Basic & Clinical Pharmacology & Toxicology最新文献

{"title":"p-Cresol and p-Cresyl Sulphate Boost Oxidative Stress: A Systematic Review of Recent Evidence","authors":"Rinvil Renaldi,&nbsp;Tjhin Wiguna,&nbsp;Antonio M. Persico,&nbsp;Andi Jayalangkara Tanra","doi":"10.1111/bcpt.70065","DOIUrl":"https://doi.org/10.1111/bcpt.70065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Recent studies have emphasized the significant role of p-cresol and its conjugated form, p-cresyl sulphate (PCS), in enhancing oxidative stress, leading to potential detrimental effects on various biological systems. Both p-cresol and PCS contribute to increased production of reactive oxygen species (ROS), which can result in tissue damage, inflammation and a cascade of physiological abnormalities. Elevated p-cresol levels have been associated with greater clinical severity in autism spectrum disorder, correlating with more severe behavioural manifestations and a history of regression. This systematic review explores the recent evidence on how these compounds promote oxidative stress and their impact on different health conditions. This review also addresses the involvement of p-cresol and PCS in conditions such as chronic kidney disease, Parkinson's disease and other neurodegenerative disorders, where oxidative damage contributes to disease progression. Furthermore, this review highlights the need for further research to understand the precise mechanisms by which p-cresol and PCS modulate oxidative stress and their potential as biomarkers for clinical diagnosis and disease management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Summary</h3>\u0000 \u0000 <div>\u0000 \u0000 <ul>\u0000 \u0000 \u0000 <li>This focused review systematically summarizes recent evidence that oxidative stress plays an important role in the damage of biological systems produced by two uremic toxins, p-cresol and its conjugated form, p-cresyl sulphate (PCS).</li>\u0000 \u0000 \u0000 <li>p-cresol coming from environmental sources or produced by some gut bacterial strains, modulates various conditions, like chronic kidney disease, Parkinson's disease and autism spectrum disorder, among others.</li>\u0000 \u0000 \u0000 <li>Oxidative damage and inflammation seemingly contribute to disease onset, progression and/or severity.</li>\u0000 \u0000 \u0000 <li>The exact mechanism by which p-cresol and PCS promote oxidative stress, their influence on disease trajectory and their potential role as biomarkers merit further investigation.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.70065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315117","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":"‘This Is My Decision’: A Qualitative Study of Individuals' Perspectives on Use of Semaglutide for Weight Loss","authors":"Trine Graabæk,&nbsp;Nini Thi Nguyen,&nbsp;Malene Svoldgaard Sørensen,&nbsp;Carina Lundby","doi":"10.1111/bcpt.70069","DOIUrl":"https://doi.org/10.1111/bcpt.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Individuals using semaglutide for weight loss constitute a new, sizeable patient group, yet limited qualitative research of this group exists. Therefore, we explored their perspectives, including motivation for treatment, attitudes towards the medication and experiences with its use. Semistructured interviews with seven individuals (five women, average age 50 years, average treatment duration 9 months) were conducted, audio-recorded, transcribed verbatim and analysed using systematic text condensation. We identified three themes: ‘I have absolutely run out of options’, ‘I am lucky to have a cooperative doctor’ and ‘It's the feeling of being normal’. Using semaglutide for weight loss was considered a life-changing event, as most respondents were concerned about declining physical health due to overweight. Most showed strong autonomy in managing their treatment, including delaying dose increases, reducing the dose or taking individual doses by ‘counting clicks’. Our data suggest a need for more support from healthcare professionals to guide individuals using semaglutide for weight loss, particularly in dosing, monitoring and managing side effects, with an emphasis on individualized and holistic care. Further research on individuals' perspectives related to weight loss and semaglutide use is needed to maintain and improve individuals' quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Summary</h3>\u0000 \u0000 <div>\u0000 \u0000 <ul>\u0000 \u0000 \u0000 <li>More people are using semaglutide to lose weight, but we still know little about their experiences.</li>\u0000 \u0000 \u0000 <li>To learn more, we interviewed seven users.</li>\u0000 \u0000 \u0000 <li>Many saw the treatment as life-changing, having struggled with overweight and concerns about their health.</li>\u0000 \u0000 \u0000 <li>It was important to them to manage the dose themselves.</li>\u0000 \u0000 \u0000 <li>Some delayed increasing the dose or took less than recommended by ‘counting clicks’.</li>\u0000 \u0000 \u0000 <li>Our findings show that people using semaglutide for weight loss need more support from healthcare professionals—especially with dosing, side effects and personal guidance.</li>\u0000 \u0000 \u0000 <li>More research is needed to better support these users and improve their quality of life.