Clinical Medicine and Therapeutics最新文献_第7页

Benefits of ACE Inhibitors in Diabetes ACE抑制剂对糖尿病的益处

Clinical Medicine and Therapeutics Pub Date : 2009-08-14 DOI: 10.4137/CMT.S2027

M. Ramos-Nino, Steven R. Blumen

引用次数: 9

Insomnia: A Review of the Use of eszopiclone 失眠:艾司佐匹克隆的应用综述

Clinical Medicine and Therapeutics Pub Date : 2009-08-12 DOI: 10.4137/CMT.S1940

Natalie D Dautovich, Jacob M Williams, C. McCrae

引用次数: 0

Management of eGFR-Mutant non-small cell Lung cancer: Focus on Gefitinib egfr突变型非小细胞肺癌的治疗:以吉非替尼为重点

Clinical Medicine and Therapeutics Pub Date : 2009-08-12 DOI: 10.4137/CMT.S2122

Y. Naito, K. Goto

{"title":"Management of eGFR-Mutant non-small cell Lung cancer: Focus on Gefitinib","authors":"Y. Naito, K. Goto","doi":"10.4137/CMT.S2122","DOIUrl":"https://doi.org/10.4137/CMT.S2122","url":null,"abstract":"Gefitinib is a first generation, reversible epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), and EGFR TKIs, such as gefitinib and erlotinib, have yielded dramatic and durable responses in approximately 75% of of non-small cell lung cancer (NSCLC) patients whose tumor has an activating EGFR mutation. EGFR mutations are found in approximately 10%–15% of lung cancers in Caucasians, and they are more frequent in female patients, patients with adenocarcinoma, patients who are never- smokers or have a history of light-smoking, and patients with Asian ethnicity. Recent phase III trials comparing gefitinib with standard chemotherapy have demonstrated a similar survival benefit of gefitinib in patients with NSCLC and improved quality of life both in a first-line setting (IPASS; comparing gefitinib with carboplatin/paclitaxel) and a previously-treated setting (INTEREST; comparing gefitinib with docetaxel). Subset analyses of the data obtained in these studies showed that in patients with EGFR-mutant NSCLC gefitinib yielded a higher response rate, longer progression-free survival, and similar overall survival than standard cytotoxic chemotherapy did. The toxicity of EGFR TKIs is generally milder than that of standard cytotoxic chemotherapy. This review focuses on gefitinib, and issues in the management of EGFR-mutant NSCLC are discussed.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76689031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Review of Enteric-coated Mycophenolate Sodium for Renal Transplant Immunosuppression 肠溶霉酚酸钠用于肾移植免疫抑制的研究进展

Clinical Medicine and Therapeutics Pub Date : 2009-08-07 DOI: 10.4137/CMT.S2218

N. Newbold, B. Riley, K. Hardinger

{"title":"A Review of Enteric-coated Mycophenolate Sodium for Renal Transplant Immunosuppression","authors":"N. Newbold, B. Riley, K. Hardinger","doi":"10.4137/CMT.S2218","DOIUrl":"https://doi.org/10.4137/CMT.S2218","url":null,"abstract":"Mycophenolic acid inhibits an enzyme, inosine monophosphate dehydrogenase (IMPDH), blocking purine synthesis of lymphocytes and therefore functioning as an effective immunosuppressive agent in transplantation. Currently, there are two available forms of mycophenolic acid (MPA) available; mycophenolate mofetil (MMF) and enteric-coated, delayed-release mycophenolate sodium (EC-MPS). Both products are approved for prophylaxis of organ rejection in renal transplant recipients. The use of MPA may be associated with adverse gastrointestinal effects which can lead to a reduction of the dose or discontinuation of therapy. Enteric-coated MPS was developed to reduce the upper gastrointestinal side effects due to its delayed release in the small intestines. Similar systemic MPA exposure is provided by oral administration of MMF 1000 mg daily and EC-MPS 720 mg, which contain near equimolar MPA content. Clinical trials in renal transplant recipients have demonstrated that EC-MPS is therapeutically equivalent to MMF when used at the time of transplantation and when used for conversion for gastrointestinal complications. The available literature regarding the incidence and severity of gastrointestinal adverse effects and the impact on quality of life remains controversial. Prospective, randomized trials of the available MPA formulations are warranted to further explore the gastrointestinal adverse effect profiles.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89699497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Clopidogrel Bisulfate: A Review of its Use in the Management of Acute Coronary Syndrome 硫酸氢氯吡格雷在急性冠脉综合征治疗中的应用综述

