Center for Education and Research on Therapeutics

描述：（由申请人提供）：在乔治城大学应急中心（GUCERT）的最初三年里，该项目研究了药物不良相互作用（adi），特别是那些导致药物引起的心律失常的药物，女性的风险增加。这些原始研究已经确定了新的潜在致命的相互作用，并促进了对各种药物类别的ADIs的认识。医疗保健提供者在实践中无法预防急性呼吸道感染，我们发现医学院和住院医生的课程中几乎没有提供相关信息，使他们能够以避免急性呼吸道感染伤害的方式开出处方。GUCERT已经开发了课程和辅助工具，指导提供者了解潜在的急性脑损伤的范围，目前正在实施和评估这些教育项目。随着搬迁到亚利桑那健康科学中心，新的AzCERT继续研究导致心律失常的药物-药物相互作用。基于网络的登记处www.QTdrugs.org继续作为发起这些研究的机制。一项具有挽救生命潜力的重大发现是观察到美沙酮可诱发致命性室性心律失常。AzCERT调查人员进行的机械研究现在使测试预防措施成为可能。新提出的项目将包括美沙酮诱导QT间期延长的预测因素的临床研究。gurert向AzCERT的过渡为扩大我们研究的定义和范围创造了机会，并将这些知识传达给西南多元文化背景下的医疗保健提供者和消费者。我们对ADIs潜在影响因素的了解正在急剧增加，这对所有医疗保健提供者构成了重大挑战。我们在最初三年的经验表明，必须从多个方面处理药物相互作用。我们现在充分认识到，由于消费者和多个提供者独立管理治疗方法的系统性失败，可能会发生药物相互作用。替代处方药物，增加非处方、草药或中性药物治疗，以及由患者修改给药方案是常见的。当提供者和消费者不公开沟通和分享治疗管理时，不良后果的风险就会增加。AzCERT将利用我们对药物相互作用的更广泛的系统定义，对实验室、临床和卫生服务进行研究。将检查整个医疗保健提供系统的弱点和潜在的改进，以防止药物-药物和药物-草药的急性呼吸道感染。同样重要的是，AzCERT将解决提供者与消费者之间的对话，并制定健康沟通模式，以最大限度地减少这些更广泛定义的adi带来的风险。

DESCRIPTION: (PROVIDED BY APPLICANT):During the initial three years of the Georgetown CERT (GUCERT) the program studied adverse drug interactions (ADIs), particularly those that result in drug-induced cardiac arrhythmias for which women are at increased risk. These original studies have identified new potentially lethal interactions and fostered awareness of ADIs across a wide array of drug classes. Healthcare providers have been unable to prevent ADIs in practice and we have found that curricula of medical schools and medicine residencies contain little information to prepare them to prescribe in ways that avoids harm from ADIs. GUCERT has developed curricula and aides to instruct providers on the range of potential ADIs, and is currently implementing and evaluating these educational programs. With the move to the Arizona Health Sciences Center, the new AzCERT continues the study of drug-drug interactions that result in arrhythmias. The web-based registry, www.QTdrugs.org, continues as the mechanism for initiating these studies. A major finding with life-saving potential is the observation that methadone can induce lethal ventricular arrhythmias. Mechanistic studies performed by AzCERT investigators now make it possible to test preventive measures. Newly proposed projects in this application will include a clinical study of the predictors of methadone-induced QT prolongation. The transition of the GUCERT to the AzCERT creates opportunities to expand the definition and scope of our research and convey this knowledge to healthcare providers and consumers in the multicultural context of the southwest. Our knowledge of the potential contributing factors for ADIs is expanding dramatically and this poses a substantial challenge for all healthcare providers. Our experience during the initial three years has shown that drug interactions must be approached on multiple fronts. We now fully recognize that drug interactions can occur due to systemic failures in which consumers and multiple providers are independently managing therapeutics. Substitution of prescribed drugs, addition of non-prescription, herbal or neutraceutical therapies, and modification of dosing regimens by patients are common. The risk of adverse outcomes grows when providers and consumers do not openly communicate and share in the management of therapies. AzCERT will employ laboratory, clinical and health services research using our broader systemic definition of drug interactions. The entire healthcare delivery system will be examined for weaknesses and potential improvements that are designed to prevent drug-drug and drug-herbal ADIs. Of equal importance, AzCERT will address the provider-consumer dialogue and develop health communication models to minimize risks from these more broadly defined ADIs.