Role of Pharmacogenomics in Reducing the Risk of Drug-Related Iatrogenesis

Michaud, Véronique; Darakjian, Lucy I; Dow, Pamela; Turgeon, Jacques

doi:10.1007/s40495-021-00280-7

Cited by 2 publications

(4 citation statements)

References 211 publications

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“…Drug induced hepatic damage is the major cause of iatrogenic disease. [69] Hepatic damage is exacerbated by oxidative stress and free radicals, which can be mitigated by the antioxidant mechanism. Plant extracts are a good source of antioxidants and can help with hepatoprotection.…”

Section: Hepato-protective Activitymentioning

confidence: 99%

“…The liver plays a significant role in metabolic homeostasis of the body, storage, secretion and detoxification of exogenous and endogenous substances, including various pharmaceutical and environmental chemicals. Drug induced hepatic damage is the major cause of iatrogenic disease [69] . Hepatic damage is exacerbated by oxidative stress and free radicals, which can be mitigated by the antioxidant mechanism.…”

Section: Biological Properties Of S Cumini Leavesmentioning

confidence: 99%

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Exploring the Chemical and Biological Potential of Jamun (Syzygium cumini (L.) Skeels) Leaves: A Comprehensive Review

Kumari,

Kumar,

Chaudhary

et al. 2023

Chemistry & Biodiversity

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Leaves of jamun collected as agro by‐produce during the cultivation of jamun is traditionally used as ayurvedic medicine to treat diabetes, gall bladder stones and other ailments. Most of the beneficial effects of jamun leaves are associated with phytochemicals found in jamun leaves such as gallic acid, tannins, mallic acid, flavonoids, essential oils, jambolin, ellagic acid, jambosine, antimellin and betulinic acid. Jamun possess curative activities like anticancer, antidiabetic, antifertility, anti‐inflammatory, antidiarrheal, antimicrobial, antinociceptive, antioxidant, antiradiation, chemotherapeutic, and gastroprotective. The main goal of this review article is to provide information on the nutritional content, phytochemical composition and health promoting properties of jamun leaves. The review of literature based on the phytochemical composition and health promoting benefits of the jamun leaves, suggests that leaves can be used as potential constituent in the formulation of pharmacological drugs. From the review literature it is found that clinical, in‐vivo, in‐vitro studies are still required to check the health promoting effects of jamun leaves extracts on humans.

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Section: Hepato-protective Activitymentioning

confidence: 99%

Section: Biological Properties Of S Cumini Leavesmentioning

confidence: 99%

Exploring the Chemical and Biological Potential of Jamun (Syzygium cumini (L.) Skeels) Leaves: A Comprehensive Review

Kumari,

Kumar,

Chaudhary

et al. 2023

Chemistry & Biodiversity

View full text Add to dashboard Cite

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“…As the population continues to age, the use of multiple medications is increasing at an alarming rate, with some reports showing an average of 14 or more prescriptions being taken by adults ≥50 years of age [ 1 , 2 ]. The comorbidities that increase with aging often necessitate polypharmacy, which increases drug-related iatrogenesis for a population that is at high risk for health problems [ 1 , 3 ]. Pharmacogenomics (PGx) assists in reducing medication-related iatrogenesis and optimizing medication regimens by identifying genomic variants known to impact drug disposition and response [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…The comorbidities that increase with aging often necessitate polypharmacy, which increases drug-related iatrogenesis for a population that is at high risk for health problems [ 1 , 3 ]. Pharmacogenomics (PGx) assists in reducing medication-related iatrogenesis and optimizing medication regimens by identifying genomic variants known to impact drug disposition and response [ 3 , 4 ]. Clinicians can use PGx test results to guide dose/drug selection, along with consideration of other patient-specific factors (e.g., age, comorbidities, concomitant medications) [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Case Report: Performing a Medication Safety Review Assisted by Pharmacogenomics to Explain a Prescribing Cascade Resulting in a Patient Fall

Russell¹,

Arwood

Toro-Pagán³

et al. 2023

Medicina

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Pharmacotherapy for major depressive disorder (MDD) typically consists of trial-and-error and clinician preference approaches, where patients often fail one or more antidepressants before finding an optimal regimen. Pharmacogenomics (PGx) can assist in prescribing appropriate antidepressants, thereby reducing the time to MDD remission and occurrence of adverse drug events. Since many antidepressants are metabolized by and/or inhibit cytochrome P450 enzymes (e.g., CYP2C19 or CYP2D6), drug-induced phenoconversion is common in patients on antidepressant combinations. This condition influences the interpretation of a patient’s PGx results, overall risk of ineffective/adverse medication response due to multi-drug interactions, and the recommendations. This complex case describes a patient with MDD, generalized anxiety disorder, and chronic pain who experienced a fall due to excessive sedation following a prescribing cascade of fluoxetine, bupropion, and doxepin. These antidepressants delivered a significant additive sedative effect and interacted with the patient’s hydrocodone, potentially contributing to uncontrolled pain, upward dose titration of hydrocodone, and a higher overall sedative burden. The PGx results and drug-induced phenoconversion described in this case report explain the patient’s excessive sedation and possibly ineffective/toxic antidepressant and opioid treatment. This case report also illustrates how a more timely multi-drug interaction assessment (preferably in conjunction with preemptive PGx testing) may have informed a different prescribing pattern, reduced/avoided a prescribing cascade, and potentially prevented a drug-related fall.

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Role of Pharmacogenomics in Reducing the Risk of Drug-Related Iatrogenesis

Cited by 2 publications

References 211 publications

Exploring the Chemical and Biological Potential of Jamun (Syzygium cumini (L.) Skeels) Leaves: A Comprehensive Review

Exploring the Chemical and Biological Potential of Jamun (Syzygium cumini (L.) Skeels) Leaves: A Comprehensive Review

Case Report: Performing a Medication Safety Review Assisted by Pharmacogenomics to Explain a Prescribing Cascade Resulting in a Patient Fall

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