An overview of coumarin as a versatile and readily accessible scaffold with broad-ranging biological activities

Privileged structures have been widely used as an effective template for the research and discovery of high value chemicals. Coumarin is a simple scaffold widespread in Nature and it can be found in a considerable number of plants as well as in some fungi and bacteria. In the last years, these natural compounds have been gaining an increasing attention from the scientific community for their wide range of biological activities, mainly due to their ability to interact with diverse enzymes and receptors in living organisms. In addition, coumarin nucleus has proved to be easily synthetized and decorated, giving the possibility of designing new coumarin-based compounds and investigating their potential in the treatment of various diseases. The versatility of coumarin scaffold finds applications not only in medicinal chemistry but also in the agrochemical field as well as in the cosmetic and fragrances industry. This review is intended to be a critical overview on coumarins, comprehensive of natural sources, metabolites, biological evaluations and synthetic approaches

Clinical Applications of Pharmacogenetics

The rapidly evolving field of Pharmacogenetics aims at identifying the genetic factors implicated in the inter-individual variation of drug response. These factors could enable patient sub-classification based on their treatment needs thus expediting drug development and promoting personalized, safer and more effective treatments. This book presents Pharmacogenetic examples from a broad spectrum of different drugs, for different diseases, which are representative of different stages of evaluation or application. It has been designed so as to serve both the unfamiliar reader through explanations of basic Pharmacogenetic concepts, the clinician with presentation of the latest developments and international guidelines, and the research scientist with examples of Pharmacogenetic applications, discussions on the limitations and an outlook on the new scientific trends in this field

Adverse drug reactions and targets for deprescribing in high risk older adults

Over the last twenty years, many prescribing tools have been developed and validated to identify inappropriate prescribing (IP) in older adults and assist physicians in medication optimisation. However, these prescribing tools have predominantly focused on identifying IP in the general older adult population, rather than targeting the population cohort that is growing at the fastest rate and that is at the highest risk of IP and adverse drug reactions (ADRs) i.e. older frailer multimorbid patients with a poor survival prognosis. Extensive research on the prevalence of ADRs has been published. However many different definitions of ADRs and many different ADR causality tools have been employed across different studies, making it difficult to compare the results of studies. To confound this area of investigation further, many ADR causality tools are not appropriate to use in older frail multimorbid adults. In addition, a limited amount of research has occurred identifying the morbidity associated with ADRs in older adults. To date, there is no standardized approach to identifying, assessing and reporting ADRs in older adults. This doctoral thesis was designed to (i) standardise the identification, assessment and reporting of ADRs in older adults, (ii) assess ADRs using this new methodology in high risk populations, and (iii) develop and validate a new usable set of criteria called STOPPFrail (Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy) to assist deprescribing in older frail multimorbid adults with a poor survival prognosis i.e. patients where the role of preventative therapy is questionable. This thesis comprises eleven chapters. The first chapter is an introduction, divided into four sections i.e. (i) demographic changes and the proportional increase in high risk older adults, (ii) prescribing considerations for older adults, (iii) consequences of IP including ADRs and (iv) potential targets for intervention. The second chapter proposes a methodologically robust way of identifying, assigning causality and reporting ADRs and tests this theory on physicians, pharmacists, biomedical scientists and nurses. The third chapter uses this new ADR methodology to identify the prevalence of ADRs in older adults presenting to hospital. The fourth chapter compares older and younger adults with cancer in terms of multimorbidity, medication use and ADRs using the same methodology proposed in Chapter 2. The fifth chapter develops and validates STOPPFrail criteria, an explicit prescribing tool to assist deprescribing in frail older adults with a poor one year survival prognosis. The sixth chapter describes the inter-rater reliability (IRR) of STOPPFrail criteria between physicians. The seventh chapter, applies STOPPFrail criteria to two representative populations i.e. a proportion of older adults deemed suitable for nursing home care and a proportion of older adults presenting for hospitalisation. Chapter eight considers the relevance of the research data developed in this thesis as well as questions any issues arising from these research studies. Chapter nine contains peer-reviewed articles that were published and awards received during the writing of this thesis. Finally, chapters ten and eleven list the references and appendices, respectively

Psoriasis

We hope you enjoy and find the information provided in this book useful in your research or practice. We urge that you continue to keep abreast of the new developments in psoriasis and share your knowledge so that we may advance treatment and cures of psoriasis

Pharmacotherapy

The intent of this book is to provide an overview of current conceptualizations of Pharmacotherapy. The book focuses on three major areas; diagnosis, treatment, and prevention for a wide array of diseases; Cognitive and Psychological disorders (Schizophrenia and Nicotine addiction), Inflammatory disorders (New Chemical anti-inflammatory and Immunotherapy), updated antihypertensive therapy and healing of ulcers with venous origin. A separate chapter is dedicated to the rationality of drug use in earthquake injuries. The last chapter deals with Imaging of potential therapeutic or diagnostic agents in animal models in the early stage of research. We hope this book is useful to a wide range of people, from students first learning about Pharmacotherapy, to advanced clinicians and researchers

Pain Management

Pain Management - Current Issues and Opinions is written by international experts who cover a number of topics about current pain management problems, and gives the reader a glimpse into the future of pain treatment. Several chapters report original research, while others summarize clinical information with specific treatment options. The international mix of authors reflects the "casting of a broad net" to recruit authors on the cutting edge of their area of interest. Pain Management - Current Issues and Opinions is a must read for the up-to-date pain clinician

The application of pharmacoinformatics in enhancing pharmaceutical care of patients with cancer

Ph.DDOCTOR OF PHILOSOPH