This document provides an update to the American Society of Clinical Oncology (ASCO) clinical practice guideline for antiemetics. The update aims to provide recommendations on using dexamethasone as a prophylactic antiemetic in patients receiving checkpoint inhibitors and information on new antiemetics, regimens, and cancer agent emetogenicity. Based on two phase III trials, the guideline recommends that all patients receiving a platinum-based doublet with or without the checkpoint inhibitor pembrolizumab receive dexamethasone as part of antiemetic prophylaxis. Recommendations for adults are largely unchanged, with some modifications for olanzapine use. The guideline adds fosaprepitant to
Pharmacy Driven Chemotherapy and Monoclonal Antibody Dose-Rounding: A Cost-Sa...ErisTollkuciPharmDBC
This document summarizes the key points of a chemotherapy dose rounding policy implemented at a medical institution. It describes how published literature has shown dose rounding can save tens of thousands to millions annually. The policy allows rounding doses within 10% of the prescribed amount. It also requires an interdisciplinary consensus for institutional guidelines. A review of three medications found dose rounding reduced vials and saved over $237,000 in an 8 month period.
This document summarizes a study that compared healthcare resource utilization and costs between an elderly patient group that received pharmacogenetic testing and clinical decision support (CDS), and a matched control group that did not receive testing. The tested group had lower rates of hospitalization, emergency department visits, and overall healthcare resource utilization compared to the untested group. Estimated potential cost savings were $218 per tested patient. Providers found the pharmacogenetic testing and CDS tool helpful, and about half followed the tool's recommendations.
The document summarizes updates to EORTC guidelines for the use of granulocyte colony-stimulating factor (G-CSF) to prevent febrile neutropenia from chemotherapy. The 2010 guidelines included 6 recommendations. Key changes were incorporating new risk assessment models and data on pegylated G-CSF and biosimilars. The guidelines emphasize using G-CSF prophylactically based on individual patient and treatment risk factors rather than reactively once neutropenia occurs. Suboptimal G-CSF use is associated with worse outcomes.
ASCO Guideline managmente of immune related advers eventsyeseniahuerta8
This document provides recommendations for managing immune-related adverse events (irAEs) in patients treated with immune checkpoint inhibitor (ICPi) therapy. An expert panel updated clinical practice guidelines based on a systematic review of recent literature on ICPi toxicity management. The recommendations state that ICPi therapy can generally continue for grade 1 toxicities with close monitoring, but consider holding treatment for most grade 2 toxicities. Grade 3 toxicities generally warrant holding ICPis and initiating high-dose corticosteroids. In general, permanent discontinuation of ICPis is recommended for grade 4 toxicities, except for endocrinopathies controlled by hormone replacement. Organ-specific toxicity management strategies are provided in tables.
This document discusses recent advances and ongoing challenges in treating metastatic prostate cancer. Key points include:
1) Androgen deprivation therapy combined with docetaxel or abiraterone plus prednisone is now standard of care for patients initially diagnosed with metastatic disease based on improved survival seen in clinical trials.
2) New, more sensitive imaging techniques are enabling earlier detection of metastases but implications for treatment are still unclear.
3) Longer survival with metastatic disease has prompted questions about optimal treatment of the primary tumor site.
4) Understanding mechanisms of castration resistance, such as altered androgen receptor signaling, may help address ongoing challenges in treating advanced disease.
This guideline provides updated recommendations for outpatient management of fever and neutropenia in adults treated for malignancy. Key recommendations include:
1) Using clinical judgment criteria or validated tools like MASCC or Talcott's rules to determine if patients are low risk and candidates for outpatient management.
2) For low risk patients, administering the first dose of empirical antibiotics in an outpatient setting and observing patients for at least 4 hours before discharge.
