ISSN
1916-694X

2010;
Volume 1 (Number 2): Pages 27-28

EDITORIAL

In this issue: PK of posaconazole, aspirin
resistance, psychotropic medications in Spain, and ribostamycin in pregnancy

Alejandro A. Nava-Ocampoa,b

aPharmaReasons and bDepartment of Pharmacology
& Toxicology, Faculty of Medicine, University of Toronto ON, Canada

Correspondence: [email-masked]

In
this second number of the first volume of the journal, we are proud to present
again two review papers and two original studies.

Posaconazole
is a recent systemic antifungal agent that belongs to the azoles chemical
family. In the European Union, posaconazole is licensed for the treatment of
adult patients with various refractory invasive infections and those with
oropharyngeal candidiasis. It is also approved as prophylactic treatment of
invasive fungal infections in high-risk patients such as those receiving chemotherapy
for acute myelogenous leukemia or those treated for a severe graft-versus-host
disease after allogeneic hematopoietic stem-cell transplantation.

The
review by LEVEQUE et al. [1] summarizes the published pharmacokinetic (PK) data of
posaconazole in humans. The authors did a thorough review of the literature on
the PK of posaconazole in different groups of subjects including children, and
patients with renal and hepatic dysfunction. The manuscript also reviewed the
factors that may potentially alter the PK of posaconazole such as food, dosing
schedule, age, body weight, body surface area, and pharmacogenetics. Potential
drug-drug interactions were also summarized.

In
the second review paper, COX [2] reviewed and analyzed the interesting and polemic
topic of aspirin resistance. There are three types of aspirin non-response:
treatment failure, and pharmacokinetic and pharmacodynamic resistance.
Treatment failure is when a clinical event occurs despite aspirin therapy and
is due to a COX-independent process. Pharmacokinetic resistance occurs when the
patient does not receive adequate exposure to the drug and is due to many
factors including non-compliance, inadequate dosing, poor bioavailability of
some preparations, and drug interaction with NSAID’s. Finally,
pharmacodynamic resistance is defined as not being treatment failure or
pharmacokinetic resistance and is the only true aspirin resistance.

The
manuscript reviewed the mechanism of action of aspirin, aspirin resistance, and
pharmacokinetic resistance. The author also analyzed the strengths and
weaknesses of different assays to evaluate aspirin resistance, i.e. aspirin,
COX-specific, and global platelet function assays. Based on his experience, the
author proposed the use of serum thromboxane as a screening test for
identifying patients with aspirin resistance.

CARRASCO-GARRIDO
et al. [3] conducted a descriptive, cross-sectional
epidemiologic study on the consumption of psychotropic medication by the
Spanish population. The authors used individual secondary data collected by the
Spanish National Health Survey (SNHS) in 2001 from the Ministry of Health,
carried out on a wide sample of the non-institutionalized Spanish population by
direct interview at home

The
study found that the consumption of psychotropic medications in Spain is still
very considerable, with women registering the highest consumption prevalence
and the greatest number of associated risk factors. The authors emphasized the
fact that psychoactive drug consumption by both men and women tends to increase
with age and a negative perception of health.

LEE
et al. [4] investigated the potential association between exposure
to ribostamycin in early pregnancy and ototoxicity in the offspring. In a
prospective cohort study, 85 women inadvertently exposed to ribostamycin during
the first trimester of pregnancy and 170 age- and gravidity-matched control
women, were voluntarily enrolled. Newborns were clinically examined at birth by
a neonatologist and by imaging studies if any suspicious abnormalities were
noted. Hearing was assessed directly by auditory brainstem response. No newborn
had neonatal ototoxicity in the exposed group.

Ribostamycin
is an aminoglycoside antibiotic used to treat infections caused by
gram-negative organisms. In Korea,
as in other countries already in use, this antibiotic is primarily used to
treat infections such as pelvic inflammatory disease (PID), cystitis, and
severe upper respiratory tract infections (URTI). The results of the study
suggest that ribostamycin is not ototoxic in the neonates born to women who
were inadvertently exposed to ribostamycin in early pregnancy. However, since
exposure occurred at 3.9 ± 1.5 weeks, when the inner ear was not yet
developed, new studies are required in order to confirm these findings.

The
second issue of the journal is a continuation of our original plan to publish
relevant studies and to be among the best options for journals covering the
topics found in the Journal of Clinical
Pharmacology & Pharmacoepidemiology. A substantial effort has been made
to expedite the review and publication processes. In addition, we have filed
the application to gain access to different indexes. Although these challenges
appear to be enormous, the support provided by the Editorial Board is
encouraging and has facilitated the work of the supporting team.

As
always, I would like to express my gratitude to the authors of the published
manuscripts for giving us the opportunity to publish their studies in this
journal, and to the readers for using us as a source of information.

The
Editor

REFERENCES

[1]
Leveque
D, Nivoix Y, Jehl F, Ubeaud-Sequier G, Herbrecht R. Pharmacokinetic profile of
the antifungal agent posaconazole. J Clin Pharmacol Pharmacoepidemiol 2010; 1:
29-38.

[2]
Cox D. Aspirin resistance: a nebulous concept. J Clin
Pharmacol Pharmacoepidemiol 2010; 1: 39-47.

[3]
Carrasco-Garrido P, Jiménez-García R,
Hernán-dez-Barrera V, Astasio-Arbiza P, Ortega-Molina P, López De
Andrés A, et al. Psychotropic
medication consumption in Spain:
influence of gender and perception of health status. J Clin Pharmacol Pharmacoepidemiol
2010; 1: 48-57.

[4]
Lee
SW, Han JY, Lee HJ, Choi JS, Ahn HK, Kim MH, et al. No association between
inadvertent exposure to ribostamycin during early pregnancy and fetal
ototoxicity. J Clin Pharmacol Pharmacoepidemiol 2010; 1: 58-61.

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