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See detailPharma Clinics. Le médicament du mois. Le benzamycin, une actualisation du traitement topique de l'acné
Pierard, Gérald ULg

in Revue Médicale de Liège (1997), 52(2), 120-2

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See detailPharma clinics. Le medicament du mois. Le clopidogrel (Plavix).
Scheen, André ULg

in Revue Médicale de Liège (2001), 56(3), 186-9

Clopidogrel is launched in Belgium by Sanofi-Synthelabo and Bristol-Myers Squibb under the trade name of Plavix. It is a potent and irreversible ADP receptor antagonist that proved to be more effective ... [more ▼]

Clopidogrel is launched in Belgium by Sanofi-Synthelabo and Bristol-Myers Squibb under the trade name of Plavix. It is a potent and irreversible ADP receptor antagonist that proved to be more effective than aspirin as antiplatelet agent in the multicentre, randomised double-blind CAPRIE study. It is indicated, at a dosage of 75 mg/day, for the reduction of atherosclerotic events including myocardial infarction, ischaemic stroke and vascular death in patients with atherosclerosis manifested by recent stroke, myocardial infarction or established peripheral vascular disease. Furthermore, recent studies demonstrated that the combination of clopidogrel with aspirin is more effective than aspirin alone and better tolerated than the combination ticlopidine-aspirin for the prevention of atherothrombosis after placement of intravascular stents. Ongoing trials are evaluating the efficacy and safety of such clopidogrel-aspirin combination after acute ischaemic coronary events or in patients at very high risk of stroke. Thus the indications of clopidogrel may become even larger in a next future. [less ▲]

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See detailPharma clinics. Le medicament du mois. Le montelukast (Singulair)
Louis, Renaud ULg

in Revue Médicale de Liège (2001), 56(6), 460-2

Montelukast (Singulair, Merck Sharp

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See detailPharma-clinics comment je traite ... une infection par le VIH. III. Les inhibiteurs non nucléosidiques de la transcriptase inverse
Nkoghe, D.; Moutschen, Michel ULg; Leonard, Philippe ULg et al

in Revue Médicale de Liège (1999), 54(12), 909-11

Non nucleoside reverse transcriptase inhibitors (NNRTI) are a new arm in the treatment of the HIV infection. They inhibit the replication by direct non competitive binding to the enzyme, and do not ... [more ▼]

Non nucleoside reverse transcriptase inhibitors (NNRTI) are a new arm in the treatment of the HIV infection. They inhibit the replication by direct non competitive binding to the enzyme, and do not require phosphorylation. The fast emergence of resistance in monotherapy obliges to use them in a triple association. The 103 mutation confers a cross-resistance. The most common adverse event is rash. Association with nucleoside analogues is additive or even synergistic. They are metabolized by the cytochrome P450. Within a combined therapy, their efficiency is comparable to protease inhibitors, notably in patients with low viral load. [less ▲]

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See detailPharma-clinics comment je traite ... une infection par le VIH. IV. Les inhibiteurs de protease
Leonard, Philippe ULg; Nkoghe, D.; Moutschen, Michel ULg et al

in Revue Médicale de Liège (2001), 56(11), 739-44

Protease inhibitors constitute the last class of antiretroviral drugs appeared on the market. They raised an enormous enthusiasm, reinforced by recent studies results. These molecules prevent the ... [more ▼]

Protease inhibitors constitute the last class of antiretroviral drugs appeared on the market. They raised an enormous enthusiasm, reinforced by recent studies results. These molecules prevent the formation of infectious viral particles, while inhibiting a viral enzyme that plays a key role in the cycle of replication of the HIV. Their efficiency, especially in association, is recognized for all stages of the infection and the intervening of a resistance often requires many mutations. However, the unexpected adverse events such as lipodystrophy and some interactions can limit their utilization in first intention. [less ▲]

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See detailPharma-clinics le medicament du mois. L'orlistat (xenical).
Scheen, André ULg; Ernest, Philippe ULg; Letiexhe, Michel ULg

in Revue Médicale de Liège (1999), 54(3), 192-6

Orlistat (tetrahydrolipstatin), launched by Roche under the trade name Xenical, is a selective inhibitor of pancreatic and gastro-intestinal lipases. It reduces the digestion of dietary fat and its ... [more ▼]

Orlistat (tetrahydrolipstatin), launched by Roche under the trade name Xenical, is a selective inhibitor of pancreatic and gastro-intestinal lipases. It reduces the digestion of dietary fat and its resorption through digestive mucosa by around 30%. It is indicated, at a dose of 3 x 120 mg/day (one dose with each meal) and together with a moderately low-calorie and low-fat diet, for the treatment of obesity. It has been shown, in placebo-controlled two-year trials, to almost double the number of obese subjects who succeed in loosing at least 10% of initial body weight. Independently, it contributes to decrease serum cholesterol levels by 6-10%. Because of its mechanism of action, this drug can induce intestinal side-effects which tend to decrease with time and with the reduction of fat intake, thus improving diet compliance. [less ▲]

