Journal of Clinical Pharmacy and Therapeutics最新文献

{"title":"Clinical Pharmacist Interventions in a Brazilian Intensive Care Unit: An Eight-Year Retrospective Analysis","authors":"Cyntia Elizabeth Fonseca Bosco Galvão,&nbsp;Dayani Galato","doi":"10.1155/jcpt/5510996","DOIUrl":"https://doi.org/10.1155/jcpt/5510996","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify the pharmaceutical interventions carried out by the clinical pharmacy service in an adult intensive care unit and to evaluate their evolution over an 8-year period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This descriptive study evaluated pharmaceutical interventions recorded between 2016 and 2023 in a general adult ICU of a public hospital in Brasília, Brazil. Data were collected from a clinical pharmacy database, including patient demographics, intervention types, acceptance rates, targeted professionals, and medications involved. Interventions were categorized and analyzed by age groups, year, and professional target.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 3582 interventions were performed in 663 patients, with an acceptance rate of 96%. The median patient age was 58 years, and 56.9% were male. The most frequent interventions were medication addition (23.5%), discontinuation (10.5%), and dosage increase (8.2%). Interventions predominantly targeted the medical team, with a shift from nursing staff in the service’s initial year. The main medications were antimicrobials (notably meropenem), anticoagulants (enoxaparin), and proton pump inhibitors (pantoprazole, omeprazole). Over time, a qualitative and quantitative change in intervention profiles was observed, with increased pharmacist participation in pharmacotherapy decisions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pharmaceutical interventions in the ICU evolved towards greater involvement in pharmacotherapy management, predominantly directed at medical professionals. High acceptance rates indicate the integration of pharmacists into the multidisciplinary team. Further studies are recommended to explore the reduction in nursing-directed interventions and the impact on patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/5510996","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147566518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Effects of Different Peritoneal Dialysis Solution Combination Schemes on Residual Renal Function and Microinflammation: A Pilot Randomized Controlled Trial","authors":"Yanan Song,&nbsp;Ming Yang,&nbsp;Zhixiang Bian,&nbsp;Li Shen,&nbsp;Qin Zhang,&nbsp;Rui Zhu,&nbsp;Shunjie Chen","doi":"10.1155/jcpt/9596675","DOIUrl":"https://doi.org/10.1155/jcpt/9596675","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This pilot study aimed to preliminarily investigate the short-term effects of a combination regimen of acarbose combined with standard glucose dialysate on residual renal function and microinflammatory status in patients newly initiated on peritoneal dialysis and to preliminarily analyze the mediating role of volume load and microinflammatory status in these outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Method&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A randomized controlled design was employed, with 128 patients newly initiating peritoneal dialysis randomly assigned in a 1:1 ratio. Ultimately, 110 patients completed full follow-up and were included in the analysis (55 patients in each of the experimental and control groups). The mean age of patients was approximately 54.5 years, with males accounting for 55.5%. At the conclusion of follow-up, both groups comprised 55 patients each. The experimental group received treatment with “1.5% glucose solution during the day + 7.5% acarbose solution at night,” while the control group received standard glucose dialysate throughout the entire study period. The intervention period lasted 24 weeks. The primary outcome measure was residual renal Kt/V at 6 months (T2). Primary outcomes were compared using covariance analysis, and mediation effects were evaluated. The mediating roles of volume load (ΔECW/TBW) and microinflammation status (Δhs-CRP) at 3 months postintervention (T1) were evaluated.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;After 6 months of intervention, patients in the experimental group demonstrated significantly higher residual kidney Kt/V at T2 compared to the control group (0.62 ± 0.14 vs. 0.54 ± 0.16, &lt;i&gt;p&lt;/i&gt; = 0.012), and their estimated glomerular filtration rate (eGFR) was also significantly superior to that of the control group (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). Concurrently, the experimental group demonstrated improved microinflammation status (hs-CRP at T2: 3.70 vs. 5.70 mg/L, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), with volume load controlled (ECW/TBW at T2: 0.394 vs. 0.402, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and nutritional status enhanced (serum albumin at T2: 38.80 vs. 35.80 g/L, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Mediation analysis indicated that treatment grouping significantly improved volume load and microinflammation status at T1 (pathway a significant, &lt;i&gt;p&lt;/i&gt; &lt; 0.01). However, neither of these factors significantly predicted residual renal function changes at T2 (pathway b not significant), and the indirect effect failed to reach statistical significance.