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.70069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144292616","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":"Long-Term Safety and Efficacy of AAV9 Vectors Expressing Human SMN1 Gene: A Preclinical Study","authors":"Vahid Mansouri,&nbsp;Maryam Bemanalizadeh,&nbsp;Naser Ahmadbeigi,&nbsp;Ramin Shakeri,&nbsp;Hiva Saffar","doi":"10.1111/bcpt.70064","DOIUrl":"https://doi.org/10.1111/bcpt.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Spinal muscular atrophy (SMA) is a severe genetic neuromuscular disorder caused by deletions or mutations in the <i>SMN1</i> gene, leading to reduced levels of the survival motor neuron (SMN) protein. Gene therapy using adeno-associated virus serotype 9 (AAV9) has emerged as a promising treatment strategy for SMA by enabling systemic delivery of a functional <i>SMN1</i> gene. This preclinical study evaluates the long-term safety and efficacy of an AAV9 vector expressing a codon-optimized human <i>SMN1</i> gene (AAV9-hcoSMN) in neonatal mice. A single intravenous dose of 5 × 10¹¹ vector genomes per mouse was administered, with animals monitored over a 24-week period for therapeutic outcomes and safety profiles. Safety assessments, including clinical observations, haematological and biochemical analyses (such as CBC, liver function tests and coagulation tests), necropsy and histopathological examinations via H&amp;E, revealed no significant adverse effects. Treated mice demonstrated 100% survival rates and exhibited no abnormalities in organ structure or function compared to controls. Efficacy assessments using quantitative PCR confirmed robust <i>SMN1</i> transgene expression in key tissues, including the central nervous system, heart, liver and skeletal muscles. These findings demonstrate that AAV9-hcoSMN therapy achieves sustained and widespread transgene expression with no observable toxicity in a neonatal mouse model, reinforcing the therapeutic potential of AAV9-based gene delivery for SMA. By providing robust preclinical evidence of both safety and efficacy, this study contributes to the growing body of data supporting gene therapy as a viable, long-term treatment strategy for SMA. These results also help inform vector design, dosing strategies and safety monitoring for future clinical translation. Further studies in larger animal models are warranted to assess long-term durability and immunogenicity prior to human application.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Summary</h3>\u0000 \u0000 <p>Spinal muscular atrophy (SMA) is a serious genetic disorder that weakens muscles and can be life-threatening. Our study tested a potential gene therapy using a harmless virus (AAV9) to deliver a healthy version of the faulty gene that causes SMA. We treated newborn mice and observed them for 6 months to check for any side effects and see if the therapy worked. The results were promising—treated mice had no health problems, and the new gene was active in important organs like the brain, muscles, and heart. This research brings us closer to a safe and effective treatment for SMA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144292617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Economic Burden Yet Low Clinical Value: Why Is so Much Sucralfate Prescribed?","authors":"Neha Wadhavkar,&nbsp;Laura Varnum,&nbsp;Steven F. Moss","doi":"10.1111/bcpt.70070","DOIUrl":"https://doi.org/10.1111/bcpt.70070","url":null,"abstract":"<div>\u0000 \u0000 <p>Sucralfate is a commonly prescribed medication in use for decades. Despite the availability of more effective medications for acid-dyspeptic conditions, including proton pump inhibitors and histamine H2-receptor antagonists, sucralfate continues to be utilized for upper gastrointestinal symptoms. We reviewed the limited evidence base supporting the approval and ongoing usage of sucralfate and performed a cost analysis using the <i>ClinCalc</i> database. The financial impact of sucralfate was comparable to famotidine, lansoprazole and ranitidine. We encourage further studies to accurately gauge the true clinical efficacy of sucralfate and to question its ongoing prescription until then.</p>\u0000 </div>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Liposomal Vitamin C Formulations Have Improved Bioavailability? A Scoping Review Identifying Future Research Directions","authors":"Anitra C. Carr","doi":"10.1111/bcpt.70067","DOIUrl":"https://doi.org/10.1111/bcpt.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Due to the essential requirement of vitamin C (ascorbate) by humans, formulation of the vitamin to increase its bioavailability is of relevance, particularly for those with higher requirements for the vitamin. In this scoping review, studies assessing the bioavailability of liposomal versus non-liposomal ascorbate were identified through database and manual searching and relevant pharmacokinetic data were extracted. Of the 321 studies identified, 10 were included in the final review. Seven of the trials used randomised crossover designs, one used parallel groups and two were non-randomised. Vastly different liposomal formulations, ascorbate doses (0.15–10 g) and sample collection durations (4–24 h) were used, thereby making it difficult