دورية أكاديمية
أعرض في EDS

Nimodipine-associated standard dose reductions and neurologic outcomes after aneurysmal subarachnoid hemorrhage: the era of pharmacogenomics.

التفاصيل البيبلوغرافية
العنوان: Nimodipine-associated standard dose reductions and neurologic outcomes after aneurysmal subarachnoid hemorrhage: the era of pharmacogenomics.
المؤلفون: Vázquez-Medina A; University of Puerto Rico, Medical Sciences Campus School of Medicine, San Juan, Puerto Rico., Turnbull MT; Department of Neurology, Mayo Clinic, Jacksonville, FL, USA., James CL; Department of Emergency Medicine, Mayo Clinic, Jacksonville, FL, USA., Cowart JB; Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, FL, USA., Lesser E; Division of Clinical Trials and Biostatistics, Mayo Clinic, Jacksonville, FL, USA., Carter RE; Division of Clinical Trials and Biostatistics, Mayo Clinic, Jacksonville, FL, USA.; Department of Artificial Intelligence and Informatics, Mayo Clinic, Jacksonville, FL, USA., Ross OA; Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA., Miller DA; Department of Neurologic Surgery, Mayo Clinic, Jacksonville, FL, USA.; Division of Neuroradiology, Mayo Clinic, Jacksonville, FL, USA., Meschia JF; Department of Neurology, Mayo Clinic, Jacksonville, FL, USA.; Department of Neurologic Surgery, Mayo Clinic, Jacksonville, FL, USA., De Jesús Espinosa A; Department of Neurosurgery, University of Puerto Rico, San Juan, Puerto Rico., Weinshilboum R; Schulze Center for Novel Therapeutics, Mayo Clinic, Rochester, MN, USA., Freeman WD; Department of Neurology, Mayo Clinic, Jacksonville, FL, USA. freeman.william1@mayo.edu.; Department of Neurologic Surgery, Mayo Clinic, Jacksonville, FL, USA. freeman.william1@mayo.edu.; Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA. freeman.william1@mayo.edu.
المصدر: The pharmacogenomics journal [Pharmacogenomics J] 2024 Jun 18; Vol. 24 (4), pp. 19. Date of Electronic Publication: 2024 Jun 18.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Nature Pub. Group Country of Publication: United States NLM ID: 101083949 Publication Model: Electronic Cited Medium: Internet ISSN: 1473-1150 (Electronic) Linking ISSN: 1470269X NLM ISO Abbreviation: Pharmacogenomics J Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Avenet, NJ : Nature Pub. Group, c2001-
مواضيع طبية MeSH: Nimodipine*/administration & dosage , Nimodipine*/adverse effects , Subarachnoid Hemorrhage*/drug therapy , Subarachnoid Hemorrhage*/genetics , Subarachnoid Hemorrhage*/complications , Calcium Channel Blockers*/administration & dosage , Calcium Channel Blockers*/adverse effects , Calcium Channel Blockers*/therapeutic use , Pharmacogenetics*/methods, Humans ; Middle Aged ; Female ; Male ; Aged ; Treatment Outcome ; Dose-Response Relationship, Drug ; Adult ; Precision Medicine/methods ; Vasospasm, Intracranial/drug therapy
مستخلص: Nimodipine, an L-type cerebroselective calcium channel antagonist, is the only drug approved by the US Food and Drug Administration for the neuroprotection of patients with aneurysmal subarachnoid hemorrhage (aSAH). Four randomized, placebo-controlled trials of nimodipine demonstrated clinical improvement over placebo; however, these occurred before precision medicine with pharmacogenomics was readily available. The standard enteral dose of nimodipine recommended after aSAH is 60 mg every 4 h. However, up to 78% of patients with aSAH develop systemic arterial hypotension after taking the drug at the recommended dose, which could theoretically limit its neuroprotective role and worsen cerebral perfusion pressure and cerebral blood flow, particularly when concomitant vasospasm is present. We investigated the association between nimodipine dose changes and clinical outcomes in a consecutive series of 150 patients (mean age, 56 years; 70.7% women) with acute aSAH. We describe the pharmacogenomic relationship of nimodipine dose reduction with clinical outcomes. These results have major implications for future individualized dosing of nimodipine in the era of precision medicine.
(© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
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المشرفين على المادة: 57WA9QZ5WH (Nimodipine)
0 (Calcium Channel Blockers)
تواريخ الأحداث: Date Created: 20240618 Date Completed: 20240618 Latest Revision: 20240813
رمز التحديث: 20240814
DOI: 10.1038/s41397-024-00340-3
PMID: 38890281
قاعدة البيانات: MEDLINE
الوصف
تدمد:1473-1150
DOI:10.1038/s41397-024-00340-3