کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5557360 1560823 2017 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Screening for genotypic and phenotypic variations in CYP450 activity in patients with therapeutic problems in a psychiatric setting, a retrospective study
موضوعات مرتبط
علوم پزشکی و سلامت داروسازی، سم شناسی و علوم دارویی داروشناسی
پیش نمایش صفحه اول مقاله
Screening for genotypic and phenotypic variations in CYP450 activity in patients with therapeutic problems in a psychiatric setting, a retrospective study
چکیده انگلیسی

ObjectivesThis retrospective study aimed to assess to what extent an adverse drug reaction (ADR), an abnormal therapeutic drug monitoring (TDM) or a non-response, was attributable to an abnormal cytochrome P450 activity in a psychiatric setting.MethodWe collected the results of investigations performed in these situations related to psychotropic drugs between January 2005 and November 2014. Activities of different cytochrome P450 were assessed by genotyping and/or phenotyping. Two experienced clinical pharmacologists assessed independently the possible association between the event and the results of the investigations.ResultsOne hundred and thirty eight clinical or biological situations had a complete assessment of all major metabolic pathways of the target drug. A majority of clinical or biological situations were observed with antidepressants (n = 93, 67.4%), followed by antipsychotics (n = 28, 20.3%), benzodiazepines and hypnotics (n = 13, 9.4%), and psychostimulants (n = 4, 2.9%). Genotype and/or phenotype determination was mainly performed because of ADRs (n = 68, 49.3%) or non-response (n = 46, 33.3%). Inter-rate reliability of the scoring system between the pharmacologists was excellent (kappa = 0.94). The probability of an association between ADR, TDM or non-response and metabolic status was rated as intermediate to high in 34.7% of all cases, with proportions of 30.4% and 36.7%, for non-response and ADR respectively.ConclusionWhen indicated by clinical pharmacologists, ADR, TDM or non-response may be attributable to a variation of the metabolic status with an intermediate to high probability in 34.7% of patients, based on the congruent assessment made by two clinical pharmacologists. Further studies assessing the clinical relevance of prospective explorations and clarifying the appropriate method according to the clinical context are needed.

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ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Pharmacological Research - Volume 118, April 2017, Pages 104-110
نویسندگان
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