3) Recommending an oral fluoroquinolone plus amoxicillin/clavulanate (or clindamycin if penicillin allergic) as initial outpatient empirical therapy, unless fluoroquinolone prophylaxis was previously used
This document provides an updated clinical practice guideline from the American Society of Clinical Oncology (ASCO) and Infectious Diseases Society of America (IDSA) on outpatient management of fever and neutropenia in adults treated for malignancy. The guideline addresses which patients may be appropriate for outpatient treatment, recommended assessments and interventions for outpatients, and antimicrobial treatment options. A systematic review was conducted and the guideline recommendations are based on the available evidence. Key recommendations include using validated tools or clinical judgment to determine which low-risk patients are candidates for outpatient management, administering initial antibiotic doses within 1 hour and monitoring patients for at least 4 hours before discharge, and considering oral fluoroquinolone plus amo
Pharmacy Driven Chemotherapy and Monoclonal Antibody Dose-Rounding: A Cost-Sa...ErisTollkuciPharmDBC
This document summarizes the key points of a chemotherapy dose rounding policy implemented at a medical institution. It describes how published literature has shown dose rounding can save tens of thousands to millions annually. The policy allows rounding doses within 10% of the prescribed amount. It also requires an interdisciplinary consensus for institutional guidelines. A review of three medications found dose rounding reduced vials and saved over $237,000 in an 8 month period.
This document summarizes a study that compared healthcare resource utilization and costs between an elderly patient group that received pharmacogenetic testing and clinical decision support (CDS), and a matched control group that did not receive testing. The tested group had lower rates of hospitalization, emergency department visits, and overall healthcare resource utilization compared to the untested group. Estimated potential cost savings were $218 per tested patient. Providers found the pharmacogenetic testing and CDS tool helpful, and about half followed the tool's recommendations.
The document summarizes updates to EORTC guidelines for the use of granulocyte colony-stimulating factor (G-CSF) to prevent febrile neutropenia from chemotherapy. The 2010 guidelines included 6 recommendations. Key changes were incorporating new risk assessment models and data on pegylated G-CSF and biosimilars. The guidelines emphasize using G-CSF prophylactically based on individual patient and treatment risk factors rather than reactively once neutropenia occurs. Suboptimal G-CSF use is associated with worse outcomes.
ASCO Guideline managmente of immune related advers eventsyeseniahuerta8
This document provides recommendations for managing immune-related adverse events (irAEs) in patients treated with immune checkpoint inhibitor (ICPi) therapy. An expert panel updated clinical practice guidelines based on a systematic review of recent literature on ICPi toxicity management. The recommendations state that ICPi therapy can generally continue for grade 1 toxicities with close monitoring, but consider holding treatment for most grade 2 toxicities. Grade 3 toxicities generally warrant holding ICPis and initiating high-dose corticosteroids. In general, permanent discontinuation of ICPis is recommended for grade 4 toxicities, except for endocrinopathies controlled by hormone replacement. Organ-specific toxicity management strategies are provided in tables.
This document discusses recent advances and ongoing challenges in treating metastatic prostate cancer. Key points include:
1) Androgen deprivation therapy combined with docetaxel or abiraterone plus prednisone is now standard of care for patients initially diagnosed with metastatic disease based on improved survival seen in clinical trials.
2) New, more sensitive imaging techniques are enabling earlier detection of metastases but implications for treatment are still unclear.
3) Longer survival with metastatic disease has prompted questions about optimal treatment of the primary tumor site.
4) Understanding mechanisms of castration resistance, such as altered androgen receptor signaling, may help address ongoing challenges in treating advanced disease.
This guideline provides updated recommendations for outpatient management of fever and neutropenia in adults treated for malignancy. Key recommendations include:
1) Using clinical judgment criteria or validated tools like MASCC or Talcott's rules to determine if patients are low risk and candidates for outpatient management.
2) For low risk patients, administering the first dose of empirical antibiotics in an outpatient setting and observing patients for at least 4 hours before discharge.
3) Recommending an oral fluoroquinolone plus amoxicillin/clavulanate (or clindamycin if penicillin allergic) as initial outpatient empirical therapy, unless fluoroquinolone prophylaxis was previously used
This document provides an updated clinical practice guideline from the American Society of Clinical Oncology (ASCO) and Infectious Diseases Society of America (IDSA) on outpatient management of fever and neutropenia in adults treated for malignancy. The guideline addresses which patients may be appropriate for outpatient treatment, recommended assessments and interventions for outpatients, and antimicrobial treatment options. A systematic review was conducted and the guideline recommendations are based on the available evidence. Key recommendations include using validated tools or clinical judgment to determine which low-risk patients are candidates for outpatient management, administering initial antibiotic doses within 1 hour and monitoring patients for at least 4 hours before discharge, and considering oral fluoroquinolone plus amo
This study compared outcomes of patients with MDR/XDR Acinetobactor baumannii pneumonia treated with tigecycline or colistin. 70 patients received either tigecycline (n=30) or colistin (n=40). There were no significant differences in clinical outcomes between the two groups except nephrotoxicity, which only occurred in the colistin group. While the study indicates comparable efficacy, limitations include its small size, retrospective design, and exclusions. Further large randomized studies are still needed to properly evaluate tigecycline and optimal treatment combinations for MDR infections.
