Expert opinion on drug metabolism & toxicology最新文献

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Screening tools to evaluate the neurotoxic potential of botanicals: building a strategy to assess safety. 评估植物药潜在神经毒性的筛选工具:建立安全评估战略。
Expert opinion on drug metabolism & toxicology Pub Date : 2024-07-01 Epub Date: 2024-07-22 DOI: 10.1080/17425255.2024.2378895
Jyotshna Kanungo, Barbara C Sorkin, Julie Krzykwa, Constance A Mitchell, Michelle Embry, Peter Spencer, G Jean Harry, Jason Cannon, Fang Liu, Christopher A McPherson, Stefan Gafner, Remco H S Westerink
{"title":"Screening tools to evaluate the neurotoxic potential of botanicals: building a strategy to assess safety.","authors":"Jyotshna Kanungo, Barbara C Sorkin, Julie Krzykwa, Constance A Mitchell, Michelle Embry, Peter Spencer, G Jean Harry, Jason Cannon, Fang Liu, Christopher A McPherson, Stefan Gafner, Remco H S Westerink","doi":"10.1080/17425255.2024.2378895","DOIUrl":"10.1080/17425255.2024.2378895","url":null,"abstract":"<p><strong>Areas covered: </strong>This paper outlines the selection of NAMs, including in vitro assays using primary rat cortical neurons, zebrafish embryos, and <i>Caenorhabditis elegans</i>. These assays aim to assess neurotoxic endpoints such as neuronal activity and behavioral responses. Microelectrode array recordings of rat cortical neurons provide insights into the impact of botanical extracts on neuronal function, while the zebrafish embryos and <i>C. elegans</i> assays evaluate neurobehavioral responses. The paper also provides an account of the selection of botanical case studies based on expert judgment and existing neuroactivity/toxicity information. The proposed battery of assays will be tested with these case studies to evaluate their utility for neurotoxicity screening.</p><p><strong>Expert opinion: </strong>The complexity of botanicals necessitates the use of multiple NAMs for effective neurotoxicity screening. This paper discusses the evaluation of methodologies to develop a robust framework for evaluating botanical safety, including complex neuronal models and key neurodevelopmental process assays. It aims to establish a comprehensive screening framework.</p>","PeriodicalId":94005,"journal":{"name":"Expert opinion on drug metabolism & toxicology","volume":" ","pages":"629-646"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bioengineered human gut-on-a-chip for advancing non-clinical pharmaco-toxicology. 用于推进非临床药物毒理学的生物工程人体肠道芯片。
Expert opinion on drug metabolism & toxicology Pub Date : 2024-07-01 Epub Date: 2024-06-24 DOI: 10.1080/17425255.2024.2365254
Yong Cheol Shin, Nam Than, Soo Jin Park, Hyun Jung Kim
{"title":"Bioengineered human gut-on-a-chip for advancing non-clinical pharmaco-toxicology.","authors":"Yong Cheol Shin, Nam Than, Soo Jin Park, Hyun Jung Kim","doi":"10.1080/17425255.2024.2365254","DOIUrl":"10.1080/17425255.2024.2365254","url":null,"abstract":"<p><strong>Introduction: </strong>There is a growing need for alternative models to advance current non-clinical experimental models because they often fail to accurately predict drug responses in human clinical trials. Human organ-on-a-chip models have emerged as promising approaches for advancing the predictability of drug behaviors and responses.</p><p><strong>Areas covered: </strong>We summarize up-to-date human gut-on-a-chip models designed to demonstrate intricate interactions involving the host, microbiome, and pharmaceutical compounds since these models have been reported a decade ago. This overview covers recent advances in gut-on-a-chip models as a bridge technology between non-clinical and clinical assessments of drug toxicity and metabolism. We highlight the promising potential of gut-on-a-chip platforms, offering a reliable and valid framework for investigating reciprocal crosstalk between the host, gut microbiome, and drug compounds.</p><p><strong>Expert opinion: </strong>Gut-on-a-chip platforms can attract multiple end users as predictive, human-relevant, and non-clinical model. Notably, gut-on-a-chip platforms provide a unique opportunity to recreate a human intestinal microenvironment, including dynamic bowel movement, luminal flow, oxygen gradient, host-microbiome interactions, and disease-specific manipulations restricted in animal and <i>in</i> <i>vitro</i> cell culture models. Additionally, given the profound impact of the gut microbiome on pharmacological bioprocess, it is critical to leverage breakthroughs of gut-on-a-chip technology to address knowledge gaps and drive innovations in predictive drug toxicology and metabolism.</p>","PeriodicalId":94005,"journal":{"name":"Expert opinion on drug metabolism & toxicology","volume":" ","pages":"593-606"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141289078","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