to directly compare the studies. Nevertheless, nine of the studies showed higher bioavailability of liposomal versus non-liposomal ascorbate: 1.2–5.4-fold higher Cmax and 1.3–7.2-fold higher AUC. However, none of the studies assessed ascorbate elimination; therefore, it is uncertain whether the ratios of liposomal to non-liposomal ascorbate in urine are equivalent to those observed in plasma. Furthermore, only two of the studies assessed in vivo cellular uptake and only two assessed potential biological effects. Thus, future studies should include urinary elimination and cellular uptake kinetics, assess participants with low baseline status and investigate potential biological effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Summary</h3>\u0000 \u0000 <div>\u0000 \u0000 <ul>\u0000 \u0000 \u0000 <li>Due to the essential requirement of vitamin C by humans, formulations to increase its uptake into the body are of relevance, particularly in those with higher requirements for the vitamin.</li>\u0000 \u0000 \u0000 <li>In this review, studies assessing the uptake of liposomal versus non-liposomal vitamin C were investigated; liposomal vitamin C comprising the vitamin encapsulated within lipids.</li>\u0000 \u0000 \u0000 <li>Ten studies were identified, which administered different liposomal formulations, vitamin C doses (0.15-10 g) and sample collection durations (4–24 h).</li>\u0000 \u0000 \u0000 <li>Nine of the studies showed higher uptake of liposomal vitamin C. Future studies should assess urinary excretion, cellular uptake and biological effects of liposomal vitamin C.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273256","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":"Barriers and Facilitators to Pharmacist-Led Deprescribing of Antihypertensives in Long-Term Care: A Survey-Based Study","authors":"Ana Vucenovic,&nbsp;Roni Y. Kraut,&nbsp;Donna P. Manca,&nbsp;Cheryl A. Sadowski","doi":"10.1111/bcpt.70060","DOIUrl":"https://doi.org/10.1111/bcpt.70060","url":null,"abstract":"<p>Pharmacist-led deprescribing is an approach of addressing polypharmacy in the long-term care (LTC) setting. However, the sustainability of this practice has not been widely studied. This study describes facilitators and barriers to pharmacist-led deprescribing from pre- and post-surveys completed as part of a randomized controlled antihypertensive deprescribing trial in Alberta, Canada. The surveys, targeting facilitators and barriers to deprescribing, were developed based on current evidence and designed through an iterative process with pharmacist input and consist of open- and closed-ended questions. Nine pharmacists completed both surveys (seven female; five have been a pharmacist ≥10 years; and eight had their Additional Prescribing Authority [authority to prescribe to full scope of practice]). The key facilitators were (1) pharmacist confidence and attitude toward deprescribing, (2) sufficient patient data, and (3) minimal tools and education required. The key barriers included (1) pharmacist perception of not being the primary decision maker on prescribing decisions, (2) insufficient support from residents' families and physicians, and (3) additional time required. These facilitators and barriers were all identified pre-deprescribing, and confirmed, and more evident post-deprescribing. These barriers will make it challenging for pharmacists to incorporate deprescribing antihypertensives into routine care.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.70060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256228","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":"Application of Artificial Intelligence in the Development of Traditional Chinese Medicine","authors":"Xuebing He,&nbsp;Mingna Sun,&nbsp;Tungalag Battulga,&nbsp;Brent R. Copp,&nbsp;Dilobarkhon Kodirova Rustamovna,&nbsp;Hongyan Li,&nbsp;Sagdullaev Shamansur Shahsaidovich,&nbsp;Janar Jenis,&nbsp;Yuqing Wang,&nbsp;Lu Liang,&nbsp;Jianye Zhang","doi":"10.1111/bcpt.70066","DOIUrl":"https://doi.org/10.1111/bcpt.70066","url":null,"abstract":"<p>Traditional Chinese medicine (TCM) has long been recognized for its mild therapeutic effects, significant efficacy and minimal adverse reactions. However, challenges such as reliance on human expertise in TCM production and quality control, unclear compositions and usage of TCM and ambiguous targets hinder its sustainable development. The emergence of artificial intelligence (AI) provides transformative potential for addressing these limitations. Recent studies have demonstrated that AI promotes the intelligent industrialization of TCM, ensures effective TCM quality, assists in the discovery of TCM targets and recommends scientifically formulated TCM prescriptions. This review consolidates and evaluates recent progress in applying AI to TCM, with a focus on pharmaceutical development, quality control and research innovation. By providing a detailed and systematic overview, this review aims to highlight the role of AI in advancing the scientific and sustainable evolution of TCM.