The document summarizes the history and requirements of Risk Evaluation and Mitigation Strategy (REMS) programs mandated by the FDA for certain drugs. It focuses on the use of erythropoiesis-stimulating agents (ESAs) in cancer patients. Several meta-analyses found ESAs increased risks of thrombosis, mortality, and decreased survival. The FDA Oncologic Drugs Advisory Committee reviewed these findings and required boxed warnings be added to ESAs about increased risks. The committee later recommended limiting ESA use to palliative patients only after receiving informed consent due to further trials showing adverse outcomes. As of 2010, over 150 drugs had FDA-mandated REMS programs including required medication guides for almost all drugs.
DDS personalised medicines M.Pharma 1st Sem Pharmaceutics.pptxkushaltegginamani18
The document discusses personalized medicines and customized drug delivery systems. It defines personalized medicine as using genetic profiling and other individual patient characteristics to guide medical treatment. Customized drug delivery systems aim to optimize drug therapy for each patient by controlling dosage and delivery through technologies like bioelectronic medicines, 3D printing of pharmaceuticals, and telepharmacy.
Personalized Medicine Pharmacogenomics-.pptAiswaryaA41
The document discusses personalized medicine and pharmacogenomics. It defines key terms like personalized medicine, pharmacogenomics, and pharmacogenetics. Personalized medicine aims to tailor treatment to an individual's unique genetic characteristics and biomarkers to improve health outcomes. The Precision Medicine Initiative launched by President Obama aims to advance this approach. Examples are provided of drugs like warfarin and abacavir where genetic testing can optimize dosing and reduce adverse reactions. Challenges include integrating pharmacogenomics into clinical practice and addressing ethical issues, but personalized medicine may improve drug development and patient care.
Fatimah Al-Shehri,journal club presentation of amplfy study..pptssuser48d545
This study compared the efficacy and safety of apixaban versus conventional therapy for the treatment of venous thromboembolism. The study included 5395 patients who were randomly assigned to receive either apixaban twice daily for 7 days then 5 mg twice daily for 6 months, or enoxaparin followed by warfarin for 6 months. The primary outcome was recurrent symptomatic VTE or death related to VTE. Apixaban was found to be noninferior to conventional therapy for the primary outcome and resulted in significantly less major bleeding events.
This study evaluated whether continuing dual antiplatelet therapy (DAPT) beyond one year after drug-eluting stent placement reduces adverse events. It was a large randomized controlled trial comparing aspirin + thienopyridine to aspirin + placebo in patients who had completed one year of standard DAPT. Continuing thienopyridine therapy until 30 months reduced stent thrombosis and major adverse cardiovascular events, but increased moderate or severe bleeding risks compared to placebo. The study provides evidence that prolonging DAPT to 30 months may benefit patients who complete one year of standard therapy without adverse events.
This document discusses the importance and benefits of pharmacogenomics in clinical practice. Pharmacogenomics is the study of how genes affect a person's response to medications. It combines pharmacology and genomics to develop safe and effective medication doses tailored to a person's genetic makeup. Integrating pharmacogenomic testing into practice can help reduce adverse drug reactions, enhance patient outcomes, and lower healthcare costs by avoiding trial-and-error prescribing. Certain populations, such as older adults taking multiple chronic medications, are most likely to benefit from this personalized approach to medication treatment and management. Successful integration requires a partnership approach to help navigate workflow requirements and provide expertise, education and support to providers.