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;For patients initiating peritonea","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/9596675","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147564507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of an Educational Antimicrobial Stewardship Program on Improving Pharmacists’ Knowledge of Antimicrobial Resistance and Stewardship at the Level of the Community","authors":"Luna El Bizri,&nbsp;Sarine El Daouk,&nbsp;Joseph Yaghi,&nbsp;André El Khoury","doi":"10.1155/jcpt/5738203","DOIUrl":"https://doi.org/10.1155/jcpt/5738203","url":null,"abstract":"<p>Antimicrobial resistance is one of the major global threats with a high impact on both the economy and health. The education of the healthcare providers is a well-recognized strategy to empower healthcare professionals in the control and mitigation of antimicrobial resistance, where pharmacists are identified as one of the major players in the rational use of antimicrobials. In this research, we designed and implemented a thorough and holistic multistage program as an educational antimicrobial stewardship program in Lebanon, targeting community pharmacists at the primary healthcare level to prepare them as future stewards. We investigated knowledge, practices, and perceptions of the participants toward AMR and AMS through pre- and postquestionnaires. Results showed moderate AMR and AMS knowledge with areas of improvement identified, highlighting the need for targeted educational efforts. Knowledge gaps decreased from 48.53% to 36.64%, indicating an improvement in AMR and AMS understanding. Pharmacists demonstrated a positive attitude toward AMR and AMS implementation with fair practice. Perceived barriers to AMS implementation included weak interprofessional collaboration, lack of compensation, and unclear national guidelines. Despite Lebanon’s fragile economic and political context, pharmacists expressed a strong willingness to dedicate time and effort in AMS educational program. These findings suggest that incorporating AMS programs designed for pharmacists in the National AMR plan can be an effective tool to reduce misuse and overuse of antimicrobials and raise awareness about AMR and the rational use of antimicrobials within the community.</p>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/5738203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147564156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Population Pharmacokinetic Model to Assess the Cytochrome P450 2B6 Metabolic Probe Bupropion and Hydroxybupropion in Vitamin D-Insufficient and -Replete Patients With Kidney Disease","authors":"Avisek Ghimire,&nbsp;Stacey M. Tuey,&nbsp;Linda Prebehalla,&nbsp;Amandla Atilano-Roque,&nbsp;Gavriel Roda,&nbsp;Lauren E. Thompson,&nbsp;Michel B. Chonchol,&nbsp;Nirav Shah,&nbsp;Michael F. Wempe,&nbsp;Thomas D. Nolin,&nbsp;Melanie S. Joy","doi":"10.1155/jcpt/3265655","DOIUrl":"https://doi.org/10.1155/jcpt/3265655","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this study was to use bupropion as a cytochrome P450 (CYP) 2B6 probe to determine CYP2B6 function by using a population pharmacokinetic approach of parent bupropion and metabolite hydroxybupropion to explore the impacts of chronic kidney disease (CKD) and vitamin D status in patients and control subjects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Plasma concentration data from 19 subjects after administration of 150 mg of sustained-release bupropion were used in pharmacokinetic modeling. Blood samples were collected pre-dose and serially post-dose and analyzed by LC-MS/MS. Population pharmacokinetic analysis was conducted using nonlinear mixed-effect modeling (Phoenix NLME v8.6.1.6, Certara Inc.). A separate post hoc analysis evaluated the formation clearance of hydroxybupropion as an assessment of CYP 2B6 functional activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final model was composed of 2 compartments with first-order formation and elimination for bupropion and hydroxybupropion. A multiplicative error model explained residual variability. Covariates tested in the model, including vitamin D baseline concentrations and CKD, did not have a significant impact on the pharmacokinetics of bupropion and hydroxybupropion. Model validation was performed using visual predictive check. A trend toward increased formation clearance was observed within the CKD group (2.21 L/h vs. 2.65 L/h, <i>p</i> = 0.39) and a slight reduction in the control group (2.96 L/h vs. 2.66 L/h, <i>p</i> = 0.85) with vitamin D repletion vs. insufficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study contributes to the understanding of CYP 2B6 function in CKD and exhibited increased CYP2B6 function in CKD subjects with vitamin D repletion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/3265655","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147564109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Trimethoprim-Sulfamethoxazole-Induced