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Evaluation of pharmacogenomics and drug-drug interaction databases in migraine

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dc.date.accessioned 2020-06-15T07:41:57Z
dc.date.issued 2020-06-15
dc.identifier.uri http://hdl.handle.net/123456789/29344
dc.title Evaluation of pharmacogenomics and drug-drug interaction databases in migraine en
ethesis.discipline.URI none und
ethesis.faculty Farmasian tiedekunta fi
ethesis.faculty Faculty of Pharmacy en
ethesis.faculty Farmaceutiska fakulteten sv
ethesis.faculty.URI http://data.hulib.helsinki.fi/id/9a2784ea-4d84-40d4-a651-895ae66a37ea
ethesis.university.URI http://data.hulib.helsinki.fi/id/50ae46d8-7ba9-4821-877c-c994c78b0d97
ethesis.university Helsingin yliopisto fi
ethesis.university University of Helsinki en
ethesis.university Helsingfors universitet sv
dct.creator Jalonen, Milla
dct.issued 2020
dct.language.ISO639-2 eng
dct.abstract There are significant inter-individual differences in the effects of drugs. These differences can be caused by, for example, other diseases, adherence to treatment, or drug-drug interactions. A drug-drug interaction can lead to an increase in the concentration of the active substance in the circulation (pharmacokinetic interactions) or a change in the effect of the drug without changes in plasma concentration (pharmacodynamic interactions). A drug-drug interaction can change the efficacy of a drug or affect the adverse drug reaction profile. The individual’s genetic background, such as diversity in drug-modifying enzymes (polymorphism), also has an effect on the efficacy and the risk for adverse drug reactions of some drugs. A pharmacogenetic test can be used to study how genetic factors affect drug treatments. The aim of this master's thesis was to examine the possibilities of personalized migraine pharmacotherapy from the perspective of pharmacogenomics and drug-drug interactions. Four online drug-drug interaction databases available in Finland were compared. Inxbase is the most widely used interaction database by physicians in Finland and it is also integrated into Finnish pharmacy systems. Other databases used in this study were the international professional database Micromedex as well as Medscape Drug Interaction Checker and Drugs.com Drug Interactions Checker. The latter two are open-access databases available for healthcare professionals and patients. Interaction searches were conducted in the selected databases between acute and prophylactic drugs used for the treatment of migraine (e.g. bisoprolol-sumatriptan). Fourteen acute and 12 prophylactic drugs were selected for this study based on the Current Care Guidelines in Finland (Käypä hoito), and the data were collected in Excel spreadsheets. The first search was completed in December 2019 and the second search in March 2020. In this study, many potential interactions were found between acute and prophylactic drugs used to treat migraine in Finland. For more than half of the drug pairs studied, a potential interaction was found in at least one of the databases. There were significant differences between the interaction databases regarding which interactions the database contains and how the severity of the interactions was classified. Of the interactions found, only 45% were found in all four databases, and each database contained interactions that were not found in the other databases. Even very serious interactions or drug pairs classified as contraindicated were not found to be consistently presented across all four databases. When selecting drug treatment for a migraine patient, potential drug-drug interactions between acute and prophylactic drugs as well as the patient's genetic background should be considered. Individualizing migraine treatment to achieve the best efficacy and to reduce the risk for adverse drug reactions is important because migraine as a disease causes a heavy burden on individuals, healthcare, and society. Pharmacogenetic tests particularly developed to help choosing migraine treatment are not yet available, but tests are available for few other indications in both public and private healthcare. The use of these tests in clinical practice will increase as physicians’ pharmacogenetic knowledge and scientific evidence on pharmacogenetic tests increase. Utilization of pharmacogenetic data requires that test results are stored in electronic health records so that they are available in the future, when changes are made to drug treatment of individuals. More studies are warranted to better understand the clinical impact of pharmacogenomics and drug-drug interactions in migraine care. en
dct.subject drug-drug interaction en
dct.subject drug-drug interaction database en
dct.subject pharmacogenomics en
dct.subject pharmacogenetic test en
dct.subject migraine en
dct.language en
ethesis.language.URI http://data.hulib.helsinki.fi/id/languages/eng
ethesis.language English en
ethesis.language englanti fi
ethesis.language engelska sv
ethesis.supervisor Korolainen, Minna
ethesis.supervisor Airaksinen, Marja
ethesis.thesistype pro gradu -tutkielmat fi
ethesis.thesistype master's thesis en
ethesis.thesistype pro gradu -avhandlingar sv
ethesis.thesistype.URI http://data.hulib.helsinki.fi/id/thesistypes/mastersthesis
dct.identifier.ethesis E-thesisID:668fb411-0f35-4fd9-a8ad-e56118f6cb21
dc.date.embargoedUntil 2023-06-09
ethesis-internal.timestamp.reviewStep 2020-05-22 11:05:41:548
ethesis.principalprofessor Airaksinen, Marja
dct.identifier.urn URN:NBN:fi:hulib-202006152792
dc.type.dcmitype Text
ethesis.facultystudyline Sosiaalifarmasia fi
ethesis.facultystudyline Social pharmacy en
ethesis.facultystudyline Socialfarmaci sv
ethesis.facultystudyline.URI http://data.hulib.helsinki.fi/id/SH55_006 und
ethesis.mastersdegreeprogram Proviisorin koulutusohjelma fi
ethesis.mastersdegreeprogram Master's Programme in Pharmacy en
ethesis.mastersdegreeprogram Utbildningsprogrammet för provisorexamen sv
ethesis.mastersdegreeprogram.URI http://data.hulib.helsinki.fi/id/MH55_001 und

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