The document discusses the increasing need for companion diagnostics to accompany targeted cancer therapies. It outlines three categories of diagnostic development: 1) Co-development of the drug and diagnostic from an early stage; 2) Development of a diagnostic after a drug is approved to identify patients who will benefit; and 3) Development of a diagnostic for one indication that is later repurposed for another. It also discusses the regulatory environment, noting that regulatory agencies like the FDA are increasingly requiring companion diagnostics and biomarkers to guide patient selection and drug approval. Developing diagnostics poses challenges for drug companies who must partner with diagnostic firms and navigate regulatory requirements.
This document discusses how complementary and alternative medicines (CAMs) are increasingly being used by patients and can impact cardiopulmonary bypass. It presents two case studies of patients taking specific CAMs (Sovaldi/Ribavirin and Saw Palmetto) who experienced bleeding issues during bypass surgery. The document advocates for perfusionists to be aware of CAMs patients are taking and create discontinuation plans in advance to improve outcomes and decrease blood product usage and costs.
Clinical pharmacokinetics and its application--
1)definition
2) APPLICATIONS OF CLINICAL PHARMACOKINETICS
Design of dosage regimens:
a) Nomograms and Tabulations in designing dosage regimen,
b) Conversion from intravenous to oral dosing,
c) Determination of dose and dosing intervals,
d) Drug dosing in the elderly and pediatrics and obese patients.
Pharmacokinetics of Drug Interaction:
a) Pharmacokinetic drug interactions
b) Inhibition and Induction of Drug metabolism
c) Inhibition of Biliary Excretion.
Therapeutic Drug monitoring:
a) Introduction
b) Individualization of drug dosage regimen (Variability – Genetic, Age and Weight, disease, Interacting drugs).
c) Indications for TDM. Protocol for TDM.
d) Pharmacokinetic/Pharmacodynamic Correlation in drug therapy.
e) TDM of drugs used in the following disease conditions: cardiovascular disease, Seizure disorders, Psychiatric conditions, and Organ transplantations
Dosage adjustment in Renal and Hepatic Disease.
a. Renal impairment
b. Pharmacokinetic considerations
c. General approach for dosage adjustment in renal disease.
d. Measurement of Glomerular Filtration rate and creatinine clearance.
e. Dosage adjustment for uremic patients.
f. Extracorporeal removal of drugs.
g. Effect of Hepatic disease on pharmacokinetics.
Population Pharmacokinetics.
a) Introduction to Bayesian Theory.
b) Adaptive method or Dosing with feedback.
c) Analysis of Population pharmacokinetic Data
The document discusses using genetic testing to guide warfarin therapy. It explains that genetic polymorphisms affect individuals' responses to medications like warfarin. Variants in CYP2C9 and VKORC1 genes influence warfarin dosing, with clinical trials showing genotype-guided dosing results in faster stabilization of anticoagulation and less risk of bleeding events. The author proposes a study at UNC to incorporate pharmacogenomic guidance in initial warfarin dosing to improve outcomes.
Acetaminophen poisoning an evidence based consensus guideline for out of hosp...Toxicologia Clinica México
This document presents guidelines for the out-of-hospital management of acetaminophen poisoning. It was created by an expert consensus panel using an evidence-based process. The guidelines provide recommendations on the initial history, need for emergency department referral, use of activated charcoal, and management of repeated supratherapeutic ingestion of acetaminophen. The recommendations are meant to assist poison centers and are not a substitute for clinical judgment. Acetaminophen poisoning is common and these guidelines aim to optimize patient outcomes, reduce costs, and decrease disruption for patients and caregivers.
This article summarizes a large healthcare system's comprehensive approach to reducing inappropriate opioid prescribing. The healthcare system implemented policies restricting opioid prescriptions, monitoring processes for patients on long-term opioids, and integrated these changes into their electronic health records. An evaluation found reductions in high dose opioid prescriptions, large opioid prescriptions, combination opioid prescriptions, and brand name opioid prescriptions after implementing these interventions between 2010-2015. The article concludes the interventions were effective in positively affecting opioid prescribing practices in this healthcare system.
The document discusses recent advances in biosimilars and their future prospects. It begins with an abstract about a student's seminar presentation on personalized medicine and pharmacogenomics. The contents section lists topics like what biosimilars are, literature reviews on the use of targeted drugs and clinical trials, the need for and advantages of personalized medicine, and case studies on using genetic testing to target lung cancer treatments. It explores how pharmacogenomics can optimize drug responses based on a patient's genetics and discusses patents and the future of personalized healthcare.