Hepatotoxicity and Cytochrome Protein 450 2C9 Using Food and Drug Administration Adverse Event Reporting System Database","authors":"Hideo Kato,&nbsp;Chihiro Shiraishi,&nbsp;Mao Hagihara,&nbsp;Hiroshige Mikamo,&nbsp;Takuya Iwamoto","doi":"10.1155/jcpt/8891620","DOIUrl":"https://doi.org/10.1155/jcpt/8891620","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Trimethoprim-sulfamethoxazole (TMP-SMX) is the second most frequently implicated drug for liver injury. A previous study reported that its onset may be due to the activation of cytochrome protein 450 (CYP) 2C9. However, few studies have measured the expression levels of CYP2C9 in clinical settings; thus, the association between TMP-SMX–induced liver injury and CYP2C9 has not yet been revealed. This study investigated the reporting frequency of liver injury associated with TMP-SMX alone and in combination with a CYP2C9 inducer or inhibitor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Disproportionality analyses using the Food and Drug Administration adverse event reporting system database were performed to compare the reporting frequency (reporting odds ratio [ROR]; 95% confidence interval [CI]) of drug-induced liver injuries. The reference group consisted of patients administered TMP-SMX alone. Rifampicin was used as the CYP inducer, and fluconazole, metronidazole, and voriconazole as the inhibitors. Drug–drug interaction (DDI) signals were calculated based on the Ω shrinkage measure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The reporting frequency of liver injury increased when used in combination with rifampicin (ROR = 16.90, 95% CI = 13.50–21.15). The concomitant use of inhibitors did not increase the reporting frequency of liver injury (fluconazole, ROR = 0.675, 95% CI = 0.583–0.782; metronidazole, ROR = 0.672, 95% CI = 0.585–0.772; voriconazole, ROR = 1.435, 95% CI = 1.237–1.665). TMP-SMX plus rifampicin only demonstrated DDI signals of liver injury in the Ω shrinkage measure (Ω = 2.878, 95% CI = 2.607–3.148).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The present study provides insight into the reporting patterns of TMP-SMX–associated liver injury with the concomitant use of CYP inducers and inhibitors and suggests a potential safety signal involving increased CYP2C9 activity. These findings should be interpreted with caution because disproportionality analyses cannot establish causality, and further clinical and mechanistic studies are warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/8891620","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147563018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peptic Ulcer Disease Treatment Using Herbal Plants: Harnessing Ethnobotanical Studies for Clinical Application","authors":"Emmanuel Okoampah,&nbsp;Joseph Payne,&nbsp;Joan Davids Shine,&nbsp;Philomina Agyeman,&nbsp;Princess Ofosuhemaa,&nbsp;Osman A. Dufailu","doi":"10.1155/jcpt/6501202","DOIUrl":"10.1155/jcpt/6501202","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Peptic ulcer disease (PUD) is a major gastrointestinal disorder associated with <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection, nonsteroidal anti-inflammatory drug (NSAID) use, and impaired mucosal defense. Ethnobotanical studies have revealed that the heavy reliance on medicinal plants as a treatment option for ulcers is usually guided by traditional knowledge and normal practice rather than scientific validation. Limitations of the existing conventional therapies have necessitated interest in scientifically evaluating the potential of medicinal plants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This review integrates ethnobotanical, phytochemical, and experimental evidence on medicinal plants used in PUD management and examines their clinical translation relevance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ethnobotanical, in vitro, in vivo, and clinical studies were identified through structured database searches and analyzed for plant species, bioactive compounds, mechanisms, and therapeutic effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Medicinal plants exhibited antioxidant, anti-inflammatory, antimicrobial, cytoprotective, and mucosal healing activities, largely mediated by flavonoids, tannins, alkaloids, terpenoids, and saponins.