MyMedR

Polymorphism of ITPA 94C>A and risk of adverse effects among patients with acute lymphoblastic leukaemia treated with 6-mercaptopurine

Wan Rosalina WR, Teh LK, Mohamad N, Nasir A, Yusoff R, Baba AA, et al.

J Clin Pharm Ther, 2012 Apr;37(2):237-41.

PMID: 21545474 DOI: 10.1111/j.1365-2710.2011.01272.x

Genetic polymorphisms of thiopurine S-methyltransferase (TPMT) and inosine triphosphate pyrophosphohydrolase (ITPA 94C>A) contribute to variable responses, including fatal adverse effects, among subjects treated with 6-mercaptopurine (6-MP). Our objectives were to investigate the distribution of specific TPMT and ITPA genotypes in healthy subjects and patients with acute lymphoblastic leukaemia (ALL) from the three main ethnic groups (Malays, Chinese and Indians) in Malaysia and the association of the polymorphisms with adverse effects of 6-MP.

Cytochrome P450 3A4 genetic polymorphisms and post-operative fentanyl requirements

Tan PC, Hassan SK, Mohamad NA, Gan SH

J Clin Pharm Ther, 2012 Feb;37(1):100-4.

PMID: 21128989 DOI: 10.1111/j.1365-2710.2010.01232.x

WHAT IS KNOWN AND OBJECTIVE: Interindividual variability in drug responses may be attributable to genetically determined alteration in enzyme activity. In this study, we investigated the association between cytochrome P450 3A4 (CYP3A4) genetic polymorphisms and post-operative fentanyl requirements.

METHODS: Patients (n = 94) scheduled for gynaecological laparotomy received i.v. fentanyl infusion (3 μg/kg/h) after induction of general anaesthesia. Post-operative fentanyl requirements were quantified by using a patient-controlled analgesia and the number of i.v. fentanyl rescue analgesia required were recorded. Pain control was assessed using visual analogue scores (VAS) and fentanyl's adverse effects were documented. CYP3A4*4, CYP3A4*5 and CYP3A4*18 alleles of cytochrome P450 3A4 were identified by polymerase chain reaction-restriction fragment length polymorphism. Differences in fentanyl requirements, VAS scores and adverse effects among the various genotypes were compared.

RESULTS AND DISCUSSION: No CYP3A4*4 and CYP3A4*5 alleles were detected. Eighty-nine patients (94·7%) were wild-type, five (5·3%) were heterozygous and none was homozygous. No significant difference was demonstrated between the genotype groups in terms of fentanyl consumption, pain control and adverse effects.

WHAT IS NEW AND CONCLUSION: CYP3A4*4 and CYP3A4*5 are rare in the Malaysian Malay population. Genetic polymorphism of CYP3A4*18 may not play an important role in influencing postoperative fentanyl requirements.

Effects of pharmaceutical care on adherence and persistence to bisphosphonates in postmenopausal osteoporotic women

Lai PS, Chua SS, Chew YY, Chan SP

J Clin Pharm Ther, 2011 Oct;36(5):557-67.

PMID: 21916908 DOI: 10.1111/j.1365-2710.2010.01210.x

Studies have shown that comprehensive interventions by pharmacists can improve adherence and persistence to osteoporosis therapy, but the association between adherence and bone turnover markers (BTMs) has never been studied. Therefore, the aim of this study was to evaluate the effects of pharmaceutical care on medication adherence (and its effects on BTMs), as well as persistence of postmenopausal osteoporotic women to prescribed bisphosphonates.

Mutational analysis of CYP2C8 in hypertensive patients using denaturing high performance liquid chromatography

Teh LK, Zahri MK, Zakaria ZA, Ismail R, Salleh MZ

J Clin Pharm Ther, 2010 Dec;35(6):723-8.

PMID: 21054465 DOI: 10.1111/j.1365-2710.2009.01146.x

CYP2C8 is involved in the cytochrome P450 (CYP) epoxygenase pathway. Arachidonic acid metabolites such as epoxyeicosatrienenoic acids and hydroxyeicosatetrenoic acids, produced may have a role in hypertension. We aimed to develop a medium through-put method for screening samples of known and new mutations of CYP2C8 using denaturing high performance liquid chromatography (DHPLC).

Modification of propranolol's bioavailability by Eurycoma longifolia water-based extract

Salman SA, Amrah S, Wahab MS, Ismail Z, Ismail R, Yuen KH, et al.

J Clin Pharm Ther, 2010 Dec;35(6):691-6.

PMID: 21054461 DOI: 10.1111/j.1365-2710.2009.01147.x

Eurycoma longifolia (E. longifolia), a herb commonly consumed for its aphrodisiac properties, is widely used by Asian males. This may include hypertensive patients receiving propranolol which may cause sexual dysfunction as one of its side-effects. There is no published study of the potential pharmacokinetic interaction between propranolol and the herb.

