Therapeutic Index [TI] refers to a therapeutic ratio where the efficiency of medication is optimised. Dr Wang Aiwen, Senior Pharmacist, from the Department of Pharmacy at Singapore General Hospital shares 5 tips when taking TI medicine.
Therapeutic index [TI] is also commonly referred as a therapeutic window, safety window or therapeutic ratio. This is the dose range where the efficacy of medication is optimised while side-effects are minimised. The figure below visually demonstrates the concept.
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5 TIPS WHEN TAKING THERAPEUTIC INDEX [TI] MEDICINE
If you are taking any of the therapeutic index [TI] medicines listed above, here are some tips to ensure your safety:
HAVE A MEDICATION LIST.
Know your medications well, especially which ones have a narrow therapeutic index. Be educated on the side-effects to look out for, and know when to see your doctor.
CHECK FOR POTENTIAL DRUG INTERACTIONS.
Show your medication list to all your healthcare providers, especially if you are seeing several different doctors. Be aware of possible interactions of new medications with your existing treatment. This includes over-the-counter preparations and herbal supplements.
ADHERE TO YOUR MEDICATION REGIME.
Avoid missing doses, and do not just adjust your dosage on your own. Remember that narrow therapeutic index [TI] drugs have a fine balance between toxicity and efficacy.
DON’T SKIP YOUR APPOINTMENTS.
Always come for your blood tests and doctors’ appointments. Your body is always changing and it is important to come for regular checks at least once a year, to be sure that the dosage previously prescribed for you is still suitable.
DO NOT “SHARE” YOUR MEDICATIONS.
What is suitable for you may not be suitable for others. The selection of medication and doses is unique to your medical conditions and health status.
When in doubt about your medications, discuss your concerns with your doctor or pharmacist.
Ref: O17
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Abstract
An appropriate therapeutic index is crucial for drug discovery and development since narrow therapeutic index [NTI] drugs with slight dosage variation may induce severe adverse drug reactions or potential treatment failure. To date, the shared characteristics underlying the targets of NTI drugs have been explored by several studies, which have been applied to identify potential drug targets. However, the association between the drug therapeutic index and the related disease has not been dissected, which is important for revealing the NTI drug mechanism and optimizing drug design. Therefore, in this study, two classes of disease [cancers and cardiovascular disorders] with the largest number of NTI drugs were selected, and the target property of the corresponding NTI drugs was analyzed. By calculating the biological system profiles and human protein–protein interaction [PPI] network properties of drug targets and adopting an AI-based algorithm, differentiated features between two diseases were discovered to reveal the distinct underlying mechanisms of NTI drugs in different diseases. Consequently, ten shared features and four unique features were identified for both diseases to distinguish NTI from NNTI drug targets. These computational discoveries, as well as the newly found features, suggest that in the clinical study of avoiding narrow therapeutic index in those diseases, the ability of target to be a hub and the efficiency of target signaling in the human PPI network should be considered, and it could thus provide novel guidance in the drug discovery and clinical research process and help to estimate the drug safety of cancer and cardiovascular disease.
Keywords
Narrow therapeutic index
Cancer
Cardiovascular disease
Artificial intelligence
Drug mechanism
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© 2021 The Authors. Published by Elsevier B.V. on behalf of Research Network of Computational and Structural Biotechnology.