Home  About us  Contact
 

Lowering Drugs (lowering + drug)

Distribution by Scientific Domains
Medical Sciences85%

Kinds of Lowering Drugs

  • lipid lowering drug
    		•

    Selected Abstracts

    Influence of genetic variation in CYP3A4 and ABCB1 on dose decrease or switching during simvastatin and atorvastatin therapy,

    PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 1 2010
    Matthijs L. Becker PharmD
    Abstract Purpose Simvastatin and atorvastatin are metabolized by the CYP3A4 enzyme and transported by the ABCB1 transporter. We studied whether the polymorphism CYP3A4*1B and the polymorphisms C1236T, G2677A/T and C3435T in the ABCB1 gene were associated with a decrease of the prescribed dose or a switch to another cholesterol lowering drug during simvastatin and atorvastatin therapy. These events may indicate that statin plasma levels were too high and resulted in an adverse drug reaction or a too strong reduction in cholesterol level. Methods We identified 1239 incident simvastatin and atorvastatin users in the Rotterdam Study, a population-based cohort study. Associations between the polymorphisms in the CYP3A4 and ABCB1 gene and the time to a decrease in dose or a switch to another cholesterol lowering drug were studied using Cox proportional hazards. Results Simvastatin and atorvastatin users with the CYP3A4*1B variant G allele had a lower risk (HR 0.46; 95%CI 0.24,0.90) for these events than users with the wild-type AA genotype. No significant associations were found for the ABCB1 polymorphisms. The association with the CYP3A4*1B polymorphism was found in women (HR 0.33; 95%CI 0.12,0.89) and was non-significant in men (HR 0.69 95%CI 0.28,1.70). This association was stronger in patients with the ABCB1 3435T variant allele versus the G allele. Conclusion In simvastatin and atorvastatin users, the CYP3A4*1B G allele is associated with a lower risk of elevated statin plasma levels, particularly in women and in users with the ABCB1 3435T variant allele. Copyright © 2009 John Wiley & Sons, Ltd. [source]

    Information search in heuristic decision making

    APPLIED COGNITIVE PSYCHOLOGY, Issue 4 2010
    Mandeep K. Dhami
    Simple heuristics of the type introduced by Gigerenzer, Todd, and The ABC Research Group (1999) embody principles for information search, stop and decision making. These heuristics suggest that such processes are simple. In an analysis of general practitioners' (GPs) information search and decision-making behaviour when prescribing a lipid lowering drug, we examined whether information search was simple, and whether a heuristic that predicts a simple decision-making process was also accurate at describing information search. We found that GPs' information search behaviour was simple in that it demonstrated characteristics of the matching heuristic (e.g. stopping rule). In addition, although the matching heuristic which correctly predicted on average 75% of GPs' decisions used significantly fewer cues on average than the GPs did in the information search task, it was reasonably accurate in describing order of information search. These findings have implications for the validity of simple heuristics describing both information search and decision making. Copyright © 2009 John Wiley & Sons, Ltd. [source]

    Bimatoprost: Mechanism of Ocular Surface Hyperemia Associated with Topical Therapy

    CARDIOVASCULAR THERAPEUTICS, Issue 3 2005
    June Chen
    ABSTRACT Bimatoprost is a safe and well-tolerated intraocular pressure (IOP) lowering drug that was approved in the United States in 2001 for the treatment of glaucoma and ocular hypertension. It is highly efficacious and produces greater mean reductions in IOP than other currently available antiglaucoma drugs. Conjunctival hyperemia is a common side effect of bimatoprost, but the hyperemia is typically mild and transient. No association has been found between signs of inflammation and the presence of hyperemia in bimatoprost-treated patients. Preclinical studies have elucidated the pharmacological mechanism of bimatoprost-related hyperemia and have examined the possible involvement of inflammation. Bimatoprost, as well as the free acid of latanoprost, elicited endothelium-de-pendent vasorelaxation in the rabbit jugular vein preparation, a quantitative in vitro model for ocular surface hyperemia (OSH). The vasorelaxant responses to either bimatoprost or latanoprost free acid were significantly inhibited by L-NAME, a nitric oxide synthase inhibitor. Similarly, the in vivo OSH responses to topically applied bimatoprost or latanoprost in dog eyes were significantly inhibited by L-NAME. As predicted, prostaglandin E2 (PGE2)-induced conjunctival hyperemia was not inhibited by L-NAME, since PGE2 has a direct relaxant effect on the vascular smooth muscle. In-life observations and histopatho-logical assessment of ocular surface tissues following bimatoprost treatment were performed for multiple-dose one month, 6 month, or 12 month safety studies in rabbits, dogs, and non-human primates. Results of these studies showed no evidence of bimatoprost-re-lated inflammation in the ocular surface tissues. In summary, OSH related to bimatoprost treatment in laboratory animals occurs by endothelial-derived nitric oxide-mediated vasodilatation and is not associated with inflammation. These studies suggest that conjunctival hyperemia, a side effect of bimatoprost treatment, results from non-inflammatory, pharmacologically based vasodilatation. [source]