Population pharmacokinetic modelling of repaglinide in healthy volunteers by using Non-Parametric Adaptive Grid Algorithm

Ruzilawati AB, Mohd Suhaimi AW, Gan SH

J Clin Pharm Ther, 2010 Feb;35(1):105-12.

PMID: 20175819 DOI: 10.1111/j.1365-2710.2009.01042.x

To estimate population pharmacokinetic parameters of repaglinide in 121 healthy Malaysian volunteers.

An observational study of drug administration errors in a Malaysian hospital (study of drug administration errors)

Chua SS, Tea MH, Rahman MH

J Clin Pharm Ther, 2009 Apr;34(2):215-23.

PMID: 19250142 DOI: 10.1111/j.1365-2710.2008.00997.x

Drug administration errors were the second most frequent type of medication errors, after prescribing errors but the latter were often intercepted hence, administration errors were more probably to reach the patients. Therefore, this study was conducted to determine the frequency and types of drug administration errors in a Malaysian hospital ward.

Garlic supplementation and serum cholesterol: a meta-analysis

Khoo YS, Aziz Z

J Clin Pharm Ther, 2009 Apr;34(2):133-45.

PMID: 19250134 DOI: 10.1111/j.1365-2710.2008.00998.x

Prevention of cardiovascular disease by modifying its major risk factors, including serum cholesterol levels, is an important strategy. Regular intake of garlic has been suggested, but its impact on cholesterol levels has been inconsistent.

Pre-admission therapy for childhood acute diarrhoea--a hospital-based study

Ng YJ, Lo YL, Lee WS

J Clin Pharm Ther, 2009 Feb;34(1):55-60.

PMID: 19125903 DOI: 10.1111/j.1365-2710.2008.00985.x

Acute gastroenteritis (AGE) is a common illness among infants and children contributing to significant mortality and morbidity. As such, appropriate treatment received prior to hospital admission is of utmost importance. This retrospective observational study aimed to determine preadmission management in paediatric patients prior to hospital admission. Two hundred and twenty-two case notes of paediatric AGE patients were reviewed over a 12-month period. One hundred and fifty-four patients received medications prior to admission with 143 (92.9%) patients received known classes of medications. Antipyretic agents were the most commonly prescribed (69.2%), followed by antibiotics (38.5%), anti-emetics (35.7%), oral rehydration salts (29.4%) and antidiarrhoeals (28.0%). The mean duration of stay in hospital was slightly shorter in patients, who received prior medications than those who did not (2.22 vs. 2.32 days respectively). Seventy per cent of children admitted for AGE were treated suboptimally prior to hospital admission with oral rehydration salts being largely under-utilized, despite their proven efficacy and safety. Sex, race and age had no influence on the type of preadmission treatment. A greater effort should be made to educate the general public in the appropriate treatment of AGE.

A prospective study evaluating clinical outcomes and costs of three NNRTI-based HAART regimens in Kerala, India

George C, Yesoda A, Jayakumar B, Lal L

J Clin Pharm Ther, 2009 Feb;34(1):33-40.

PMID: 19125901 DOI: 10.1111/j.1365-2710.2008.00988.x

This prospective, observational, study evaluates the clinical outcomes, drug utilization patterns, and adherence to treatment of patients on highly active anti retroviral therapy (HAART) at a government institution in Kerala, India.

Heparin-induced thrombocytopenia and recent advances in its therapy

Hassan Y, Awaisu A, Aziz NA, Aziz NH, Ismail O

J Clin Pharm Ther, 2007 Dec;32(6):535-44.

PMID: 18021330

To highlight therapeutic controversies, and present a critical review of the most recent evidence on the management of heparin-induced thrombocytopenia (HIT).

Single step PCR for detection of allelic variation of MDR1 gene (P-glycoprotein) among three ethnic groups in Malaysia

Teh LK, Lee WL, Amir J, Salleh MZ, Ismail R

J Clin Pharm Ther, 2007 Jun;32(3):313-9.

PMID: 17489883

P-glycoprotein (PgP) is the most extensively studied ATP-binding cassette (ABC) coded by MDR1 gene. To date, 29 single nucleotide polymorphisms (SNPs) have been identified; but only SNP C3435T has been correlated with intestinal PgP expression levels and shown to influence the absorption of orally taken drugs that are PgP substrates. Individuals homozygous for the T allele have more than fourfold lower PgP expression compared with C/C individuals. We developed a one step primer based allele specific PCR method to detect SNP at C3435T to investigate the distribution of this genotype in the local population.

Discontinuation of penicillamine in the absence of alternative orphan drugs (trientine-zinc): a case of decompensated liver cirrhosis in Wilson's disease

Ping CC, Hassan Y, Aziz NA, Ghazali R, Awaisu A

J Clin Pharm Ther, 2007 Feb;32(1):101-7.

PMID: 17286794

To report a case of early-decompensated liver cirrhosis secondary to discontinuation of penicillamine therapy in a patient with Wilson's disease.

