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 machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".