    Liver fibrosis attributed to lipid lowering medications: two cases

    JOURNAL OF INTERNAL MEDICINE, Issue 3 2001
    Z. Punthakee
    Abstract. Punthakee Z, Scully LJ, Guindi MM, Ooi TC (Department of Medicine, Division of Gastroenterology, Department of Pathology and the Laboratory of Medicine and the Division of Endocrinology and Metabolism, The Ottawa Hospital , Civic Campus, University of Ottawa, Ottawa, Canada). Liver fibrosis attributed to lipid lowering medications: two cases (Case Report). J Intern Med 2001; 250: 249,254. We identified two cases of chronic active hepatitis with liver fibrosis induced by lipid lowering drugs of the statin and fibrate classes despite regular monitoring of transaminases. There are few reports of clinically significant hepatitis induced by these drugs and even fewer cases of fibrosis. Given the growing use of these drugs, there are implications for monitoring patients on long-term therapy for liver damage. [source]

    Refill adherence and polypharmacy among patients with type 2 diabetes in general practice

    PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 11 2009
    Rykel van Bruggen PhD
    Abstract Background and Aims Non-adherence is considered a major barrier to better outcomes of diabetes care. A relationship has been established between polypharmacy and patients' adherence. This study aims to investigate the occurrence of polypharmacy and non-adherence in general practice, their mutual relationship and the association between adherence and the intermediate outcomes of diabetes care. Materials and Methods We used the baseline and follow-up data of a randomised controlled trial (RCT) that compared usual care with care in accordance with a locally adapted national guideline. This study took place in the Netherlands and involved 30 general practices and 1283 patients. We obtained a complete medication profile of all participants and calculated the number of prescribed drugs and the adherence indices (AI) for oral blood glucose, blood pressure and cholesterol lowering drugs. Patients with an adherence index <,0.8 were considered non-adherent. Clustering at practice level and case-mix were taken into account. Results Approximately 80% of the participating patients demonstrated an adherence index ,,0.8 for oral blood glucose, blood pressure and cholesterol lowering drugs. In the intervention group, increase of drug prescriptions exceeded that of controls (1.1,±,2.0 vs. 0.6,±,1.5, p,<,0.001, adjusted p,<,0.05). There was evidence of an inverse relationship between the number of drugs that had been prescribed during the last 6 months of the study and patients' adherence to blood pressure lowering medications (adjusted OR 0.84, 95%CI 0.78,0.91). After one year, HbA1c and total cholesterol levels were significantly lower in adherent patients. Conclusion During the intervention the mean number of drug prescriptions increased in both the study groups. This did not result in a lower adherence to blood glucose and cholesterol lowering medications. Given the relationship between the number of medications and patients' adherence to blood pressure lowering drugs, it may be wise to discuss adherence before prescribing multiple drug regimens. Copyright © 2009 John Wiley & Sons, Ltd. [source]

    Pharmacy data in epidemiological studies: an easy to obtain and reliable tool

    PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 5 2002
    Taco B. M. Monster MPharmSc
    Abstract Purpose The agreement between drug use measured in computerized pharmacy records and patient interviews or questionnaires is generally good. However, most investigations on this subject studied selected populations or subsets. We studied the coverage of Dutch pharmacy data for our study cohort, and the agreement between the different sources. Methods We used the data from 8592 subjects of an on-going population-based study, focused on the impact of microalbuminuria (PREVEND). Data on drug use was collected in a questionnaire and at community pharmacies. Drug use was measured in the year preceding the questionnaire. Agreement between the sources was measured using kappa-values, sensitivity and positive predictive value. Results Pharmacy data could be collected for 7568 (88%) of the study cohort. Pharmacy data and questionnaires showed good agreement for antihypertensives, lipid lowering drugs, oral antidiabetics and oral contraceptives, but poor agreement for nitrates, hormone replacement therapy and painkillers. Conclusions Pharmacy data could be collected for a large proportion of our cohort. For chronically used drugs pharmacy data generally agrees well with questionnaires. However, for drugs used for shorter periods, as needed, or also available over-the-counter, the agreement is not so good. Pharmacy data can be a valuable source of drug information in epidemiological studies. Copyright © 2002 John Wiley & Sons, Ltd. [source]

    Low-Density Lipoprotein Apheresis: Clinical Results with Different Methods

    ARTIFICIAL ORGANS, Issue 2 2002
    Rolf Bambauer
    Abstract: In 40 patients (22 women, 18 men) suffering from familial hypercholesterolemia resistant to diet and lipid lowering drugs, low-density lipoprotein (LDL) apheresis was performed over 84.9 ± 43.2 months. Four different systems (Liposorber, 28 of 40, Kaneka, Osaka, Japan; Therasorb, 6 of 40, Baxter, Munich, Germany; Lipopak, 2 of 40, Pocard, Moscow, Russia; and Dali, 4 of 40, Fresenius, St. Wendel, Germany) were used. With all methods, average reductions of 50.6% for total cholesterol, 52.2% for LDL, 64.3% for lipoprotein (a) (Lp[a]), and 43.1% for triglycerides, and an average increase of 10.3% for high-density lipoprotein (HDL) were reached. Severe side effects such as shock or allergic reactions were very rare (0.5%) in all methods. In the course of treatment, an improvement in general well being and increased performance were experienced by 39 of 40 patients. Assessing the different apheresis systems used, at the end of the trial, there were no significant differences with respect to the clinical outcome experienced with the patients' total cholesterol, LDL, HDL, and triglyceride concentrations. However, to reduce high Lp(a) levels, the immunoadsorption method with special Lp(a) columns (Lipopak) seems to be most effective: ,59% versus ,25% (Kaneka) , (Baxter), and ,29% (Dali). The present data demonstrate that treatment with LDL apheresis of patients suffering from familial hypercholesterolemia resistant to maximum conservative therapy is very effective and safe even in long-term application. [source]