Clinical Medicine and Therapeutics Pub Date : 2009-08-07 DOI: 10.4137/CMT.S1170

R. Rossini, G. Musumeci, Tamar Nijaradze, A. Gavazzi

{"title":"Clopidogrel Bisulfate: A Review of its Use in the Management of Acute Coronary Syndrome","authors":"R. Rossini, G. Musumeci, Tamar Nijaradze, A. Gavazzi","doi":"10.4137/CMT.S1170","DOIUrl":"https://doi.org/10.4137/CMT.S1170","url":null,"abstract":"Antiplatelet therapy is the cornerstone in the modern therapy of patients with acute coronary syndromes (ACS), because of the unique role of platelets in coronary thrombosis. Clopidogrel in combination with aspirin is the current “gold standard” for reducing cardiovascular events in such patients, providing a synergistic platelet inhibition through different platelet activation pathways. Clopidogrel is a thienopyridine which inhibits ADP-induced platelet aggregation, with no direct effects on the metabolism of arachidonic acid. Due to a better safety profile with a similar antiplatelet effectiveness, it is preferred to ticlopidine. In patients with ACS without ST segment elevation (NSTEMI), clopidogrel plus aspirin is able to reduce the relative risk of adverse cardiovascular events by 20%, compared with aspirin alone. Clopidogrel plays a key role also in patients undergoing coronary stenting, in order to prevent stent thrombosis. Pretreatment and long-term treatment with clopidogrel reduces by about one-third the risk of cardiovascular death or myocardial infarction in NSTEMI ACS patients undergoing percutaneous coronary angioplasty (PCI). However, a long-term dual antiplatelet therapy is associated with a higher rate of bleeding events. Clinical practice guidelines currently recommend long-term dual antiplatelet therapy with aspirin and clopidogrel in patients with ACS and a pre-treatment with clopidogrel in every patient scheduled for PCI. The concept of clopidogrel resistance and the need for a pretreatment in patients undergoing coronary stent implantation led to the concept that an improved antiplatelet regimen with novel drugs is desirable.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78216870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Current and Prospective Pharmacotherapies in Gastroesophageal Reflux Disease 胃食管反流病的当前和未来药物治疗

Clinical Medicine and Therapeutics Pub Date : 2009-08-05 DOI: 10.4137/CMT.S2744

L. Nguyen, J. Birk

{"title":"Current and Prospective Pharmacotherapies in Gastroesophageal Reflux Disease","authors":"L. Nguyen, J. Birk","doi":"10.4137/CMT.S2744","DOIUrl":"https://doi.org/10.4137/CMT.S2744","url":null,"abstract":"Gastroesophageal reflux disease (GERD) is very common and is a costly problem to manage. The annual direct cost for managing the disease is estimated to be more than $9 billion dollars in the USA. In western populations, 25% of people over age 30 report having heartburn at least once a month, 12% at least once per week, and 5% describe daily symptoms. However, the prevalence of the disease tends to be underestimated, with unrecognized GERD occurring in more than 50% of patients seen in general practice for unrelated conditions. GERD is defined as symptoms or mucosal damage produced by the abnormal reflux of gastric contents against the gradient of the lower esophageal sphincter (LES) pressure into the distal esophagus, leading to impaired quality of life and other complications. The disease is thought to be caused by reduced pressure of the lower esophageal sphincter (LES) and delayed gastric emptying. It is well-recognized that GERD is associated with a variety of clinical syndromes and that it is frequently a chronic condition, often requiring long-term maintenance therapy. It can be subdivided into erosive esophagitis (EE) and non-erosive reflux disease (NERD). Patients with NERD have no mucosal breaks in the esophagus, but have typical reflux symptoms. The spectrum of upper gastrointestinal complications of GERD includes erosive esophagitis, stricture and Barrett’s esophagus, which may increase the risk of esophageal adenocarcinoma. Treatment options available for GERD range from over-the-counter (OTC) antacids to proton pump inhibitors (PPIs) and anti-reflux endoscopic procedures and surgery. This article will review each of the pharmacotherapeutic options, including new developments in proton pump inhibitor isomers, potassium competitive acid blockers and endoscopic therapy for gastroesophageal reflux disease.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82069506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Pharmacotherapy of Epilepsy: Focus on Levetiracetam 癫痫的药物治疗:以左乙拉西坦为主