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244419","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":"Protective Effect of Melissa officinalis (Lemon Balm) Extract on Cytokine Levels and Oxidative Stress in Ovalbumin Induced Lung Toxicity in Rats","authors":"Vahideh Abbasnia,&nbsp;Mohsen Foadoddini,&nbsp;Mohammad Reza Khazdair","doi":"10.1111/bcpt.70068","DOIUrl":"https://doi.org/10.1111/bcpt.70068","url":null,"abstract":"<div>\u0000 \u0000 <p>This study assessed the effects of a hydroalcoholic extract derived from <i>Melissa officinalis</i> (lemon balm) at doses of 50, 100 and 200 mg/kg in a rat model of experimental allergic asthma. We evaluated biomarkers of oxidative stress, including nitrite (NO₂), malondialdehyde (MDA), thiol (SH), superoxide dismutase (SOD) and catalase (CAT), along with mediators such as interleukin-4 (IL-4), IL-17, interferon-gamma (IFN-γ) and immunoglobulin E (IgE) in bronchoalveolar lavage fluid (BALF). The untreated asthmatic group showed significantly elevated levels of MDA, NO₂, IL-4, IL-17 and IgE (<i>p</i> &lt; 0.001), while levels of SH, IFN-γ and the activities of SOD and CAT were markedly reduced compared with the control group. In contrast, treatment groups receiving plant extracts and dexamethasone (Dex) demonstrated a significant decrease in levels of NO₂, MDA, IL-4, IL-17 and IgE. Additionally, the levels of SH, IFN-γ and the activities of SOD and CAT were significantly elevated compared with the untreated asthmatic group (<i>p</i> &lt; 0.05 to <i>p</i> &lt; 0.001). The therapeutic efficacy of <i>Melissa officinalis</i> extract in reducing oxidative damage and inflammatory mediators in asthmatic rats was comparable to that of dexamethasone. This finding highlights the potential therapeutic benefits of the plant in alleviating asthma-related symptoms.</p>\u0000 </div>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traditional Chinese Medicine for Anti-Arrhythmias: Mechanisms via Potassium Channels","authors":"Chenhao Gao,&nbsp;Ting Xu,&nbsp;Lingyu Linda Ye,&nbsp;Dayue Darrel Duan","doi":"10.1111/bcpt.70059","DOIUrl":"https://doi.org/10.1111/bcpt.70059","url":null,"abstract":"<p>Cardiac arrhythmia is a common life-threatening cardiovascular disorder. Potassium channels play a crucial role in cardiac electrophysiology, and their dysfunction is closely associated with the occurrence and development of arrhythmia. Traditional Chinese medicine (TCM) has a long-standing history of treating various diseases, including arrhythmia and offers a rich source of compounds for anti-arrhythmic drugs. To provide in-depth new insights for the development of novel anti-arrhythmic therapies, this review delves into the effects of TCM on potassium channels through multiple ways, including the direct interaction between the active ingredients contained and potassium channels, regulation of the expression of related genes and proteins, intervention in intracellular signalling pathways and exertion of antioxidant and anti-inflammatory effects. With continued efforts in standardization, research and integration with Western medicine, TCM is playing an increasingly important role in the treatment of arrhythmia and provides novel options for patients worldwide. Phenomics and pharmacophenomics as well as the artificial intelligence–based GPCR ligand screening system may provide new paradigms and platforms for discovering and developing more anti-arrhythmic drugs.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197476","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":"Real-World Complexity of Prescribing Cascades","authors":"J. T. H. Nielen,&nbsp;K. van der Walle,&nbsp;S. H. Spronk,&nbsp;F. J. H. Magdelijns,&nbsp;P. Denig,&nbsp;F. Karapinar-Çarkıt","doi":"10.1111/bcpt.70063","DOIUrl":"https://doi.org/10.1111/bcpt.70063","url":null,"abstract":"<p>Prescribing cascades occur when an adverse drug reaction (ADR) to one medication is treated with additional medication. Most literature focusses on this simplistic singular concept of one medication followed by another. However, ADRs in clinical practice may appear less straightforward, making prescribing cascades difficult to identify and deprescribe. More insight is needed into the real-world complexity of prescribing cascades, since they may negatively impact both patients and the healthcare system. This article aims to provide exemplary cases of the real-world complexity of prescribing cascades and explores strategies to identify, mitigate and prevent them. The real-world cases discussed highlight the multifaceted nature of prescribing cascades in clinical practice. They show several factors contributing to the challenges in recognizing ADRs and preventing prescribing cascades, including misinterpretation of ADRs, fragmented healthcare systems and accumulation of pharmacological effects and comorbidities within an individual patient. Several strategies are recommended to improve identification, mitigation and prevention of prescribing cascades. Although educating patients and healthcare providers (HCPs) can help bridge the knowledge gap, additional strategies are needed. Implementing supportive tools to deprescribe, enhanced communication among HCPs and patients regarding ADRs and rationale for medication changes, and monitoring patients for ADRs are considered the most promising strategies.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.70063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197299","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}