Where developmental toxicity meets explainable artificial intelligence: state-of-the-art and perspectives. 发育毒性与可解释人工智能的结合:最新进展与前景。
Expert opinion on drug metabolism & toxicology Pub Date : 2024-07-01 Epub Date: 2023-12-29 DOI: 10.1080/17425255.2023.2298827
Maria Vittoria Togo, Fabrizio Mastrolorito, Angelica Orfino, Elisabetta Anna Graps, Anna Rita Tondo, Cosimo Damiano Altomare, Fulvio Ciriaco, Daniela Trisciuzzi, Orazio Nicolotti, Nicola Amoroso
{"title":"Where developmental toxicity meets explainable artificial intelligence: state-of-the-art and perspectives.","authors":"Maria Vittoria Togo, Fabrizio Mastrolorito, Angelica Orfino, Elisabetta Anna Graps, Anna Rita Tondo, Cosimo Damiano Altomare, Fulvio Ciriaco, Daniela Trisciuzzi, Orazio Nicolotti, Nicola Amoroso","doi":"10.1080/17425255.2023.2298827","DOIUrl":"10.1080/17425255.2023.2298827","url":null,"abstract":"<p><strong>Introduction: </strong>The application of Artificial Intelligence (AI) to predictive toxicology is rapidly increasing, particularly aiming to develop non-testing methods that effectively address ethical concerns and reduce economic costs. In this context, Developmental Toxicity (Dev Tox) stands as a key human health endpoint, especially significant for safeguarding maternal and child well-being.</p><p><strong>Areas covered: </strong>This review outlines the existing methods employed in Dev Tox predictions and underscores the benefits of utilizing New Approach Methodologies (NAMs), specifically focusing on eXplainable Artificial Intelligence (XAI), which proves highly efficient in constructing reliable and transparent models aligned with recommendations from international regulatory bodies.</p><p><strong>Expert opinion: </strong>The limited availability of high-quality data and the absence of dependable Dev Tox methodologies render XAI an appealing avenue for systematically developing interpretable and transparent models, which hold immense potential for both scientific evaluations and regulatory decision-making.</p>","PeriodicalId":94005,"journal":{"name":"Expert opinion on drug metabolism & toxicology","volume":" ","pages":"561-577"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138886816","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
In-silico approaches to assessing multiple high-level drug-drug and drug-disease adverse drug effects. 评估药物对药物和药物对疾病的多种高水平不良反应的实验室方法。
Expert opinion on drug metabolism & toxicology Pub Date : 2024-07-01 Epub Date: 2024-02-01 DOI: 10.1080/17425255.2023.2299337
Xuan Xu, Jim E Riviere, Shahzad Raza, Nuwan Indika Millagaha Gedara, Remya Ampadi Ramachandran, Lisa A Tell, Gerald J Wyckoff, Majid Jaberi-Douraki
{"title":"<i>In-silico</i> approaches to assessing multiple high-level drug-drug and drug-disease adverse drug effects.","authors":"Xuan Xu, Jim E Riviere, Shahzad Raza, Nuwan Indika Millagaha Gedara, Remya Ampadi Ramachandran, Lisa A Tell, Gerald J Wyckoff, Majid Jaberi-Douraki","doi":"10.1080/17425255.2023.2299337","DOIUrl":"10.1080/17425255.2023.2299337","url":null,"abstract":"<p><strong>Introduction: </strong>Pharmacovigilance plays a pivotal role in monitoring adverse events (AEs) related to chemical substances in human/animal populations. With increasing spontaneous-reporting systems, researchers turned to <i>in-silico</i> approaches to efficiently analyze drug safety profiles. Here, we review <i>in-silico</i> methods employed for assessing multiple drug-drug/drug-disease AEs covered by comparative analyses and visualization strategies.</p><p><strong>Areas covered: </strong>Disproportionality, involving multi-stage statistical methodologies and data processing, identifies safety signals among drug-AE pairs. By stratifying data based on disease indications/demographics, researchers address confounders and assess drug safety. Comparative analyses, including clustering techniques and visualization techniques, assess drug similarities, patterns, and trends, calculate correlations, and identify distinct toxicities. Furthermore, we conducted a thorough Scopus search on 'pharmacovigilance,' yielding 5,836 publications spanning 2003 to 2023.