EMPADE Study: Evaluation of Medical Prescriptions and Adverse Drug Events in COPD Patients Admitted to Intensive Care Unit

Adil, Mir S.; Khan, Asaduzzaman; Mn, Khan; I, Sultan; Sa, Ali; Farooqui, Amreen

doi:10.7860/jcdr/2015/14563.6721

Cited by 7 publications

(8 citation statements)

References 13 publications

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“…COPD is associated with comorbidity and polypharmacy 51 . Adverse drug reactions are a common cause of morbidity in patients with COPD 52,53 . The reduction in oral drug clearance associated with COPD in this study places patients at risk of unintended over‐exposure and adverse drug reactions 1,2 …”

Section: Discussionmentioning

confidence: 84%

“…51 Adverse drug reactions are a common cause of morbidity in patients with COPD. 52,53 The reduction in oral drug clearance associated with COPD in this study places patients at risk of unintended overexposure and adverse drug reactions. 1,2 The participants in this study were typical of ambulatory patients with COPD 54,55 and the healthy participants were typical of those used in pharmacokinetic studies to define doses.…”

Section: Clinical Significancementioning

confidence: 88%

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Drug metabolism in severe chronic obstructive pulmonary disease: A phenotyping cocktail study

McNeill

Zhang

Epton

et al. 2021

Brit J Clinical Pharma

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To evaluate the effect of severe chronic obstructive pulmonary disease (COPD) on drug metabolism by comparing the pharmacokinetics of patients with severe COPD with healthy volunteers and using the modified Inje drug cocktail.Methods: This was a single-centre pharmacokinetic study with 12 healthy participants and 7 participants with GOLD D COPD. Midazolam 1 mg, dextromethorphan 30 mg, losartan 25 mg, omeprazole 20 mg, caffeine 130 mg and paracetamol 1000 mg were simultaneously administered and intensive pharmacokinetic sampling was conducted over 8 hours. Drug metabolism by CYP3A4, CYP2D6, CYP2C9, CYP2C19, CYP1A2, UGT1A6 and UGT1A9 in participants with COPD were compared with phenotypes in healthy controls. Results:The oral clearance (95% confidence interval) in participants with COPD relative to controls was: midazolam 63% (60-67%); dextromethorphan 72% (40-103%); losartan 53% (52-55%); omeprazole 35% (31-39%); caffeine 52% (50-53%); and paracetamol 73% (72-74%). There was a 5-fold increase in AUC for omeprazole and approximately 2-fold increases for caffeine, losartan, dextromethorphan, and midazolam. The AUC of paracetamol, which is mostly glucuronidated, was increased by about 60%. Conclusion:Severe COPD is associated with a clinically significant reduction in oral drug clearance. This may be greater for cytochrome P450 substrates than for glucuronidated drugs. This supports reduced starting doses when prescribing for patients with severe COPD.

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Section: Discussionmentioning

confidence: 84%

Section: Clinical Significancementioning

confidence: 88%

Drug metabolism in severe chronic obstructive pulmonary disease: A phenotyping cocktail study

McNeill

Zhang

Epton

et al. 2021

Brit J Clinical Pharma

View full text Add to dashboard Cite

show abstract

“…An AE can be defined as a detrimental, unintended effect of a therapy which occurs at doses commonly used for the prophylaxis, diagnosis, or treatment. 35 Although Ahn et al noticed a reduction in viral load post-CP transfusion, they are still undetermined if the findings are a result of therapy or the pathology of COVID-19 itself. 36 Concluding remarks from other studies reflect their investigators’ credence in CP for COVID-19 therapy.…”

Section: Outcomes Of Cp Therapy In Covid-19 Trialsmentioning

confidence: 99%

Convalescent plasma appears efficacious and safe in COVID-19

Khulood

Adil

Sultana

et al. 2020

Therapeutic Advances in Infection

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A cluster of pneumonia cases of unknown etiology associated with pyrexia and acute respiratory distress was identified in Southern China. Links between the previous severe acute respiratory syndrome (SARS) cases and the region’s seafood market were noted with the possibility of a new zoonosis and SARS-CoV-2 was identified as the responsible agent. Currently, there are no effective prophylactic or therapeutic options to deal with coronavirus disease-19 (COVID-19) or any other human coronavirus (HCoV) infections. Convalescent plasma (CP) therapy is a classic adaptive immunotherapy which has been in use for more a century to prevent and treat infections including SARS, Middle East respiratory syndrome (MERS), and H1N1 pandemic. Moreover, the World Health Organization regarded CP transfusion as the most promising therapy to treat MERS-CoV. This review was undertaken to demonstrate the potential of CP in the treatment of the pandemic COVID-19 disease. A total of eight studies conducted on CP therapy in patients with COVID-19 were reviewed wherein 25,028 patients above 18 years of age were involved. The vast majority of patients reported favorable outcomes when treated with CP with <1% serious adverse events. Despite its promising beneficial effects in patients severely ill with COVID-19, CP therapy requires further evaluation in randomized clinical trials (RCTs) as a lack of satisfactory efficacy data from this area certainly enhances the hesitancy with regard to employing this treatment. In the present circumstances of unsatisfactory pharmacological therapy and the urgent need for a successful curative remedy, considering the use of CP therapy is reasonable provided RCTs confirm its safety, efficacy, and tolerability.

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“…Authors [8][9][10][11] have reported similar preferences and trends of use of oral medicines over inhalation treatment as the former is cheaper, easily available and simple to use and later one is costlier, requires specialist/pulmonologist consultation and requires training before use. They also mentioned similar to our study as transient symptom control with oral medicines is one of the 'disease control criteria' which can be achieved with oral medicines, although long term benefits of these medicines are not known or not expected by patients [8][9][10][11]. GOLD guidelines and Indian guideline [12] also recommended against use of oral medicines in COPD unless the patient is unaffordable and or inhaled medicines are not available.…”

Section: Oral Medicines Use Preference By Doctors and Patients In Man...mentioning

confidence: 99%

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2023

World J. Adv. Pharm. Life Sci.

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Chronic obstructive pulmonary disease (COPD) is common chronic lung disease usually treated in all health care settings as per knowledge of disease, availability of medicines and affordability of patients in India. COPD is second leading cause of death in list of all cause of mortality. COPD is under evaluated and half-heartedly treated with irrational oral medicines in spite of rational inhalation therapy in primary to tertiary care settings. More than half of the cases died due to cardiovascular causes are having underlying COPD as precipitating factor. More disease awareness regarding use of spirometry in health care professionals for proper diagnosis of COPD with more emphasis on rational inhalation treatment is must to prevent morbidity of mortality of this treatable disease.

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EMPADE Study: Evaluation of Medical Prescriptions and Adverse Drug Events in COPD Patients Admitted to Intensive Care Unit

Cited by 7 publications

References 13 publications

Drug metabolism in severe chronic obstructive pulmonary disease: A phenotyping cocktail study

Drug metabolism in severe chronic obstructive pulmonary disease: A phenotyping cocktail study

Convalescent plasma appears efficacious and safe in COVID-19

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