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See detailPharma-clinics le médicament du mois. La nevirapine. Viramune
Nkoghe, D.; Leonard, Philippe ULg; Moutschen, Michel ULg et al

in Revue Médicale de Liège (1999), 54(12), 948-51

Nevirapine is the first non nucleoside reverse transcriptase inhibitor registered in Belgium and indicated in the treatment of HIV-1 infection. In association with 2 nucleoside analogues, its efficiency ... [more ▼]

Nevirapine is the first non nucleoside reverse transcriptase inhibitor registered in Belgium and indicated in the treatment of HIV-1 infection. In association with 2 nucleoside analogues, its efficiency is similar to a tritherapy with protease inhibitor, particularly in naive patients with low viral load. It has a good tolerance profile and is easy to take. Studies in progress should permit to widen its indications. [less ▲]

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See detailPharma-clinics le medicament du mois. Le naratriptan (naramig).
Scheen, André ULg

in Revue Médicale de Liège (1999), 54(3), 189-91

Naratriptan, launched by Glaxo Wellcome under the trade name Naramig, is a potent and selective agonist of 5-HT1B and 5-HT1D vascular receptors. Available as tablets of 2.5 mg, it is indicated in the ... [more ▼]

Naratriptan, launched by Glaxo Wellcome under the trade name Naramig, is a potent and selective agonist of 5-HT1B and 5-HT1D vascular receptors. Available as tablets of 2.5 mg, it is indicated in the acute treatment of migraine, with or without aura. A single oral dose of 2.5 mg naratriptan is characterized by a satisfactory clinical efficacy (already significant after one hour, maximum after 4 hours and persisting during 24 hours), a reduction by half of the recurrence of the migraine crisis within the 24 hours and an excellent tolerance profile. [less ▲]

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See detailPharma-clinics le medicament du mois. Le rabeprazole (Pariet)
Louis, Edouard ULg

in Revue Médicale de Liège (2002), 57(1), 53-6

Proton pomp inhibitors (PPI) have revolutionized the treatment of gastro-oesophageal reflux disease and gastro-duodenal ulcers. Rabeprazole (Pariet) is the last PPI arrived on the Belgian market ... [more ▼]

Proton pomp inhibitors (PPI) have revolutionized the treatment of gastro-oesophageal reflux disease and gastro-duodenal ulcers. Rabeprazole (Pariet) is the last PPI arrived on the Belgian market. Controlled studies have shown an efficacy similar to emeprazole in the treatment of oeso-gastro-duodenal acid diseases. Rabeprazole has a favourable profile with rapid action and good safety. [less ▲]

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See detailPharma-clinics. Comment j'explore... une asthenie chronique
Moutschen, Michel ULg

in Revue Médicale de Liège (1995), 50(6), 268-9

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See detailPharma-clinics. Comment je traite ... le zona
Nikkels, Arjen ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (1999), 54(2), 71-75

The treatment of herpes zoster relies on the intravenous or oral administration of antiviral drugs. Oral aciclovir for shingles is hindered by its low bioavailability. New antiviral drugs with improved ... [more ▼]

The treatment of herpes zoster relies on the intravenous or oral administration of antiviral drugs. Oral aciclovir for shingles is hindered by its low bioavailability. New antiviral drugs with improved oral bioavailability (famciclovir and valaciclovir) allow a better efficacy. The opportuneness of treating herpes zoster is different in the immunocompetent and immunocompromised patients, and during childhood and pregnancy. [less ▲]

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See detailPharma-clinics. Comment je traite ... les verrues péri-ungueales
Lambert, Jean-Luc ULg; Richert, Bertrand ULg; de LA BRASSINNE, Michel ULg

in Revue Médicale de Liège (1999), 54(8), 646-52

Warts are common benign lesions for which no specific antiviral treatment is available. In some cases, patients and doctors can be put off by poor results. Before selecting any treatment for peri- and ... [more ▼]

Warts are common benign lesions for which no specific antiviral treatment is available. In some cases, patients and doctors can be put off by poor results. Before selecting any treatment for peri- and subungual warts, it is of utmost importance to bear in mind the risk of damaging the nail matrix. This paper reviews the advantages and inconveniences of the current available treatments in this location. [less ▲]

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See detailPharma-clinics. Comment je traite ... un sujet avec une concentration basse de cholesterol HDL.
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(12), 727-31

The decision to treat an individual with low HDL cholesterol level depends on his overall cardiovascular risk profile and the therapeutic strategy is based upon the characteristics of the lipid profile ... [more ▼]

