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Gammal RS, Pirmohamed M, Somogyi AA, Morris SA, Formea CM, Elchynski AL, Oshikoya KA, McLeod HL, Haidar CE, Whirl-Carrillo M, Klein TE, Caudle KE, Relling MV. Expanded Clinical Pharmacogenetics Implementation Consortium Guideline for Medication Use in the Context of G6PD Genotype. Clin Pharmacol Ther 2023; 113:973-985. [PMID: 36049896 PMCID: PMC10281211 DOI: 10.1002/cpt.2735] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/26/2022] [Indexed: 11/06/2022]
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is associated with development of acute hemolytic anemia in the setting of oxidative stress, which can be caused by medication exposure. Regulatory agencies worldwide warn against the use of certain medications in persons with G6PD deficiency, but in many cases, this information is conflicting, and the clinical evidence is sparse. This guideline provides information on using G6PD genotype as part of the diagnosis of G6PD deficiency and classifies medications that have been previously implicated as unsafe in individuals with G6PD deficiency by one or more sources. We classify these medications as high, medium, or low to no risk based on a systematic review of the published evidence of the gene-drug associations and regulatory warnings. In patients with G6PD deficiency, high-risk medications should be avoided, medium-risk medications should be used with caution, and low-to-no risk medications can be used with standard precautions, without regard to G6PD phenotype. This new document replaces the prior Clinical Pharmacogenetics Implementation Consortium guideline for rasburicase therapy in the context of G6PD genotype (updates at: www.cpicpgx.org).
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Affiliation(s)
- Roseann S. Gammal
- Department of Pharmacy Practice, Massachusetts College of Pharmacy and Health Sciences, Boston, MA, USA
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Munir Pirmohamed
- MRC Centre for Drug Safety Science, Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Andrew A. Somogyi
- Discipline of Pharmacology, School of Biomedicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Sarah A. Morris
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, TN, USA
- Department of Cancer Pharmacology and Pharmacogenomics, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | - Christine M. Formea
- Department of Pharmacy and Intermountain Precision Genomics, Intermountain Healthcare, Salt Lake City, UT, USA
| | | | - Kazeem A. Oshikoya
- Department of Pharmacology, Therapeutics and Toxicology, College of Medicine, Lagos State University, Ikeja, Lagos, Nigeria
| | - Howard L. McLeod
- Intermountain Precision Genomics, Intermountain Healthcare, St George, UT, USA
| | - Cyrine E. Haidar
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | | | - Teri E. Klein
- Department of Biomedical Data Science, Stanford University, Stanford, CA, USA
| | - Kelly E. Caudle
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Mary V. Relling
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, TN, USA
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Joshi R, Myers E, Kokhanov A. Congenital Disorders of Red Blood Cells. Neoreviews 2022; 23:e813-e828. [PMID: 36450647 DOI: 10.1542/neo.23-12-e813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
See Bonus NeoBriefs videos and downloadable teaching slides Understanding the physiologic process of red blood cell development in utero and subsequent erythropoiesis in the neonate is crucial as this determines red blood cell structure and therefore function, which is vital to neonatal health. Infants frequently experience anemia, and special consideration must be given to the evaluation of these infants to determine the correct etiology. Traditionally, anemia is conceptualized in terms of inadequate red blood cell production, increased red blood cell destruction, or whole blood loss. This framework translates well to inherited red blood cell defects, which include genetic abnormalities in bone marrow productivity or structure of the red blood cell membrane, enzymes, or hemoglobin. This article highlights fetal and neonatal erythropoiesis and the underlying etiologies of the inherited red blood cell disorders, as well as reviews the appropriate diagnostic evaluation and next steps in management. It is imperative that neonatal clinicians remain informed about these disorders to enable early recognition and treatment, and ultimately to improve outcomes in affected infants.
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Affiliation(s)
- Rhucha Joshi
- Division of Neonatal Medicine, Department of Pediatrics, University of California Irvine, Irvine, CA
| | - Erin Myers
- Department of Pediatrics, University of California Irvine, Irvine, CA
| | - Artemiy Kokhanov
- Department of Neonatology, MemorialCare Miller Children's and Women's Hospital Long Beach, Long Beach, CA
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Dongre K, Jungo A, Späni S, Zysset Y, Leuppi-Taegtmeyer A. Disease-Drug Interactions Requiring Special Attention. PRAXIS 2022; 111:700-705. [PMID: 36102026 DOI: 10.1024/1661-8157/a003923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This short review addresses disease-drug interactions requiring special attention, namely interactions between common conditions and over-the-counter medication and interactions between rare conditions and drugs that are absolutely contraindicated. We specifically examine over-the-counter analgesics, antiemetics and drugs used to treat allergy symptoms and underlying disease conditions they can exacerbate. Resources for avoiding disease-drug interactions in patients with rare conditions, such as myasthenia gravis, glucose-6-phosphate deficiency, mitochondriopathies and long QT-syndrome are given. We also discuss methods for avoiding disease-drug interactions in clinical practice. These include awareness, regular diagnosis- and drug-history taking, consulting the product information, good communication between healthcare providers and patient education. Furthermore, pharmacovigilance activities help in the early identification and characterization of adverse drug reactions resulting from disease-drug interactions.