</p><p><strong>Expert opinion: </strong>Pharmacovigilance relies on diverse data sources, presenting challenges in the integration of <i>in-silico</i> approaches and requiring compliance with regulations and AI adoption. Systematic use of statistical analyses enables identifications of potential risks with drugs. Frequentist and Bayesian methods are used in disproportionalities, each with its strengths and weaknesses. Integration of pharmacogenomics with pharmacovigilance enables personalized medicine, with AI further enhancing patient engagement. This multidisciplinary approach holds promise, improving drug efficacy and safety, and should be a core mission of One-Health studies.</p>","PeriodicalId":94005,"journal":{"name":"Expert opinion on drug metabolism & toxicology","volume":" ","pages":"579-592"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652470","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
Beyond the hype and toward application: liver complex in vitro models in preclinical drug safety. 超越炒作,走向应用:临床前药物安全性中的肝脏复合体体外模型。
Expert opinion on drug metabolism & toxicology Pub Date : 2024-07-01 Epub Date: 2024-03-13 DOI: 10.1080/17425255.2024.2328794
Sushma Jadalannagari, Lorna Ewart
{"title":"Beyond the hype and toward application: liver complex in vitro models in preclinical drug safety.","authors":"Sushma Jadalannagari, Lorna Ewart","doi":"10.1080/17425255.2024.2328794","DOIUrl":"10.1080/17425255.2024.2328794","url":null,"abstract":"<p><strong>Introduction: </strong>Drug induced Liver-Injury (DILI) is a leading cause of drug attrition and complex <i>in vitro</i> models (CIVMs), including three dimensional (3D) spheroids, 3D bio printed tissues and flow-based systems, could improve preclinical prediction. Although CIVMs have demonstrated good sensitivity and specificity in DILI detection their adoption remains limited.</p><p><strong>Areas covered: </strong>This article describes DILI, the challenges with its prediction and the current strategies and models that are being used. It reviews data from industry-FDA collaborations and strategic partnerships and finishes with an outlook of CIVMs in preclinical toxicity testing. Literature searches were performed using PubMed and Google Scholar while product information was collected from manufacturer websites.</p><p><strong>Expert opinion: </strong>Liver CIVMs are promising models for predicting DILI although, a decade after their introduction, routine use by the pharmaceutical industry is limited. To accelerate their adoption, several industry-regulator-developer partnerships or consortia have been established to guide the development and qualification. Beyond this, liver CIVMs should continue evolving to capture greater immunological mimicry while partnering with computational approaches to deliver systems that change the paradigm of predicting DILI.</p>","PeriodicalId":94005,"journal":{"name":"Expert opinion on drug metabolism & toxicology","volume":" ","pages":"607-619"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095411","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
In NAMs we trust - an innovative paradigm-shift in risk-based chemicals management for globally harmonized protection goals. 我们相信国家监测与评估机制--基于风险的化学品管理的创新范式转变,以实现全球统一的保护目标。
Expert opinion on drug metabolism & toxicology Pub Date : 2024-07-01 Epub Date: 2024-05-09 DOI: 10.1080/17425255.2024.2353765
Camilla Alexander-White
{"title":"In NAMs we trust - an innovative paradigm-shift in risk-based chemicals management for globally harmonized protection goals.","authors":"Camilla Alexander-White","doi":"10.1080/17425255.2024.2353765","DOIUrl":"10.1080/17425255.2024.2353765","url":null,"abstract":"","PeriodicalId":94005,"journal":{"name":"Expert opinion on drug metabolism & toxicology","volume":" ","pages":"545-547"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878208","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
Recent progress in machine learning approaches for predicting carcinogenicity in drug development. 用于预测药物开发致癌性的机器学习方法的最新进展。
Expert opinion on drug metabolism & toxicology Pub Date : 2024-07-01 Epub Date: 2024-05-27 DOI: 10.1080/17425255.2024.2356162
Nguyen Quoc Khanh Le, Thi-Xuan Tran, Phung-Anh Nguyen, Trang-Thi Ho, Van-Nui Nguyen
