maternal and pediatric populations have historically been considered "therapeutic orphans" due to their limited inclusion in clinical trials. Physiologic changes during pregnancy and lactation and growth and maturation of children alter pharmacokinetics (PK) and pharmacodynamics (PD) of drugs. Precision therapy in these populations requires knowledge of these effects. Efforts to enhance maternal and pediatric participation in clinical studies have increased over the past few decades. However, studies supporting precision therapeutics in these populations are often small and, in isolation, may have limited impact. Integration of data from various studies, for example through physiologically based pharmacokinetic/pharmacodynamic (PBPK/PD) modeling or bioinformatics approaches, can augment the value of data from these studies, and help identify gaps in understanding. To catalyze research in maternal and pediatric precision therapeutics, the Obstetric and Pediatric Pharmacology and Therapeutics Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) established the Maternal and Pediatric Precision in Therapeutics (MPRINT) Hub. Herein, we provide an overview of the status of maternal-pediatric therapeutics research and introduce the Indiana University-Ohio State University MPRINT Hub Data, Model, Knowledge and Research Coordination Center (DMKRCC), which aims to facilitate research in maternal and pediatric precision therapeutics through the integration and assessment of existing knowledge, supporting pharmacometrics and clinical trials design, development of new real-world evidence resources, educational initiatives, and building collaborations among public and private partners, including other NICHD-funded networks. By fostering use of existing data and resources, the DMKRCC will identify critical gaps in knowledge and support efforts to overcome these gaps to enhance maternal-pediatric precision therapeutics.
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    Treatment of Adolescent Cannabis Use Disorders
    (Elsevier, 2023) Adams, Zachary W.; Marriott, Brigid R.; Hulvershorn, Leslie A.; Hinckley, Jesse; Psychiatry, School of Medicine
    This review summarizes treatments for cannabis use disorder (CUD) in adolescents. The best supported CUD treatments are cognitive behavioral psychotherapies, including family-based models that facilitate environmental changes and youth-focused models that incorporate skills training, motivational interviewing, and contingency management to promote reductions in cannabis use. Some medications show promise in reducing cannabis craving and withdrawal symptoms. Further research is needed on the efficacy and implementation of existing treatments given the changes in cannabis use trends over time and on emerging technologies that may expand access to evidence-based CUD treatments.