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Affiliation(s)
- Kanchan Dongre
- Regional Pharmacovigilance Centre Basel, University Hospital Basel, Basel, Switzerland
- Department of Clinical Pharmacology and Toxicology, University and University Hospital Basel, Basel, Switzerland
| | - Anja Jungo
- Regional Pharmacovigilance Centre Basel, University Hospital Basel, Basel, Switzerland
- Department of Clinical Pharmacology and Toxicology, University and University Hospital Basel, Basel, Switzerland
| | - Selina Späni
- Hospital Pharmacy, Kantonsspital Baselland, Liestal, Switzerland
| | | | - Anne Leuppi-Taegtmeyer
- Regional Pharmacovigilance Centre Basel, University Hospital Basel, Basel, Switzerland
- Department of Clinical Pharmacology and Toxicology, University and University Hospital Basel, Basel, Switzerland
- Hospital Pharmacy, Kantonsspital Baselland, Liestal, Switzerland
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Sarkar A, Rohilla M, Kumari S. Concurrence of glucose-6-phosphate dehydrogenase deficiency in pregnancy. J OBSTET GYNAECOL 2022; 42:747-750. [DOI: 10.1080/01443615.2021.2024157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Avir Sarkar
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, India
| | - Minakshi Rohilla
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, India
| | - Snigdha Kumari
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, India
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Traditional African remedies induce hemolysis in a glucose-6-phopshate dehydrogenase deficient zebrafish model. Sci Rep 2020; 10:19172. [PMID: 33154437 PMCID: PMC7645625 DOI: 10.1038/s41598-020-75823-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 10/06/2020] [Indexed: 11/24/2022] Open
Abstract
Traditional remedies are widely used throughout Africa in routine care for infants. However, such remedies could have detrimental effects. Acute bilirubin encephalopathy (ABE) and kernicterus spectrum disorder (KSD) are common newborn health conditions in the developing world, contributing to substantial neonatal mortality and morbidity. They frequently occur in children with glucose-6-phopshate dehydrogenase (G6PD) deficiency. Using our established zebrafish model of G6PD deficiency, we tested the effects of three traditional compounds used in the care of the newborn umbilical cord: eucalyptus oil, methylated spirits, and Yoruba herbal tea. We found that eucalyptus oil induced a 13.4% increase in a hemolytic phenotype versus control, while methylated spirits showed a 39.7% increase in affected phenotype. Yoruba herbal tea exposure showed no effect. While methylated spirits are already a known pro-oxidant, these data indicate that eucalyptus oil may also be a hemolytic trigger in those with G6PD deficiency. Discovering which agents may contribute to the pathophysiology of G6PD deficiency is critical to eliminate ABE and KSD, especially in countries with a high prevalence of G6PD deficiency. The next step in elucidating the role of these agents is to determine the clinical correlation between the use of these agents and ABE/KSD.
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Tan CSS, Lee SWH. Warfarin and food, herbal or dietary supplement interactions: A systematic review. Br J Clin Pharmacol 2020; 87:352-374. [PMID: 32478963 DOI: 10.1111/bcp.14404] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/20/2020] [Accepted: 05/22/2020] [Indexed: 12/12/2022] Open
Abstract
AIMS To present an updated overview on the safety of concurrent use of food, herbal or dietary supplement and warfarin. METHODS A systematic literature review was performed on 5 databases from inception up to 31 December 2019. These interactions were classified depending on the likelihood of interaction and supporting evidences. RESULTS A total of 149 articles describing 78 herbs, food or dietary supplements were reported to interact with warfarin. These reports described potentiation with 45 (57.7%) herbs, food or dietary supplements while 23 (29.5%) reported inhibition and 10 (12.8%) reported limited impact on warfarin pharmacokinetics and pharmacodynamics. Twenty unique herb and dietary supplements also reported to result in minor bleeding events, such as purpura and gum bleeding as well as major events such as intracranial bleeding that led to death. CONCLUSION While most food, herbs and supplements can be safely taken in moderation, healthcare professionals should be aware of the increased risk of bleeding when taking several food and herbs. These include Chinese wolfberry, chamomile tea, cannabis, cranberry, chitosan, green tea, Ginkgo biloba, ginger, spinach, St. John's Wort, sushi and smoking tobacco. Patients should be counselled to continue to seek advice from their healthcare professionals when starting any new herbs, food or supplement.
