Therapeutic drug monitoring in methadone maintenance therapy (MMT) : an evaluation of genetic factors influencing clinical outcomes and serum concentrations of methadone

Terapi Gantian Methadone (TGM) telah digunakan secara meluas dan berfungsi untuk mengelakkan berlakunya gejala penarikan dalam kalangan penyalahguna dadah jenis opiat. Ia merupakan salah satu daripada kaedah pendekatan “pengurangan kemudaratan” (harm reduction) bagi menurunkan kadar penularan jangki...

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Main Author:	Mohamed Nazar, Nor Ilyani
Format:	Thesis
Language:	English
Published:	2013
Subjects:	R735-854 Medical education Medical schools Research
Online Access:	http://eprints.usm.my/36393/1/Dr.__Aedrianee_Reeza_Alwi_TSTZ_%28NN24%29.pdf
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spelling	my-usm-ep.363932019-04-12T05:26:13Z Therapeutic drug monitoring in methadone maintenance therapy (MMT) : an evaluation of genetic factors influencing clinical outcomes and serum concentrations of methadone 2013-06 Mohamed Nazar, Nor Ilyani R735-854 Medical education. Medical schools. Research Terapi Gantian Methadone (TGM) telah digunakan secara meluas dan berfungsi untuk mengelakkan berlakunya gejala penarikan dalam kalangan penyalahguna dadah jenis opiat. Ia merupakan salah satu daripada kaedah pendekatan “pengurangan kemudaratan” (harm reduction) bagi menurunkan kadar penularan jangkitan melalui darah dalam komuniti terutamanya HIV AIDS yang boleh membawa maut. Walau bagaimanapun, proses penentuan dos yang optimum bagi setiap pesakit adalah sukar dan mencabar kerana ia menunjukkan kepelbagaian aktiviti farmakologi yang tinggi dalam individu yang berbeza. Kajian ini menghuraikan hubungkait di antara kepekatan methadone darah (Ctrough) dengan dos harian pesakit dan keberkesanan yang dikehendaki iaitu keterukkan gejala penarikan dan ujian pengesahan air kencing bagi pengambilan dadah terlarang. Hubungan antara pelbagai haplotaip gen CYP2B6 dengan kepekatan methadone darah dan variasi polimorfisme nukleotida tunggal OPRM1 (A118G) dengan tahap keberkesanan klinikal yang diukur juga dikaji. Methadone maintenance therapy (MMT) has been widely used to prevent withdrawal symptoms among opiate use disorder patients. It is one of the harm reduction approaches in order to reduce the spread of fatally blood borne diseases in the community especially HIV AIDS. However, determining the optimal dose in patients is somehow difficult and challenging as it shows wide inter-individual variability of pharmacological activity. This study correlates the trough serum methadone concentrations (Ctrough) at steady state with the methadone dose and the clinical outcomes namely severity of withdrawal symptoms and urinalysis for other illicit drugs. The relationship between various CYP2B6 haplotypes with the Ctrough and OPRM1 (A118G) single nucleotide polymorphisms (SNPs) with the clinical outcomes measures were also studied. 2013-06 Thesis http://eprints.usm.my/36393/ http://eprints.usm.my/36393/1/Dr.__Aedrianee_Reeza_Alwi_TSTZ_%28NN24%29.pdf application/pdf en public phd doctoral Universiti Sains Malaysia Pusat Pengajian Sains Perubatan (School of Medical Sciences)
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	R735-854 Medical education Medical schools Research
spellingShingle	R735-854 Medical education Medical schools Research Mohamed Nazar, Nor Ilyani Therapeutic drug monitoring in methadone maintenance therapy (MMT) : an evaluation of genetic factors influencing clinical outcomes and serum concentrations of methadone
description	Terapi Gantian Methadone (TGM) telah digunakan secara meluas dan berfungsi untuk mengelakkan berlakunya gejala penarikan dalam kalangan penyalahguna dadah jenis opiat. Ia merupakan salah satu daripada kaedah pendekatan “pengurangan kemudaratan” (harm reduction) bagi menurunkan kadar penularan jangkitan melalui darah dalam komuniti terutamanya HIV AIDS yang boleh membawa maut. Walau bagaimanapun, proses penentuan dos yang optimum bagi setiap pesakit adalah sukar dan mencabar kerana ia menunjukkan kepelbagaian aktiviti farmakologi yang tinggi dalam individu yang berbeza. Kajian ini menghuraikan hubungkait di antara kepekatan methadone darah (Ctrough) dengan dos harian pesakit dan keberkesanan yang dikehendaki iaitu keterukkan gejala penarikan dan ujian pengesahan air kencing bagi pengambilan dadah terlarang. Hubungan antara pelbagai haplotaip gen CYP2B6 dengan kepekatan methadone darah dan variasi polimorfisme nukleotida tunggal OPRM1 (A118G) dengan tahap keberkesanan klinikal yang diukur juga dikaji. Methadone maintenance therapy (MMT) has been widely used to prevent withdrawal symptoms among opiate use disorder patients. It is one of the harm reduction approaches in order to reduce the spread of fatally blood borne diseases in the community especially HIV AIDS. However, determining the optimal dose in patients is somehow difficult and challenging as it shows wide inter-individual variability of pharmacological activity. This study correlates the trough serum methadone concentrations (Ctrough) at steady state with the methadone dose and the clinical outcomes namely severity of withdrawal symptoms and urinalysis for other illicit drugs. The relationship between various CYP2B6 haplotypes with the Ctrough and OPRM1 (A118G) single nucleotide polymorphisms (SNPs) with the clinical outcomes measures were also studied.
format	Thesis
qualification_name	Doctor of Philosophy (PhD.)
qualification_level	Doctorate
author	Mohamed Nazar, Nor Ilyani
author_facet	Mohamed Nazar, Nor Ilyani
author_sort	Mohamed Nazar, Nor Ilyani
title	Therapeutic drug monitoring in methadone maintenance therapy (MMT) : an evaluation of genetic factors influencing clinical outcomes and serum concentrations of methadone
title_short	Therapeutic drug monitoring in methadone maintenance therapy (MMT) : an evaluation of genetic factors influencing clinical outcomes and serum concentrations of methadone
title_full	Therapeutic drug monitoring in methadone maintenance therapy (MMT) : an evaluation of genetic factors influencing clinical outcomes and serum concentrations of methadone
title_fullStr	Therapeutic drug monitoring in methadone maintenance therapy (MMT) : an evaluation of genetic factors influencing clinical outcomes and serum concentrations of methadone
title_full_unstemmed	Therapeutic drug monitoring in methadone maintenance therapy (MMT) : an evaluation of genetic factors influencing clinical outcomes and serum concentrations of methadone
title_sort	therapeutic drug monitoring in methadone maintenance therapy (mmt) : an evaluation of genetic factors influencing clinical outcomes and serum concentrations of methadone
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan (School of Medical Sciences)
publishDate	2013
url	http://eprints.usm.my/36393/1/Dr.__Aedrianee_Reeza_Alwi_TSTZ_%28NN24%29.pdf
_version_	1747820632429559808

Therapeutic drug monitoring in methadone maintenance therapy (MMT) : an evaluation of genetic factors influencing clinical outcomes and serum concentrations of methadone

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