Indiana University-Purdue University Indianapolis (IUPUI) / Pharmacodynamics (PD) studies the relationship between drug concentration and drug effect on target sites. This field has recently gained attention as studies involving PD Drug-Drug interactions (DDI) assure discovery of multi-targeted drug agents and novel efficacious drug combinations. A PD drug combination could be synergistic, additive or antagonistic depending upon the summed effect of the drug combination at a target site. The PD literature has grown immensely and most of its knowledge is dispersed across different scientific journals, thus the manual identification of PD DDI is a challenge. In order to support an automated means to extract PD DDI, we propose Pharmacodynamics Miner (PD-Miner). PD-Miner is a text-mining tool, which is capable of identifying PD DDI from in vitro PD experiments. It is powered by two major features, i.e., collection of full text articles and in vitro PD ontology. The in vitro PD ontology currently has four classes and more than hundred subclasses; based on these classes and subclasses the full text corpus is annotated. The annotated full text corpus forms a database of articles, which can be queried based upon drug keywords and ontology subclasses. Since the ontology covers term and concept meanings, the system is capable of formulating semantic queries. PD-Miner extracts in vitro PD DDI based upon references to cell lines and cell phenotypes. The results are in the form of fragments of sentences in which important concepts are visually highlighted. To determine the accuracy of the system, we used a gold standard of 5 expert curated articles. PD-Miner identified DDI with a recall of 75% and a precision of 46.55%. Along with the development of PD Miner, we also report development of a semantically annotated in vitro PD corpus. This corpus includes term and sentence level annotations and serves as a gold standard for future text mining.

Indiana University-Purdue University Indianapolis (IUPUI) / Polypharmacy is a general clinical practice, there is a high chance that multiple administered drugs will interfere with each other, such phenomenon is called drug-drug interaction (DDI). DDI occurs when drugs administered change each other's pharmacokinetic (PK) or pharmacodynamic (PD) response. DDIs in many ways affect the overall effectiveness of the drug or at some times pose a risk of serious side effects to the patients thus, it becomes very challenging to for the successful drug development and clinical patient care. Biomedical literature is rich source for in-vitro and in-vivo DDI reports and there is growing need to automated methods to extract the DDI related information from unstructured text. In this work we present an ontology (PK ontology), which defines annotation guidelines for annotation of PK DDI studies. Using the ontology we have put together a corpora of PK DDI studies, which serves as excellent resource for training machine learning, based DDI extraction algorithms. Finally we demonstrate the use of PK ontology and corpora for extracting PK DDIs from biomedical literature using machine learning algorithms.

Indiana University-Purdue University Indianapolis (IUPUI) / Drug-drug interactions (DDIs) refer to situations where one drug affects the pharmacokinetics or pharmacodynamics of another. DDIs represent a major cause of morbidity and mortality. A common adverse drug reaction (ADR) that can result from, or be exacerbated by DDIs is drug-induced myopathy. Identifying DDIs and understanding their underlying mechanisms is key to the prevention of undesirable effects of DDIs and to efforts to optimize therapeutic outcomes. This dissertation is dedicated to identification of clinically important myopathic DDIs and to elucidation of their underlying mechanisms. Using data mined from the published cytochrome P450 (CYP) drug interaction literature, 13,197 drug pairs were predicted to potentially interact by pairing a substrate and an inhibitor of a major CYP isoform in humans. Prescribing data for these drug pairs and their associations with myopathy were then examined in a large electronic medical record database. The analyses identified fifteen drug pairs as DDIs significantly associated with an increased risk of myopathy. These significant myopathic DDIs involved clinically important drugs including alprazolam, chloroquine, duloxetine, hydroxychloroquine, loratadine, omeprazole, promethazine, quetiapine, risperidone, ropinirole, trazodone and simvastatin. Data from in vitro experiments indicated that the interaction between quetiapine and chloroquine (risk ratio, RR, 2.17, p-value 5.29E-05) may result from the inhibitory effects of quetiapine on chloroquine metabolism by cytochrome P450s (CYPs). The in vitro data also suggested that the interaction between simvastatin and loratadine (RR 1.6, p-value 4.75E-07) may result from synergistic toxicity of simvastatin and desloratadine, the major metabolite of loratadine, to muscle cells, and from the inhibitory effect of simvastatin acid, the active metabolite of simvastatin, on the hepatic uptake of desloratadine via OATP1B1/1B3. Our data not only identified unknown myopathic DDIs of clinical consequence, but also shed light on their underlying pharmacokinetic and pharmacodynamic mechanisms. More importantly, our approach exemplified a new strategy for identification and investigation of DDIs, one that combined literature mining using bioinformatic algorithms, ADR detection using a pharmacoepidemiologic design, and mechanistic studies employing in vitro experimental models.