An improved rapid genotyping method for the study of beta-2 adrenergic receptor gene polymorphisms using single tube allele specific multiplex PCR

Zilfalil BA, Hoh BP, Nizam MZ, Liza-Sharmini AT, Teh LK, Ismail R

J Clin Pharm Ther, 2006 Dec;31(6):637-40.

PMID: 17176369

Seventeen single nucleotide polymorphisms (SNPs) have been identified so far, within the beta-2 receptor (beta(2) AR) gene. The presence of so many SNPs within the beta(2) AR gene causes a problem, for those studying beta(2) AR pharmacogenetics, in relation to which SNPs to choose. Most of the work has focused on the three common SNPs within the coding block (alleles 16, 27 and 164) and the techniques developed have been for these three functionally important alleles.

Malaysian Indians are genetically similar to Caucasians: CYP2C9 polymorphism

Zainuddin Z, Teh LK, Suhaimi AW, Ismail R

J Clin Pharm Ther, 2006 Apr;31(2):187-91.

PMID: 16635054

CYP2C9 is one of the major drug metabolizing enzymes for many drugs including warfarin, NSAIDs and losartan. It is polymorphic in many populations. Data on the distribution of CYP2C9 and the implication of CYP2C9 polymorphism in the Malaysian population is lacking. Our objectives were therefore to investigate the prevalence of CYP2C9 variants among unrelated healthy volunteers of Malays, Chinese and Indians in Malaysia.

The relevance of CYP2D6 genetic polymorphism on chronic metoprolol therapy in cardiovascular patients

Ismail R, Teh LK

J Clin Pharm Ther, 2006 Feb;31(1):99-109.

PMID: 16476126

CYP2D6 polymorphisms are well described in normal populations but there are few data on its clinical significance. We therefore investigated the influence of CYP2D6 polymorphism on steady-state plasma concentrations and apparent oral clearance of metoprolol in patients with cardiovascular diseases.

Genetic polymorphism of CYP2C8 in three Malaysian ethnics: CYP2C8*2 and CYP2C8*3 are found in Malaysian Indians

Muthiah YD, Lee WL, Teh LK, Ong CE, Ismail R

J Clin Pharm Ther, 2005 Oct;30(5):487-90.

PMID: 16164496

CYP2C8 is genetically polymorphic. Four variants, CYP2C8*2, CYP2C8*3, CYP2C8*4 and CYP2C8*5, which contain mutations in the coding regions have been reported to exhibit different enzyme activity as compared with CYP2C8*1.

Genetic polymorphism of CYP2D6 in patients with cardiovascular disease -- a cohort study

Teh LK, Zilfalil BA, Marina I, Rosemi BS, Ismail R

J Clin Pharm Ther, 2004 Dec;29(6):559-64.

PMID: 15584944 DOI: 10.1111/j.1365-2710.2004.00600.x

BACKGROUND: Cardiovascular diseases are complex diseases that are influenced by both environmental and genetic factors. CYP2D6 found in the brain and the heart is involved in the metabolism of many environmental and some endogenous substances and neurotransmitters responsible for maintaining homeostasis. This raises an interesting hypothesis that it may have a role in the development of or protection against cardiovascular diseases.
OBJECTIVE: To study the distribution of genotypes of CYP2D6 among patients with cardiovascular diseases in Malaysia.
METHOD:We obtained DNA from 128 patients who were followed up for cardiovascular diseases. Polymerase chain reaction-based methods were used to determine common CYP2D6 alleles.
RESULTS: One hundred and twenty-eight patients were enrolled. Most of the patients also had concurrent illnesses. Eleven genotypes were identified in the patients and 41% carried CYP2D6*1/*10. The second most common genotype was homozygous for the wild type gene, followed by homozygous CYP2D6*10/*10 at 14.48 %. A small percentage of the patients were heterozygous CYP2D6*1/*4. One patient was genotyped homozygous CYP2D6*4/*4 predicting a poor metabolizer prevalence of 0.78% (95% CI +/- 1.52%). Analysis using Hardy-Weinberg equilibrium showed that all of the gnotypes were consistent with equilibrium except for CYP2D6*1/*10 (chi(2); P < 0.05).
CONCLUSION: Our study suggests a possible involvement of CYP2D6 genotypes in cardiovascular system diseases, which need to be validated by further studies.

Population pharmacokinetic modelling of tramadol with application of the NPEM algorithms

Gan SH, Ismail R, Wan Adnan WA, Zulmi W, Jelliffe RW

J Clin Pharm Ther, 2004 Oct;29(5):455-63.

PMID: 15482390

Although the kinetic behaviour of tramadol has been described, the present study is the first to our knowledge, to report specifically on the population pharmacokinetic modelling of tramadol hydrochloride.

Herbal medicines: predictors of recommendation by physicians

Aziz Z

J Clin Pharm Ther, 2004 Jun;29(3):241-6.

PMID: 15153085

We hypothesized that as the use of herbal medicines increases in the general population, so do patients' requests to physicians for recommendations. However, why some physicians recommend herbal medicines while others do not is not well understood.

Displaying publications 21 - 40 of 53 in total