The decision to treat an individual with low HDL cholesterol level depends on his overall cardiovascular risk profile and the therapeutic strategy is based upon the characteristics of the lipid profile (isolated abnormality, associated hypertriglyceridaemia or combined elevation of LDL cholesterol). The treatment must favour diet and exercise, before considering a possible pharmacological approach. Results are usually acceptable with better life habits and appropriate diet when low HDL cholesterol level is associated to hypertriglyceridaemia. From a pharmacological point of view, the best results are obtained with fibrates or nicotinic acid. However, results are often disappointing when low HDL cholesterol level is isolated. [less ▲]

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See detailPharma-clinics. Comment je traite ... Une infection par le VIH. II. Inhibiteurs nucléosidiques de la transcriptase reverse
Moutschen, Michel ULg; Nkoghe, D.; Leonard, Philippe ULg et al

in Revue Médicale de Liège (1997), 52(12), 750-2

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See detailPharma-clinics. Comment je traite... II. Approche thérapeutique du cancer colorectal métastatique
Jerusalem, Guy ULg; Bours, Vincent ULg; Fillet, Georges ULg

in Revue Médicale de Liège (1998), 53(6), 318-21

Since its introduction in 1953, 5-fluorouracil based chemotherapy remained the standard treatment in advanced colorectal cancer. Continuous infusion or biochemical modulation by folinic acid enhanced the ... [more ▼]

Since its introduction in 1953, 5-fluorouracil based chemotherapy remained the standard treatment in advanced colorectal cancer. Continuous infusion or biochemical modulation by folinic acid enhanced the therapeutic efficacy of this agent. Quality of life is limited by the toxicity of these regimens as well as by the frequent visits to the hospital during each cycle. Raltitrexed, a thymidylate synthase inhibitor, offers similar antitumoral activity together with a tolerability in comparison to standard 5-fluorouracil based chemotherapy and its simple dosage schedule also contributes to better quality of life. New chemotherapeutic agents are currently in development for the treatment of patients refractory to 5-fluorouracil. Irinotecan and oxaliplatin demonstrate promising activity. [less ▲]

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See detailPharma-clinics. Comment je traite... un patient diabétique de type 1 par pompe portable à insuline
Philips, J. C.; Scheen, André ULg

in Revue Médicale de Liège (1996), 51(11), 678-80

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See detailPharma-Clinics. Comment je traite... un patient diabétique de Type 2 par régime
Paquot, Nicolas ULg

in Revue Médicale de Liège (1996), 51(8), 497-9

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See detailPharma-clinics. Comment je traite... une acné du visage
Pierard, Gérald ULg

in Revue Médicale de Liège (1996), 51(5), 327-31

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See detailPharma-Clinics. Essais cliniques medicamenteux: importance et role du medecin generaliste .
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(1), 17-20

Clinical trials are an essential step in the development of a drug. They must be conducted according to strict rules called "Good Clinical Practice" or GCP. GCP requirements aim to guarantee a perfect ... [more ▼]

Clinical trials are an essential step in the development of a drug. They must be conducted according to strict rules called "Good Clinical Practice" or GCP. GCP requirements aim to guarantee a perfect methodology in the planning, realization and interpretation of clinical trials. The latter can be divided in four phases: phase 1 aiming to demonstrate the safety and to investigate the pharmacokinetics/metabolism of the drug in healthy volunteers; phase 2 aiming to study the intrinsic activity (generally versus a placebo) and safety of the compound in a rather small number of (hospitalized) patients; phase 3 aiming to confirm the comparative efficacy (versus a placebo or a reference drug) and safety of the pharmacological agent in a quite large number of (ambulatory) patients; and phase 4 carried out after commercialization, to verify the clinical utility of the drug in conditions of daily practice. Because he/she occupies a crucial position in the recruitment and follow-up of outpatients, the general practitioner should play a more active role in clinical trials, provided that he/she could work in collaboration with academic centers specialized in clinical pharmacology which can help to perform studies in accordance with GCP requirements. [less ▲]

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See detailPharma-clinics. Le dopage a l'erythropoietine ou l'utilisation detournee des progres therapeutiques.
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(8), 499-502

Sport performance depends on the capacity of oxygen transport to the exercising skeletal muscles. Performance may be increased thanks to an haematocrit augmentation, either by training in high altitude ... [more ▼]

Sport performance depends on the capacity of oxygen transport to the exercising skeletal muscles. Performance may be increased thanks to an haematocrit augmentation, either by training in high altitude, using blood transfusions, or injecting erythropoietin (Epo). Since the synthesis of Epo by bioengineering, doping with recombinant human Epo has become popular in sports in general, and in cycling in particular. This new kind of doping might have been responsible for several sudden deaths in young athletes, essentially in racing cyclists. Until now, such a doping is hardly to be detected. However, it should deserve careful consideration from both public health authorities and sports communities in order to stop what could become a real plague. [less ▲]

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