1.Discordance between medication adherence and blood pressure control in primary care clinics in Negeri Sembilan, Malaysia: The problem of therapeutic inertia
Chun Wai Chan ; Junyi Wang ; Joanne Johnny Bouniu ; Parampreet Singh ; Cheong Lieng Teng
International e-Journal of Science, Medicine and Education 2015;9(3):27-32
Introduction: Poor adherence to anti-hypertensive
agents may be a major contributor for suboptimal blood
pressure control among patients with hypertension.
This study was conducted to assess the adherence to
antihypertensive agents using Morisky Medication
Adherence Scale (MMAS-8) among primary care
patients, and to determine whether the blood pressure
control is associated with the level of adherence.
Methodolgy: This cross-sectional study was conducted
between June 2011 and August 2011. Adults with
hypertension older or equal to aged 30 with or without
diabetes were recruited from two public primary care
clinics in Negeri Sembilan, Malaysia. Medication
adherence was assessed using MMAS-8.
Results: Data from 231 patients were analysed, whereby
68% of them had good medication adherence but only
38.1% of the patients had their blood pressure under
control. Statistical analysis failed to find correlation
between adherence and blood pressure control. Twenty
per cent of hypertensive subjects were on beta-blocker
alone, and 37.1% of patients with either diabetes or
proteinuria were not prescribed either angiotensinconverting
enzyme inhibitors (ACEI) or angiotensin
receptor blocker (ARB). Above half the patients
(51.5%) were on monotherapy.
Conclusion: Discordance between adherence to antihypertensive
agents and hypertension control is clearly
shown in this study, and the likely explanation for the
discordance is therapeutic inertia.
Keywords: primary care; hypertension; therapeutic inertia;
medication adherence
Hypertension
;
Blood Pressure
2.Comparative study on the medical education training model in China and Australia
Jiayu MO ; Xianming KONG ; Chunming WANG ; Macintyre RAINA ; Travaglia JOANNE ; Balasooriya CHINTHAKA
Chinese Journal of Medical Education Research 2015;(1):1-6
With the significant reformation of the health care system in China, medical edu-cation has also been adjusted rapidly in order to meet the needs of health services and development of medical and health undertakings. However, as a result of the adjustment of medical education system and the different schooling system in different regions around the country, medical education system and academic degree in China can hardly be comparedaround the world, and the education institutions such as universities in foreign countries can't understand clearly our country's medical education system and degree very well. Based on the medical education theory and practice of Australia, this paper de-scribes and analyses the difference of medical education system between the two countries, so as to provide some idea on perfecting the medical educationtralning model in China as well as lay a founda-tion for the comparison between Chinese medical education system and mature systems of foreign countriessuch as Australia.
3.Targeting uptake transporters for cancer imaging and treatment.
Acta Pharmaceutica Sinica B 2020;10(1):79-90
Cancer cells reprogram their gene expression to promote growth, survival, proliferation, and invasiveness. The unique expression of certain uptake transporters in cancers and their innate function to concentrate small molecular substrates in cells make them ideal targets for selective delivering imaging and therapeutic agents into cancer cells. In this review, we focus on several solute carrier (SLC) transporters known to be involved in transporting clinically used radiopharmaceutical agents into cancer cells, including the sodium/iodine symporter (NIS), norepinephrine transporter (NET), glucose transporter 1 (GLUT1), and monocarboxylate transporters (MCTs). The molecular and functional characteristics of these transporters are reviewed with special emphasis on their specific expressions in cancers and interaction with imaging or theranostic agents [., I-123, I-131, I-iobenguane (mIBG), F-fluorodeoxyglucose (F-FDG) and C pyruvate]. Current clinical applications and research areas of these transporters in cancer diagnosis and treatment are discussed. Finally, we offer our views on emerging opportunities and challenges in targeting transporters for cancer imaging and treatment. By analyzing the few clinically successful examples, we hope much interest can be garnered in cancer research towards uptake transporters and their potential applications in cancer diagnosis and treatment.
4.Renal drug transporters and their significance in drug-drug interactions.
Acta Pharmaceutica Sinica B 2016;6(5):363-373
The kidney is a vital organ for the elimination of therapeutic drugs and their metabolites. Renal drug transporters, which are primarily located in the renal proximal tubules, play an important role in tubular secretion and reabsorption of drug molecules in the kidney. Tubular secretion is characterized by high clearance capacities, broad substrate specificities, and distinct charge selectivity for organic cations and anions. In the past two decades, substantial progress has been made in understanding the roles of transporters in drug disposition, efficacy, toxicity and drug-drug interactions (DDIs). In the kidney, several transporters are involved in renal handling of organic cation (OC) and organic anion (OA) drugs. These transporters are increasingly recognized as the target for clinically significant DDIs. This review focuses on the functional characteristics of major human renal drug transporters and their involvement in clinically significant DDIs.