In this webinar, Dr. Azad discusses colorectal cancer recurrence. She addresses things to do to help reduce the risk of recurrence, in addition to what steps should be taken if colon or rectal cancer returns.
Colorectal Cancer Research & Treatment News - recap from the May 2014 ASCO co...Fight Colorectal Cancer
This document summarizes key findings from the PRIME trial evaluating the addition of panitumumab to FOLFOX4 as first-line treatment for metastatic colorectal cancer. Biomarker analysis found that KRAS exon 2 wild-type tumors derived greater benefit from the addition of panitumumab, with a progression-free survival advantage compared to FOLFOX4 alone. Further biomarker testing found mutations in other RAS isoforms or BRAF reduced likelihood of benefit from panitumumab. The results support use of RAS/BRAF mutation testing to select patients for first-line anti-EGFR therapy in combination with chemotherapy.
The document discusses efforts by the National Institutes of Health (NIH) and Food and Drug Administration (FDA) to advance personalized medicine through several initiatives:
1. Developing a more integrated pathway to connect target identification by researchers to drug approval to help fill the void of insufficient private sector interest in most new targets.
2. The TRND program will help accelerate development of drugs for rare and neglected diseases by funding preclinical development.
3. The FDA is developing standards to incorporate genetic information into drug and device development and using biomarkers to evaluate therapies through its Critical Path Initiative.
The document discusses the drug Avastin and challenges facing its manufacturer Roche/Genentech. It summarizes that while Avastin provides significant benefits to some cancer patients, recent clinical trials found only small average survival benefits or no survival benefits at all for some cancer types. As a result, government agencies and insurers are challenging Roche/Genentech to develop predictive biomarkers to identify the patients most likely to benefit from Avastin treatment. The manufacturer has tested over 150 potential biomarkers but has yet to find effective ones, which could impact patients and the drug's position in personalized cancer treatment.
Chair, Sumanta Kumar Pal, MD, FASCO, David F. McDermott, MD, and Tian Zhang, MD, MHS, prepared useful Practice Aids pertaining to renal cell carcinoma for this CME/MOC activity titled “Breaking New Ground in RCC Management: Expert Guidance on Leveraging Therapeutic Strategies.” For the full presentation, downloadable Practice Aids, and complete CME/MOC information, and to apply for credit, please visit us at http://bit.ly/3AB7i5r. CME/MOC credit will be available until March 16, 2024.
This study compared outcomes of patients with MDR/XDR Acinetobactor baumannii pneumonia treated with tigecycline or colistin. 70 patients received either tigecycline (n=30) or colistin (n=40). There were no significant differences in clinical outcomes between the two groups except nephrotoxicity, which only occurred in the colistin group. While the study indicates comparable efficacy, limitations include its small size, retrospective design, and exclusions. Further large randomized studies are still needed to properly evaluate tigecycline and optimal treatment combinations for MDR infections.
The document summarizes the history and requirements of Risk Evaluation and Mitigation Strategy (REMS) programs mandated by the FDA for certain drugs. It focuses on the use of erythropoiesis-stimulating agents (ESAs) in cancer patients. Several meta-analyses found ESAs increased risks of thrombosis, mortality, and decreased survival. The FDA Oncologic Drugs Advisory Committee reviewed these findings and required boxed warnings be added to ESAs about increased risks. The committee later recommended limiting ESA use to palliative patients only after receiving informed consent due to further trials showing adverse outcomes. As of 2010, over 150 drugs had FDA-mandated REMS programs including required medication guides for almost all drugs.
DDS personalised medicines M.Pharma 1st Sem Pharmaceutics.pptxkushaltegginamani18
The document discusses personalized medicines and customized drug delivery systems. It defines personalized medicine as using genetic profiling and other individual patient characteristics to guide medical treatment. Customized drug delivery systems aim to optimize drug therapy for each patient by controlling dosage and delivery through technologies like bioelectronic medicines, 3D printing of pharmaceuticals, and telepharmacy.