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Affiliation(s)
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia.,Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Selangor, Malaysia.,School of Pharmacy, Monash University, Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
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7
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Chong PZ, Ng HY, Tai JT, Lee SWH. Efficacy and Safety of Ginkgo biloba in Patients with Acute Ischemic Stroke: A Systematic Review and Meta-Analysis. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2020; 48:513-534. [PMID: 32349519 DOI: 10.1142/s0192415x20500263] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Ginkgo biloba and its extract have been suggested to have a neuroprotective role in patients with acute ischemic stroke. We aimed to examine the efficacy and safety of Ginkgo biloba use in patients with acute ischemic stroke. We searched seven databases for randomized controlled studies examining the use of Ginkgo biloba in patients with acute ischemic stroke. Relevant studies were retrieved, screened, and data were extracted independently by two reviewers. Random effects meta-analyses were performed to evaluate the efficacy and safety outcomes of Ginkgo biloba. We subsequently assessed the certainty of evidence using the GRADE (Grading of Recommendation Assessment, Development and Evaluation) methodology. We found 12 randomized controlled studies enrolling 1466 patients. Pooled results suggest that Ginkgo biloba use was associated with an improvement in neurological function among individuals with AIS with a reduction of 2.87 points on the National Institute of Health Stroke Scale score (95% CI: -4.01--1.74, p<0.001). Ginkgo biloba use was also associated with an improvement in activities of daily living and functional outcome (Mean Difference: 9.52; 4.66-14.33, p<0.001). Subgroup analysis suggest that the impact was larger when using an injectable formulation of Ginkgo biloba compared to the oral formulation. There was no apparent impact of Ginkgo biloba use on all-cause mortality (Risk ratio (RR): 1.21; 0.29-5.09, p=0.80) or cerebrovascular bleeding (RR: 0.82; 0.43-1.57, p=0.55). There was limited evidence on to support the use of gingko biloba in terms of improving quality of life and other stroke events. As such, more studies are needed before it can be recommended for routine use in improving neurological and cognitive function in patients with acute ischemic stroke.
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Affiliation(s)
- Phui Zee Chong
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Selangor, Malaysia
| | - Huey Ying Ng
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Selangor, Malaysia
| | - Jing Tong Tai
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Selangor, Malaysia
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Selangor, Malaysia.,School of Pharmacy, Taylor's University Lakeside Campus, Jalan Taylor's, 47500 Selangor, Malaysia
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9
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Liew NY, Chong YY, Yeow SH, Kua KP, Saw PS, Lee SWH. Prevalence of potentially inappropriate medications among geriatric residents in nursing care homes in Malaysia: a cross-sectional study. Int J Clin Pharm 2019; 41:895-902. [PMID: 31073975 DOI: 10.1007/s11096-019-00843-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 05/03/2019] [Indexed: 12/27/2022]
Abstract
Background Polypharmacy has been associated with an increased risk of morbidity and mortality among older adults especially those living in nursing homes. Explicit criteria to evaluate the appropriateness of medications have recently been updated. Objective To estimate and compare the prevalence of potentially inappropriate medications (PIMs) among older adults in nursing homes using screening tool for older people's prescription (STOPP-2) and the 2015 Beers criteria. Setting Nursing care homes in the Klang Valley, Malaysia. Method A cross-sectional survey of medications used among residents living in nursing homes was performed. The 2015 Beers criteria and STOPP-2 criteria were used to evaluate the use of PIMs among this population. These PIMs were subsequently classified using the Pharmaceutical Network Europe classification (PCNE). Main outcome measure Number of PIMs among residents using both criteria. Results A total of 155 residents were recruited into the study. The prevalence of PIMs was 9.7% using the STOPP-2 criteria, 17.6% using the 2015 Beers criteria and 21.3% when both tools were used in combination. The PCNE criteria identified a total of 198 drug related issues, with an average of 1.27 issue per resident. Factors associated with higher risk of having PIM include multiple medication use and history of psychiatric disorder. Conclusion The 2015 Beers criteria was able to identify more PIM's compared to STOPP-2 criteria. The findings also support the expansion of pharmacists' services in nursing homes in Malaysia.
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Affiliation(s)
- Ngit Yi Liew
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | - Ying Yee Chong
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | - Shiau Huey Yeow
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | - Kok Pim Kua
- Department of Pharmacy, Klinik Kesihatan Puchong, Puchong, Selangor, Malaysia
| | - Pui San Saw
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia.
- Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
- Gerentology Laboratory, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
- School of Pharmacy, Taylor's University, Jalan Taylors, 47500, Subang Jaya, Selangor, Malaysia.
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10
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La Vieille S, Lefebvre DE, Khalid AF, Decan MR, Godefroy S. Dietary restrictions for people with glucose-6-phosphate dehydrogenase deficiency. Nutr Rev 2018; 77:96-106. [DOI: 10.1093/nutrit/nuy053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Sébastien La Vieille
- Bureau of Chemical Safety, Food Directorate, Health Canada, Ottawa, Ontario, Canada
- Department of Food Sciences, Faculty of Agriculture and Food Sciences, Université Laval, Québec City, Québec, Canada
| | - David E Lefebvre
- Bureau of Chemical Safety, Food Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Ahmad Firas Khalid
- Health Policy PhD Program, McMaster University, Hamilton, Ontario, Canada
| | - Matthew R Decan
- Bureau of Chemical Safety, Food Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Samuel Godefroy
- Department of Food Sciences, Faculty of Agriculture and Food Sciences, Université Laval, Québec City, Québec, Canada
- Institute of Nutrition and Functional Foods, Université Laval, Québec City, Québec, Canada
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11
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Lewis JE, Costantini F, Mims J, Chen X, Furdui CM, Boothman DA, Kemp ML. Genome-Scale Modeling of NADPH-Driven β-Lapachone Sensitization in Head and Neck Squamous Cell Carcinoma. Antioxid Redox Signal 2018; 29:937-952. [PMID: 28762750 PMCID: PMC6104251 DOI: 10.1089/ars.2017.7048] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIMS The purpose of this study was to investigate differential nicotinamide adenine dinucleotide phosphate, reduced (NADPH) production between radiation-sensitive and -resistant head and neck squamous cell carcinoma (HNSCC) cell lines and whether these differences are predictive of sensitivity to the chemotherapeutic β-lapachone. RESULTS We have developed a novel human genome-scale metabolic modeling platform that combines transcriptomic, kinetic, thermodynamic, and metabolite concentration data. Upon incorporation of this information into cell line-specific models, we observed that the radiation-resistant HNSCC model redistributed flux through several major NADPH-producing reactions. Upon RNA interference of canonical NADPH-producing genes, the metabolic network can further reroute flux through alternate NADPH biosynthesis pathways in a cell line-specific manner. Model predictions of perturbations in cellular NADPH production after gene knockdown match well with experimentally verified effects of β-lapachone treatment on NADPH/NADP+ ratio and cell viability. This computational approach accurately predicts HNSCC-specific oxidoreductase genes that differentially affect cell viability between radiation-responsive and radiation-resistant cancer cells upon β-lapachone treatment. INNOVATION Quantitative genome-scale metabolic models that incorporate multiple levels of biological data are applied to provide accurate predictions of responses to a NADPH-dependent redox cycling chemotherapeutic drug under a variety of perturbations. CONCLUSION Our modeling approach suggests differences in metabolism and β-lapachone redox cycling that underlie phenotypic differences in radiation-sensitive and -resistant cancer cells. This approach can be extended to investigate the synergistic action of NAD(P)H: quinone oxidoreductase 1 bioactivatable drugs and radiation therapy. Antioxid. Redox Signal. 29, 937-952.
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Affiliation(s)
- Joshua E Lewis
- 1 The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University , Atlanta, Georgia
| | - Francesco Costantini
- 2 School of Chemical and Biomolecular Engineering, Georgia Institute of Technology , Atlanta, Georgia
| | - Jade Mims
- 3 Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine , Winston-Salem, North Carolina
| | - Xiaofei Chen
- 3 Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine , Winston-Salem, North Carolina
| | - Cristina M Furdui
- 3 Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine , Winston-Salem, North Carolina
| | - David A Boothman
- 4 Department of Pharmacology, University of Texas Southwestern Medical Center , Dallas, Texas
| | - Melissa L Kemp
- 1 The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University , Atlanta, Georgia
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Lee SWH, Chaiyakunapruk N, Lai NM. What G6PD-deficient individuals should really avoid. Br J Clin Pharmacol 2016; 83:211-212. [PMID: 27650490 DOI: 10.1111/bcp.13091] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 08/07/2016] [Accepted: 08/10/2016] [Indexed: 11/29/2022] Open
Affiliation(s)
| | - Nathorn Chaiyakunapruk
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia.,School of Population Health, University of Queensland, Brisbane, QLD, Australia.,Center of Pharmaceutical Outcomes Research (CPOR), Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.,School of Pharmacy, University of Wisconsin, Madison, WI, USA
| | - Nai Ming Lai
- School of Medicine, Taylor's University, Subang Jaya, Malaysia
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