Fakulti Farmasi | Faculty of Pharmacy, UKM
Centre for Quality
Management of Medicines
Pharmacotherapeutic
CURRENT ACTIVE PROJECTS:
Prof Mohd Makmor Bakry
Genetic-based Individual Pharmacotherapy
- Genetic polymorphisms of selected genes are known to impact the functions of drug metabolising enzymes, drug transporter proteins and drug receptors. Changes in these proteins affect the pharmacokinetic and pharmacodynamic of medication. Current research project explores the effect of selected genetic variants on the effectiveness and safety of analgesic and anaesthetic agents.
A/ Prof Farida Hanim Islahuddin
Individualizing medication management in chronic kidney disease patients
- There has been a rise in chronic kidney disease (CKD) worldwide. Among CKD patients, managing medication is a great clinical challenge, given the plethora of medications required. Our work addresses individual adherence to medication, by developing a tool – (Continuous Adherence Prediction tool) to predict those at risk of non-adherence based on socio-demographic and clinical background. The tool can be used by pharmacists to identify those at risk of non-adherence and may need additional counseling or education to slow CKD progression. In addition to this, we have also identified that CYP3A5*3 polymorphisms and frequent adjustments are factors that contribute to rapid CKD progression. Therefore, further work on CYP450 polymorphisms are now being investigated to identify its association with CKD management and rapid CKD progression, in an attempt to further understand individual response to medication among CKD patients.
Long-term effects of COVID-19: a pharmacist role
- The COVID-19 pandemic has raised many questions related to treatment and management of patients. At present, healthcare professionals are constantly managing acute treatment, although very little is known with regards to its long-term effects. We are currently investigating the various complications related to post-acute COVID-19 infection and addressing the need for further management by pharmacists. The information collected will lead to standard guides and references for pharmacists to ensure optimal long-term effects of COVID-19 management is delivered.
Dr Adyani Md Redzuan
The Outcomes Of Streptokinase Versus Tenecteplase In St-Elevation Myocardial Infarction (STEMI): A Propensity-Matched Retrospective Analysis In A Multiracial Asian Country
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Fibrinolysis using Streptokinase (SK) or Tenecteplase (TNK) is the current primary reperfusion strategy (>70%) in ST-elevation myocardial infarction (STEMI) management in Malaysia’s public hospitals. The perception of the superiority of TNK and the cost difference between the fibrinolytic agents may affect the physicians’ decisions in terms of treatment of choice. The comparative outcomes of these fibrinolytic agents in the Asian population were unknown despite being widely use. Hence, this study is conducted to assess and compare the outcomes of SK versus TNK in our multiracial STEMI patients.
Reconstructing Digoxin Nomogram Based On Population Pharmacokinetics Data
- Digoxin is widely prescribed for the treatment of congestive heart failure and atrial fibrillation Due to its narrow therapeutic index nature, close therapeutic drug monitoring is indicated to ensure its safety and efficacy. Calculation for digoxin dosing is rather complex putting the patient at risk of either sub- or supratherapeutic drug concentration. Hence, this study is conducted to investigate the trend of achieving therapeutic serum digoxin concentration (SDC) in patients taking digoxin, identify factors affecting therapeutic SDC and construct a Digoxin nomogram to aid with dosing. New findings from this project will be the proposed Digoxin nomogram to provide a convenient, safe and effective dosing determination.
Dr Shamin Mohd Saffian
New oral anticoagulant dosing and monitoring.
- Dabigatran, rivaroxaban and apixaban (NOACs) are new generation oral anticoagulants. They are administered as fixed doses for most patients and routine anticoagulation monitoring is not recommended in clinical practice. However, there is evidence that the clinical outcomes are correlated with the plasma concentrations. Hence we have several projects that overarchingly aim to improve the monitoring and dosing of oral anticoagulants. This involves a number of projects involving evidence synthesis from published literature as well as primary prospective observational studies to gain real-world evidence.
Vitamin D status in Malaysia.
- There is a strong relationship between vitamin D and COVID-19 infection. Many studies have shown that the severity of COVID-19 is correlated with the degree of vitamin D status and Malaysia is one of the countries that is badly hit by the pandemic. Although Malaysia is close to the equator which in theory would allow sufficient sun exposure to prevent vitamin D deficiency, several local studies have shown that the prevalence of vitamin D deficiency to be high in Malaysia. This study aims to pool all studies that report the Vitamin D status in Malaysia. The outcome of this study is expected to inform public health measures that can be taken to improve the health status of people residing in Malaysia.
Clinical pharmacology and pharmacometrics.
- Pharmacometrics is the field of study of the methodology and application of mathematical and statistical models for disease and pharmacological measurement. Typically this involves identifying target concentrations, development of pharmacokinetic and pharmacodynamic models to describe the time-course of drug action and methods to achieve the target concentration. Currently there are several projects related to intravenous immunoglobulin G, antibiotics and anticoagulants.
Dr Siti Azdiah Abdul Aziz
Factors Affecting Modification of Initial Antiretroviral Therapy Regimen in PLWH
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Human immunodeficiency virus (HIV) infection is a disease that requires lifelong antiretroviral therapy (ART). It is essential to increase the durability of initial ART regimen, to improve clinical outcomes and preserve future ART options. The aim of this research is to investigate the reasons and factors associated with modifications of the initial ART regimen among treatment-naïve patients in infectious disease clinics of two tertiary hospitals in Malaysia.
Dr Chandini Menon Premakumar
Systematic Review: Effects of Glutamine in Gastrointestinal and colorectal cancer patients
Glutamine is the most abundant type of non-essential amino acid in our body. It plays important roles in regulating gene expression, protein turnover, anti-oxidative function, nutrient metabolism, immunity, and acid-base balance. It can be produced in sufficient amounts by the body in healthy individuals. The shortage of glutamine is reflected as a decrease in plasma concentration, which is a prognostic factor for poor outcome in these conditions. It has been repeatedly demonstrated that critical illnesses such as trauma and/or sepsis, burns, and severe acute pancreatitis are associated with profound intracellular glutamine depletion. A decrease of free glutamine in muscle to approximately 50% of normal levels has long been considered a hallmark of the metabolic responses to stress. This project aims to provide a comprehensive overview with evidence on the effects of glutamine in gastrointestinal and colorectal cancer patients.
EXTERNAL COLLABORATORS:
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