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study has revealed medicinal plants as an ideal candidate for ulceration management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/6501202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147562578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment of the Drug Exposure Models in the Dosing Environment of Inhaled Preparations and Discussion on Contamination Prevention and Control Measures in the Dosing Procedure","authors":"Dan Zhang,&nbsp;Wei Cong,&nbsp;Zejuan Wang,&nbsp;Xiaolin Wang,&nbsp;Jin Wang","doi":"10.1155/jcpt/6648011","DOIUrl":"10.1155/jcpt/6648011","url":null,"abstract":"<p>In order to discuss the contamination prevention and control measures in the dosing procedure of human pharmacokinetic and bioequivalence studies for inhaled preparations, a total of four drug exposure models of mometasone furoate aqueous nasal spray were established in the negative pressure dosing room and the airtight dosing room with sitting and standing positions for the drug administration, respectively. The samples collected from the relevant parts after drug exposure in the dosing environment were determined by high-performance liquid chromatography–tandem mass spectrometry. The contamination caused by drug scattering on the relevant parts was investigated. Under the four drug exposure models, the surfaces of the investigated parts near the spray site were significantly contaminated by scattered drug. The facilities, such as the negative pressure ventilation system and air shower, could not remove scattered drug from the contaminated surfaces, while the investigated parts protected by protective articles were not contaminated. The results indicated that it was effective to prevent and control the contamination caused by drug exposure and scattering in the dosing environment and avoid secondary contamination to the collected biological samples by reasonably arranging respective regions and personnel movements, properly wearing and removing protective articles, and timely and appropriate handling of unexpected drug exposure.</p>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/6648011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147568982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified Guizhi Plus Huangqi Decoction Improves Antiphospholipase A2 Receptor Antibody–Induced Podocyte Injury Through Modulating Autophagy-Related Markers via AMPK/mTOR Pathway","authors":"Manxia Huang,&nbsp;Yangpu Li,&nbsp;Zhishu Yang,&nbsp;Yunxin Lin,&nbsp;Zhuoting Liu,&nbsp;Zilan Jiang,&nbsp;Tingting Tan,&nbsp;Xinhui Liu,&nbsp;Youjia Zeng","doi":"10.1155/jcpt/8039321","DOIUrl":"10.1155/jcpt/8039321","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Phospholipase A2 receptor (PLA2R)–associated membranous nephropathy (MN) is a primary cause of nephrotic syndrome in adults. Modified Guizhi plus Huangqi decoction (MGPHD) has been clinically effective for PLA2R MN. This basic study was designed to investigate the efficacy and mechanisms of MGPHD in treating PLA2R MN.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A PLA2R MN mouse model was established by intraperitoneal injection of anti-PLA2R antibodies in transgenic mice expressing PLA2R1 in podocytes. Mice were administered MGPHD for 10 consecutive days. 24-h urine volume, urinary albumin/creatinine, biochemical parameters, and renal pathological changes were assessed. Western blotting evaluated proteins related to PLA2R, podocyte cytoskeleton, autophagy, and AMPK/mTOR pathway in renal tissues. Astragaloside IV and icariin in MGPHD were detected by liquid chromatography–tandem mass spectrometry (LC-MS/MS). In vitro, anti-PLA2R antibodies were used to establish a podocyte injury model in podocytes (AB 8/13). Molecular docking assessed the binding of the two compounds to podocyte cytoskeleton proteins. Western blot detection of related proteins in vitro was consistent with the results obtained in vivo.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;MGPHD treatment improved podocyte injury, increased 24-h urine volume and serum albumin, and decreased urinary albumin/creatinine and serum cholesterol (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Immunofluorescence showed a reduced deposition of PLA2R antigen and complement C3, and electron microscopy demonstrated a restored foot process morphology. Western blotting revealed downregulated PLA2R, P62, and &lt;i&gt;p&lt;/i&gt;-mTOR/mTOR and upregulated &lt;i&gt;α&lt;/i&gt;-actinin-4, LC3II/I, and &lt;i&gt;p&lt;/i&gt;-AMPK/AMPK (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Anti-PLA2R antibodies caused podocyte cytoskeleton rearrangement and autophagy-related marker impairment in vitro, roughly consistent with in vivo Western blotting results. Molecular docking showed a stable binding of astragaloside IV and icariin to podocyte cytoskeleton proteins. Astragaloside IV and icariin at different doses protected podocytes by stabilizing AMPK/mTOR pathway autophagy-related markers and reducing anti-PLA2R antibody–induced injury.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;MGPHD and its active components, astragaloside IV and icariin, effectively ameliorate anti-PLA2R antibody–induced podocyte injury by partially restoring the podocyte cytoskeleton and modulating autophagy-related markers, possibly through the AMPK/mTOR pathway.