Personalized Medicine Pharmacogenomics-.pptAiswaryaA41
The document discusses personalized medicine and pharmacogenomics. It defines key terms like personalized medicine, pharmacogenomics, and pharmacogenetics. Personalized medicine aims to tailor treatment to an individual's unique genetic characteristics and biomarkers to improve health outcomes. The Precision Medicine Initiative launched by President Obama aims to advance this approach. Examples are provided of drugs like warfarin and abacavir where genetic testing can optimize dosing and reduce adverse reactions. Challenges include integrating pharmacogenomics into clinical practice and addressing ethical issues, but personalized medicine may improve drug development and patient care.
Fatimah Al-Shehri,journal club presentation of amplfy study..pptssuser48d545
This study compared the efficacy and safety of apixaban versus conventional therapy for the treatment of venous thromboembolism. The study included 5395 patients who were randomly assigned to receive either apixaban twice daily for 7 days then 5 mg twice daily for 6 months, or enoxaparin followed by warfarin for 6 months. The primary outcome was recurrent symptomatic VTE or death related to VTE. Apixaban was found to be noninferior to conventional therapy for the primary outcome and resulted in significantly less major bleeding events.
This study evaluated whether continuing dual antiplatelet therapy (DAPT) beyond one year after drug-eluting stent placement reduces adverse events. It was a large randomized controlled trial comparing aspirin + thienopyridine to aspirin + placebo in patients who had completed one year of standard DAPT. Continuing thienopyridine therapy until 30 months reduced stent thrombosis and major adverse cardiovascular events, but increased moderate or severe bleeding risks compared to placebo. The study provides evidence that prolonging DAPT to 30 months may benefit patients who complete one year of standard therapy without adverse events.
This document discusses the importance and benefits of pharmacogenomics in clinical practice. Pharmacogenomics is the study of how genes affect a person's response to medications. It combines pharmacology and genomics to develop safe and effective medication doses tailored to a person's genetic makeup. Integrating pharmacogenomic testing into practice can help reduce adverse drug reactions, enhance patient outcomes, and lower healthcare costs by avoiding trial-and-error prescribing. Certain populations, such as older adults taking multiple chronic medications, are most likely to benefit from this personalized approach to medication treatment and management. Successful integration requires a partnership approach to help navigate workflow requirements and provide expertise, education and support to providers.
The document discusses the increasing need for companion diagnostics to accompany targeted cancer therapies. It outlines three categories of diagnostic development: 1) Co-development of the drug and diagnostic from an early stage; 2) Development of a diagnostic after a drug is approved to identify patients who will benefit; and 3) Development of a diagnostic for one indication that is later repurposed for another. It also discusses the regulatory environment, noting that regulatory agencies like the FDA are increasingly requiring companion diagnostics and biomarkers to guide patient selection and drug approval. Developing diagnostics poses challenges for drug companies who must partner with diagnostic firms and navigate regulatory requirements.
This document discusses how complementary and alternative medicines (CAMs) are increasingly being used by patients and can impact cardiopulmonary bypass. It presents two case studies of patients taking specific CAMs (Sovaldi/Ribavirin and Saw Palmetto) who experienced bleeding issues during bypass surgery. The document advocates for perfusionists to be aware of CAMs patients are taking and create discontinuation plans in advance to improve outcomes and decrease blood product usage and costs.
Clinical pharmacokinetics and its application--
1)definition
2) APPLICATIONS OF CLINICAL PHARMACOKINETICS
Design of dosage regimens:
a) Nomograms and Tabulations in designing dosage regimen,
b) Conversion from intravenous to oral dosing,
c) Determination of dose and dosing intervals,
d) Drug dosing in the elderly and pediatrics and obese patients.
Pharmacokinetics of Drug Interaction:
a) Pharmacokinetic drug interactions
b) Inhibition and Induction of Drug metabolism
c) Inhibition of Biliary Excretion.
Therapeutic Drug monitoring:
a) Introduction
b) Individualization of drug dosage regimen (Variability – Genetic, Age and Weight, disease, Interacting drugs).
c) Indications for TDM. Protocol for TDM.
d) Pharmacokinetic/Pharmacodynamic Correlation in drug therapy.
e) TDM of drugs used in the following disease conditions: cardiovascular disease, Seizure disorders, Psychiatric conditions, and Organ transplantations
Dosage adjustment in Renal and Hepatic Disease.
a. Renal impairment
b. Pharmacokinetic considerations
c. General approach for dosage adjustment in renal disease.
d. Measurement of Glomerular Filtration rate and creatinine clearance.
e. Dosage adjustment for uremic patients.
f. Extracorporeal removal of drugs.
g. Effect of Hepatic disease on pharmacokinetics.