Clinical Medicine and Therapeutics Pub Date : 2009-08-05 DOI: 10.4137/CMT.S1096

M. E. Adams, A. Chung, Lea S. Eiland

引用次数: 0

pharmacotherapy of Candida Infections with echinocandins 刺白菌素对念珠菌感染的药物治疗

Clinical Medicine and Therapeutics Pub Date : 2009-08-04 DOI: 10.4137/CMT.S2311

A. Espinel-Ingroff, E. Cantón, E. Martín-Mazuelos, J. Pemán

引用次数: 8

Management Options in Chronic Stable Angina Pectoris: Focus on Ranolazine 慢性稳定型心绞痛的治疗选择:关注雷诺嗪

Clinical Medicine and Therapeutics Pub Date : 2009-07-31 DOI: 10.4137/CMT.S2214

D. Vadnais, N. Wenger

{"title":"Management Options in Chronic Stable Angina Pectoris: Focus on Ranolazine","authors":"D. Vadnais, N. Wenger","doi":"10.4137/CMT.S2214","DOIUrl":"https://doi.org/10.4137/CMT.S2214","url":null,"abstract":"Chronic stable angina pectoris results from a fixed coronary arterial obstruction causing an imbalance between myocardial oxygen supply and demand. Current therapy aims to reduce cardiovascular events (vasculoprotective) thereby improving survival, and/or relieve ischemic symptoms (antianginal) thereby improving the quality of life. Vasculoprotective therapy consists of lifestyle modification, antiplatelet agents, lipid lowering therapy and angiotensin-converting enzyme (ACE) inhibitors. Conventional antianginal therapy for patients with chronic stable angina consists of beta-blockers, calcium channel blockers and nitrates, with surgical or percutaneous revascularization serving an adjunctive role. Despite the investigation of multiple novel therapies and medications over the past 25 years, arguably the most significant contribution to antianginal therapy during that time involved the recent introduction of ranolazine. Ranolazine acts via a distinctive pathway, inhibiting the late sodium current of the action potential in ischemic myocytes. Multiple studies have demonstrated that ranolazine significantly reduces anginal symptoms and improves exercise performance in patients with chronic stable angina but does not reduce mortality. Ranolazine does not affect either heart rate or blood pressure, a unique property among the current antianginal agents. Despite its QT prolongation, ranolazine has a proven safety profile and is not proarrhythmic. In fact, in a recent large randomized trial, ranolazine reduced the incidence of supraventricular tachycardia, ventricular tachycardia, new-onset atrial fibrillation and bradycardic events. Ranolazine may confer some additional benefits such as a reduction in HbA1c levels and improved left ventricular diastolic function. Ranolazine is now approved for use in chronic stable angina. Current guidelines recommend beta-blockers as the first line antianginal agent due to the proven mortality reduction. However, for patients with bradycardia or hypotension, ranolazine may be considered as initial antianginal therapy.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87867194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

pharmacotherapy with pamidronate Disodium of Osteolytic Bone Metastases of Breast cancer, Osteolytic Lesions of Multiple Myeloma, and paget's Disease 用帕米膦酸二钠治疗乳腺癌、多发性骨髓瘤和佩吉特病的骨溶解性转移

Clinical Medicine and Therapeutics Pub Date : 2009-07-30 DOI: 10.4137/CMT.S2166

A. Hoff, Y. Novis

引用次数: 0