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Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu01:29

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Genetic variations significantly influence drug response through pharmacokinetics, receptor interactions, and biologic milieu modifications. Pharmacokinetic alterations impact drug metabolism and clearance, affecting efficacy and toxicity. Variants in drug-metabolizing enzymes, such as CYP2C9 and CYP2C19, alter drug activation and elimination. For example, CYP2C9 loss-of-function variants require lower warfarin doses to prevent excessive bleeding, while CYP2C19 variants reduce clopidogrel...
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Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
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[Clopidogrel resistance].

Yeşim Güray1, Umit Güray, Sule Korkmaz

  • 1Türkiye Yüksek Ihtisas Eğitim ve Araştirma Hastanesi, Kardiyoloji Kliniği, Ankara, Türkiye. yesimguray@gmail.com

Anadolu Kardiyoloji Dergisi : AKD = the Anatolian Journal of Cardiology
|June 13, 2009
PubMed
Summary

Clopidogrel resistance, where patients have activated platelets despite treatment, is a significant issue in atherothrombotic diseases. This review explores its mechanisms, clinical impact, and alternative therapies for improved patient outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Hematology

Background:

  • Platelets are crucial in atherothrombotic diseases like heart attacks and strokes.
  • Clopidogrel is a widely used antiplatelet medication, often combined with aspirin.
  • Some patients show reduced effectiveness to clopidogrel, leading to treatment failure.

Purpose of the Study:

  • To review the mechanisms behind clopidogrel resistance.
  • To assess the clinical significance of this therapeutic failure.
  • To explore alternative treatment options for non-responsive patients.

Main Methods:

  • Literature review of clinical trials and studies on clopidogrel.
  • Analysis of proposed mechanisms for clopidogrel resistance.
  • Evaluation of clinical outcomes associated with clopidogrel resistance.

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Main Results:

  • Clopidogrel resistance is linked to higher rates of morbidity and mortality.
  • Multiple factors contribute to impaired response to clopidogrel.
  • Understanding resistance mechanisms is key to identifying alternative therapies.

Conclusions:

  • Clopidogrel resistance poses a significant clinical challenge in managing atherothrombotic events.
  • Further research into resistance mechanisms is needed.
  • Exploring alternative antiplatelet strategies is essential for these patients.