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 ","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/8039321","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147567899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population Pharmacokinetic and Pharmacodynamic Analysis of Voriconazole-Induced Liver Injury in Chinese Lung Transplant Patients","authors":"Dan Zhang,&nbsp;Wenwen Du,&nbsp;Wei Qin,&nbsp;Bo Li,&nbsp;Pengmei Li,&nbsp;Xiaoxing Wang,&nbsp;Wenqian Chen","doi":"10.1155/jcpt/4521997","DOIUrl":"https://doi.org/10.1155/jcpt/4521997","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Voriconazole (VCZ) served as primary therapy for invasive aspergillosis in lung transplant recipients. However, VCZ-induced hepatotoxicity emerged as a frequent adverse effect that critically compromised postoperative management and complication prevention in this vulnerable population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed population pharmacokinetic/pharmacodynamic (PK/PD) modeling using nonlinear mixed-effects methodology. The analysis included a one-compartment PK model with alkaline phosphatase (ALP) as the primary hepatotoxicity biomarker. Monte Carlo simulations assessed the effects of dosing regimens on ALP dynamics across various covariate scenarios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final PK/PD model indicated an apparent systemic clearance of 3.09 L/h and a central volume of 80.31 L. The exposure–response relationship was described using an indirect response model, with the pharmacological effect linked to increases in ALP levels. The maximum drug effect (E_max) was 188.78. The rate constant for psoriatic plaque production (K_in) was 0.31/day, while the rate for plaque loss (K_out) was 0.53/day. Creatinine clearance (CrCL) was identified as a key covariate for apparent clearance, while weight and tacrolimus (TAC) trough level were significant for Emax. The average probability of target attainment for optimized regimens reached 50.2% across all covariate combinations. Clinical simulations identified 100 mg twice daily (bid) as the optimal maintenance dose for hepatotoxicity prevention. Weight-based dose reduction was recommended for recipients below 50 kg, with stringent therapeutic drug monitoring of TAC concentrations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our population PK/PD model provides clinically actionable guidance for VCZ dose optimization, particularly for underweight lung transplant recipients on maintenance therapy. The model effectively predicts and prevents VCZ-induced hepatotoxicity while maintaining therapeutic efficacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/4521997","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146199350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Real-World Safety of Ravulizumab in Generalized Myasthenia Gravis: Insights From a Detailed Analysis of FAERS Data","authors":"Yakun Wang,&nbsp;Qian Guo,&nbsp;Jiayu Bai,&nbsp;Jiaqi Shi,&nbsp;Ziquan Yang","doi":"10.1155/jcpt/6688602","DOIUrl":"https://doi.org/10.1155/jcpt/6688602","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ravulizumab represents the inaugural long-acting complement C5 inhibitor that has received approval in various countries around the globe for individuals diagnosed with generalized myasthenia gravis (gMG) who are positive for anti-acetylcholine receptor antibodies. The objective of this study was to leverage the FDA Adverse Event Reporting System (FAERS) database to detect and analyze signals of adverse events (AEs) associated with ravulizumab in real-world scenarios, thereby informing the safety management of its clinical use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The FAERS database was retrospectively queried to extract all AEs related to ravulizumab since 2019. Disproportionality analysis was employed to evaluate the safety of ravulizumab in clinical practice, utilizing methods such as the reporting odds ratio (ROR), proportional reporting ratio (PRR), multi-item gamma Poisson shrinker (MGPS), and Bayesian confidence propagation neural network (BCPNN). AEs that met the positivity threshold for at least one method were classified as potential adverse reactions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 6994 reports identified “primary suspected”. Signals were detected for AEs listed on the drug label upper respiratory tract infection (ROR 2.51, 95% CI 1.79–3.52), headache (ROR 2.77, 95% CI 2.53–3.02), diarrhea (ROR 1.09, 95% CI 0.95–1.25), and hypertension (ROR 0.51, 95% CI 0.36–0.72). Additionally, potential new signals were identified for AEs not mentioned on the label, including various muscle diseases (such as muscular weakness [ROR 9.50, 95% C 8.50–10.62] and gait disturbance [ROR 2.54, 95% CI 2.17–2.99]), nervous system reactions (including feeling abnormal [ROR 2.99, 95% CI 2.62–3.42] and dysphagia [ROR 5.27, 95% CI 4.50–6.18]), and eye diseases (such as diplopia [ROR 30.32, 95% CI 26.59–34.57] and eyelid ptosis [ROR 58.10, 95% CI 49.84–67.74]). The significance of monitoring for AEs, particularly during the first month following the initiation of treatment, was underscored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study presents preliminary safety data on the practical application of ravulizumab, confirming some known AEs while also identifying new potential AEs associated with the drug. These findings offer valuable safety information for clinicians who prescribe ravulizumab for the treatment of gMG.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/6688602","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146196935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}