{"title":"Recent progress in machine learning approaches for predicting carcinogenicity in drug development.","authors":"Nguyen Quoc Khanh Le, Thi-Xuan Tran, Phung-Anh Nguyen, Trang-Thi Ho, Van-Nui Nguyen","doi":"10.1080/17425255.2024.2356162","DOIUrl":"10.1080/17425255.2024.2356162","url":null,"abstract":"<p><strong>Introduction: </strong>This review explores the transformative impact of machine learning (ML) on carcinogenicity prediction within drug development. It discusses the historical context and recent advancements, emphasizing the significance of ML methodologies in overcoming challenges related to data interpretation, ethical considerations, and regulatory acceptance.</p><p><strong>Areas covered: </strong>The review comprehensively examines the integration of ML, deep learning, and diverse artificial intelligence (AI) approaches in various aspects of drug development safety assessments. It explores applications ranging from early-phase compound screening to clinical trial optimization, highlighting the versatility of ML in enhancing predictive accuracy and efficiency.</p><p><strong>Expert opinion: </strong>Through the analysis of traditional approaches such as in vivo rodent bioassays and in vitro assays, the review underscores the limitations and resource intensity associated with these methods. It provides expert insights into how ML offers innovative solutions to address these challenges, revolutionizing safety assessments in drug development.</p>","PeriodicalId":94005,"journal":{"name":"Expert opinion on drug metabolism & toxicology","volume":" ","pages":"621-628"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140924127","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
New approach methods on the bench side to accelerate clinical trials during pregnancy. 加快孕期临床试验的新方法。
Expert opinion on drug metabolism & toxicology Pub Date : 2024-07-01 Epub Date: 2024-05-13 DOI: 10.1080/17425255.2024.2353944
Ramkumar Menon, Lauren Richardson, Ananth Kumar Kammala
{"title":"New approach methods on the bench side to accelerate clinical trials during pregnancy.","authors":"Ramkumar Menon, Lauren Richardson, Ananth Kumar Kammala","doi":"10.1080/17425255.2024.2353944","DOIUrl":"10.1080/17425255.2024.2353944","url":null,"abstract":"<p><strong>Introduction: </strong>Pregnant women are therapeutic orphans as they are excluded from clinical drug development and therapeutic trials. We identify limitations in conducting clinical trials and propose two 'New Approach Methods'(NAMs) to overcome them.</p><p><strong>Areas covered: </strong>NAMs have proven invaluable tools in basic and clinical research to understand human health and disease better, elucidate mechanisms, and study the efficacy and toxicity of therapeutics that have not been possible through animal-based methodologies. The lack of humanized experimental models of FMi and drugs that can safely and effectively cross FMi to reduce the risk of adverse pregnancy has hindered progress in the field of reproductive pharmacology. This report discusses two technological advancements in perinatal research and medicine to accelerate clinical trials during pregnancy. (1) We have developed a humanized microphysiologic system, an Organ-on-a-chip (OOC) platform, to study FMi and their utility in pharmacological studies, and (2) use of extracellular vesicles (EVs) as drug delivery vehicles that are immunologically inert and can cross the fetomaternal barriers.</p><p><strong>Expert opinion: </strong>We provide an overview of NAMs that can accelerate preclinical trials and develop drugs to cross the feto-maternal barriers to reduce the risk of adverse pregnancy outcomes like preterm birth.</p>","PeriodicalId":94005,"journal":{"name":"Expert opinion on drug metabolism & toxicology","volume":" ","pages":"555-560"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913606","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
Pharmacokinetic and toxicological considerations affecting antiretroviral drug dosing in pregnant women. 影响孕妇抗逆转录病毒药物剂量的药代动力学和毒理学因素。
Expert opinion on drug metabolism & toxicology Pub Date : 2024-06-01 Epub Date: 2024-05-14 DOI: 10.1080/17425255.2024.2353762
Zoran Todorović, Gordana Dragović, Relja Lukić