Population Pharmacokinetics.
a) Introduction to Bayesian Theory.
b) Adaptive method or Dosing with feedback.
c) Analysis of Population pharmacokinetic Data
The document discusses using genetic testing to guide warfarin therapy. It explains that genetic polymorphisms affect individuals' responses to medications like warfarin. Variants in CYP2C9 and VKORC1 genes influence warfarin dosing, with clinical trials showing genotype-guided dosing results in faster stabilization of anticoagulation and less risk of bleeding events. The author proposes a study at UNC to incorporate pharmacogenomic guidance in initial warfarin dosing to improve outcomes.
Acetaminophen poisoning an evidence based consensus guideline for out of hosp...Toxicologia Clinica México
This document presents guidelines for the out-of-hospital management of acetaminophen poisoning. It was created by an expert consensus panel using an evidence-based process. The guidelines provide recommendations on the initial history, need for emergency department referral, use of activated charcoal, and management of repeated supratherapeutic ingestion of acetaminophen. The recommendations are meant to assist poison centers and are not a substitute for clinical judgment. Acetaminophen poisoning is common and these guidelines aim to optimize patient outcomes, reduce costs, and decrease disruption for patients and caregivers.
This article summarizes a large healthcare system's comprehensive approach to reducing inappropriate opioid prescribing. The healthcare system implemented policies restricting opioid prescriptions, monitoring processes for patients on long-term opioids, and integrated these changes into their electronic health records. An evaluation found reductions in high dose opioid prescriptions, large opioid prescriptions, combination opioid prescriptions, and brand name opioid prescriptions after implementing these interventions between 2010-2015. The article concludes the interventions were effective in positively affecting opioid prescribing practices in this healthcare system.
The document discusses recent advances in biosimilars and their future prospects. It begins with an abstract about a student's seminar presentation on personalized medicine and pharmacogenomics. The contents section lists topics like what biosimilars are, literature reviews on the use of targeted drugs and clinical trials, the need for and advantages of personalized medicine, and case studies on using genetic testing to target lung cancer treatments. It explores how pharmacogenomics can optimize drug responses based on a patient's genetics and discusses patents and the future of personalized healthcare.
In this webinar, Dr. Azad discusses colorectal cancer recurrence. She addresses things to do to help reduce the risk of recurrence, in addition to what steps should be taken if colon or rectal cancer returns.
Colorectal Cancer Research & Treatment News - recap from the May 2014 ASCO co...Fight Colorectal Cancer
This document summarizes key findings from the PRIME trial evaluating the addition of panitumumab to FOLFOX4 as first-line treatment for metastatic colorectal cancer. Biomarker analysis found that KRAS exon 2 wild-type tumors derived greater benefit from the addition of panitumumab, with a progression-free survival advantage compared to FOLFOX4 alone. Further biomarker testing found mutations in other RAS isoforms or BRAF reduced likelihood of benefit from panitumumab. The results support use of RAS/BRAF mutation testing to select patients for first-line anti-EGFR therapy in combination with chemotherapy.
The document discusses efforts by the National Institutes of Health (NIH) and Food and Drug Administration (FDA) to advance personalized medicine through several initiatives:
1. Developing a more integrated pathway to connect target identification by researchers to drug approval to help fill the void of insufficient private sector interest in most new targets.
2. The TRND program will help accelerate development of drugs for rare and neglected diseases by funding preclinical development.
3. The FDA is developing standards to incorporate genetic information into drug and device development and using biomarkers to evaluate therapies through its Critical Path Initiative.
The document discusses the drug Avastin and challenges facing its manufacturer Roche/Genentech. It summarizes that while Avastin provides significant benefits to some cancer patients, recent clinical trials found only small average survival benefits or no survival benefits at all for some cancer types. As a result, government agencies and insurers are challenging Roche/Genentech to develop predictive biomarkers to identify the patients most likely to benefit from Avastin treatment. The manufacturer has tested over 150 potential biomarkers but has yet to find effective ones, which could impact patients and the drug's position in personalized cancer treatment.
