Posaconazole a Prophylactic Therapy in Cancer Patients: Analysis and Pharmacokinetics
Bibliographic record
Abstract
Abstract Intorduction: Posaconazole (PZ), an antifungal prophylactic therapy in hematologic cancer patients, was added to Al-Amal Hospital formulary in 2010. The objectives of this study are: 1. To identify the practice guidelines and pharmacokinetics information regarding PZ use in Qatar and worldwide. 2. To conduct a drug use evaluation (DUE) report at Al-Amal Hospital. Methods: Literature review was conducted to answer the first objective. A retrospective DUE report was conducted to include 10 randomly chosen hematologic cancer patients who used PZ during the year 2010. Patients profiles were reviewed and data were collected into a pre-prepared collection sheet. Results: PZ was approved for prophylaxis in hematologic cancer patients →13 years in USA, Canada, and Australia, →18 years in the European Union and >15 years in Qatar. PZ has low bioavailability that can be enhanced by co-administration of high fat meals and by dividing the total daily dose. Data regarding PZ TDM is controversial. PZ undergoes several drug-drug interactions. For example, co-administration of proton pump inhibitors may result in PZ sub-therapeutic levels. Co-administration of vincristine may result in higher neurological toxicity, mainly gastrointestinal problems, due to the inhibitory potency of PZ on cytochrome P450 enzymes. A patient receiving vincristine based chemotherapy protocol concurrently with PZ developed seizure. Another patient developed mild breakthrough fungal infection while on PZ prophylactically. Conclusion: The PZ regulations in Qatar are similar to the worldwide recommendations. The PZ practice in Al-Amal hospital abides by the regulations. Possible serious PZ drug-drug interactions, seizures, in hematologic cancer patients should be highlighted and carefully monitored.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".