{"title":"Pharmacokinetic and toxicological considerations affecting antiretroviral drug dosing in pregnant women.","authors":"Zoran Todorović, Gordana Dragović, Relja Lukić","doi":"10.1080/17425255.2024.2353762","DOIUrl":"10.1080/17425255.2024.2353762","url":null,"abstract":"<p><strong>Introduction: </strong>To prevent mother-to-child transmission (PMTCT) of the human immunodeficiency virus (HIV) during pregnancy, the appropriate dosing regimens of antiretroviral (ARV) drugs need to be determined. Reliable data about pharmacokinetic (PK) characteristics of ARVs from randomized clinical trials (RCTs) are lacking, and post-marketing observational studies may offer valuable, but sometimes insufficient data, especially in pregnant people living with HIV (PLWHIV). This review article is focused PK and toxicological considerations affecting ARV dosing in pregnant PLWHIV.</p><p><strong>Areas covered: </strong>In our search, we included studies focused on PKs of ARVs in pregnancy available on PubMed, abstracts from recent global conferences and data from modeling studies. There are no significant changes in PKs of nucleoside/nucleotide reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors throughout pregnancy. In contrast, the PKs of PIs and INSTIs are more variable, especially in the second and third trimesters.</p><p><strong>Expert opinion: </strong>Pregnant women are left out of RCTs. To the greatest extent possible, future research should include pregnant persons in RCTs, including PK studies, strictly considering maternal and fetal safety. Alternative innovative approaches/models need to be developed to obtain reliable data about rational pharmacotherapy of ARVs in the effective PMTCT of HIV, with maximum safety.</p>","PeriodicalId":94005,"journal":{"name":"Expert opinion on drug metabolism & toxicology","volume":" ","pages":"419-437"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913607","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
Pharmacokinetics, pharmacodynamics, safety, and tolerability of dopamine-receptor antagonists for the prevention of chemotherapy-induced nausea and vomiting. 用于预防化疗引起的恶心和呕吐的多巴胺受体拮抗剂的药代动力学、药效学、安全性和耐受性。
Expert opinion on drug metabolism & toxicology Pub Date : 2024-06-01 Epub Date: 2024-06-25 DOI: 10.1080/17425255.2024.2367593
Adile Orhan, Carolyn Nguyen, Alexandre Chan, Jørn Herrstedt
{"title":"Pharmacokinetics, pharmacodynamics, safety, and tolerability of dopamine-receptor antagonists for the prevention of chemotherapy-induced nausea and vomiting.","authors":"Adile Orhan, Carolyn Nguyen, Alexandre Chan, Jørn Herrstedt","doi":"10.1080/17425255.2024.2367593","DOIUrl":"10.1080/17425255.2024.2367593","url":null,"abstract":"<p><strong>Introduction: </strong>Dopamine (D)<sub>2,3</sub>-receptor antagonists (RAs) were the first antiemetics used in the prophylaxis of chemotherapy-induced nausea and vomiting (CINV).</p><p><strong>Areas covered: </strong>Eight D<sub>2,3</sub>-RAs, amisulpride, domperidone, droperidol, haloperidol, metoclopramide, metopimazine, olanzapine and prochlorperazine are reviewed focusing on pharmacokinetics, pharmacodynamics, antiemetic effect and side effects.</p><p><strong>Expert opinion: </strong>Since the introduction of D<sub>2,3</sub>-RAs, antiemetics such as corticosteroids, 5-hydroxytryptamine (5-HT)<sub>3</sub>-RAs and neurokinin (NK)<sub>1</sub>-RAs have been developed. The classical D<sub>2,3</sub>-RAs are recommended in the prophylaxis of CINV from low emetic risk chemotherapy, but not as a fixed component of an antiemetic regimen for moderately or highly (HEC) emetic risk chemotherapy. D<sub>2,3</sub>-RAs are also used in patients with breakthrough nausea and vomiting. It should be emphasized, that most of these drugs are not selective for dopamine receptors.The multi-receptor targeting agent, olanzapine, is recommended in the prophylaxis of HEC-induced CINV as part of a four-drug antiemetic regimen, including a 5-HT<sub>3</sub>-RA, dexamethasone and a NK<sub>1</sub>-RA. Olanzapine is the most effective agent to prevent chemotherapy-induced nausea.Side effects differ among various D<sub>2,3</sub>-RAs. Metopimazine and domperidone possess a low risk of extrapyramidal side effects. Domperidone and metoclopramide are prokinetics, whereas metopimazine delays gastric emptying and haloperidol does not influence gastric motility. Many D<sub>2,3</sub>-RAs increase the risk of prolonged QTc interval; other side effects include sedation and orthostatic hypotension.</p>","PeriodicalId":94005,"journal":{"name":"Expert opinion on drug metabolism & toxicology","volume":" ","pages":"473-489"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141328241","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
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