Chair, Sumanta Kumar Pal, MD, FASCO, David F. McDermott, MD, and Tian Zhang, MD, MHS, prepared useful Practice Aids pertaining to renal cell carcinoma for this CME/MOC activity titled “Breaking New Ground in RCC Management: Expert Guidance on Leveraging Therapeutic Strategies.” For the full presentation, downloadable Practice Aids, and complete CME/MOC information, and to apply for credit, please visit us at http://bit.ly/3AB7i5r. CME/MOC credit will be available until March 16, 2024.
Elevate Your Nonprofit's Online Presence_ A Guide to Effective SEO Strategies...TechSoup
Whether you're new to SEO or looking to refine your existing strategies, this webinar will provide you with actionable insights and practical tips to elevate your nonprofit's online presence.
Level 3 NCEA - NZ: A Nation In the Making 1872 - 1900 SML.pptHenry Hollis
The History of NZ 1870-1900.
Making of a Nation.
From the NZ Wars to Liberals,
Richard Seddon, George Grey,
Social Laboratory, New Zealand,
Confiscations, Kotahitanga, Kingitanga, Parliament, Suffrage, Repudiation, Economic Change, Agriculture, Gold Mining, Timber, Flax, Sheep, Dairying,
CapTechTalks Webinar Slides June 2024 Donovan Wright.pptxCapitolTechU
Slides from a Capitol Technology University webinar held June 20, 2024. The webinar featured Dr. Donovan Wright, presenting on the Department of Defense Digital Transformation.
Creative Restart 2024: Mike Martin - Finding a way around “no”Taste
Ideas that are good for business and good for the world that we live in, are what I’m passionate about.
Some ideas take a year to make, some take 8 years. I want to share two projects that best illustrate this and why it is never good to stop at “no”.
A Visual Guide to 1 Samuel | A Tale of Two HeartsSteve Thomason
These slides walk through the story of 1 Samuel. Samuel is the last judge of Israel. The people reject God and want a king. Saul is anointed as the first king, but he is not a good king. David, the shepherd boy is anointed and Saul is envious of him. David shows honor while Saul continues to self destruct.
🔥🔥🔥🔥🔥🔥🔥🔥🔥
إضغ بين إيديكم من أقوى الملازم التي صممتها
ملزمة تشريح الجهاز الهيكلي (نظري 3)
💀💀💀💀💀💀💀💀💀💀
تتميز هذهِ الملزمة بعِدة مُميزات :
1- مُترجمة ترجمة تُناسب جميع المستويات
2- تحتوي على 78 رسم توضيحي لكل كلمة موجودة بالملزمة (لكل كلمة !!!!)
#فهم_ماكو_درخ
3- دقة الكتابة والصور عالية جداً جداً جداً
4- هُنالك بعض المعلومات تم توضيحها بشكل تفصيلي جداً (تُعتبر لدى الطالب أو الطالبة بإنها معلومات مُبهمة ومع ذلك تم توضيح هذهِ المعلومات المُبهمة بشكل تفصيلي جداً
5- الملزمة تشرح نفسها ب نفسها بس تكلك تعال اقراني
6- تحتوي الملزمة في اول سلايد على خارطة تتضمن جميع تفرُعات معلومات الجهاز الهيكلي المذكورة في هذهِ الملزمة
واخيراً هذهِ الملزمة حلالٌ عليكم وإتمنى منكم إن تدعولي بالخير والصحة والعافية فقط
كل التوفيق زملائي وزميلاتي ، زميلكم محمد الذهبي 💊💊
🔥🔥🔥🔥🔥🔥🔥🔥🔥
How to Manage Reception Report in Odoo 17Celine George
A business may deal with both sales and purchases occasionally. They buy things from vendors and then sell them to their customers. Such dealings can be confusing at times. Because multiple clients may inquire about the same product at the same time, after purchasing those products, customers must be assigned to them. Odoo has a tool called Reception Report that can be used to complete this assignment. By enabling this, a reception report comes automatically after confirming a receipt, from which we can assign products to orders.