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World Journal of Pharmacology 2014年第4期3卷 56-71页

作者： Hayley K Blackburn douglas r allington Kendra A Procacci Michael P rivey Department of Pharmacy Practice University of Montana Skaggs School of Pharmacy Missoula MT 59812 United States Department of Pharmacy Community Medical Center Missoula MT 59804 United States Department of Pharmacy Grant Creek Family Practice Missoula MT 59804 United States

Asthma affects approximately 8% of women during pregnancy. Pregnancy results in a variable course for asthma control, likely contributed to by physiological changes affecting the respiratory, immune, and hor-monal systems. While asthma during pregnancy has been associated with an increased risk of maternal and fetal complications including malformations, available data also suggest that active asthma management and monitoring can decrease the risk of adverse outcomes. The diagnosis, disease classifcation, and goals for asthma management in the pregnant woman are the same as for nonpregnant patients. However, evidence shows that pregnant asthmatics are more likely to be under-treated, resulting in asthma exacerbations occurring in approximately one third and hospitalization in one tenth of patients. Pharmacotherapeutic management of asthma exacerbations in pregnant patients follows stan-dard treatment guidelines. In contrast, the principles of asthma maintenance therapy are slightly modified in the pregnant patient. Patients and practitioners may avoid use of asthma medications due to concern for a risk of fetal complications and malformations. A variable amount of information is available regarding the risk of a given asthma medication to cause adverse fetal out-comes, and it is preferable to use an inhaled product. Nevertheless, based on available data, the majority of asthma medications are regarded as safe for use during pregnancy. And, any increased risk to either the mother or fetus from medication use appears to be small compared to that associated with poor asthma control.

关键词： Asthma Pregnancy Fetal outcomes Maternal outcomes Management of asthma Pharmacotherapy

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Alemtuzumab: A Place in Therapy for Treatment of Multiple Sclerosis

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International Journal of Clinical Medicine 2013年第10期4卷 459-471页

作者： Teya M. Tietje douglas r. allington Michael P. rivey Skaggs School of Pharmacy University of Montana Missoula USA Skaggs School of Pharmacy University of Montana Missoula USA Pharmacy Department Community Medical Center Mis-soula USA.

Alemtuzumab is a humanized mononclonal antibody known to cause rapid depletion of B-and T-cell lymphocytes. Subsequent repletion of these lymphocytes leads to changes in adaptive immunity. Alemtuzumab is approved by the United States Food and Drug Administration (FDA) for the treatment of B-cell lymphocytic leukemia but has been investigated off-label in recent years for treatment of autoimmune diseases, including multiple sclerosis (MS). In MS treatment, alemtuzumab is administered as pulsed therapy, given once daily initially for 5 consecutive days and then for 3 consecutive days at 12-month intervals. Alemtuzumab has recently been compared to interferon beta 1-a in one phase II and two phase III trials in patients with relapsing-remitting MS. results from the studies show alemtuzumab compared to interferon beta 1-a is associated with a greater reduction in the risk of sustained accumulation of disability and is more effective in reducing disease relapse rates. The treatment of MS continues to be a healthcare challenge due to the modest clinical benefit and adverse effect profiles of available disease modifying treatment options. Available data suggest alemtuzumab may offer better efficacy outcomes compared to traditional disease modifying therapies in patients with MS. However, the agent has not been compared to other new disease modifying medications that have been recently introduced.

关键词： Alemtuzumab Multiple Sclerosis Monoclonal Antibody Lymphocyte Depletion

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