Thesis (doctoral)--Mainz, 1980.

Thesis (doctoral)--Köln, 1987.

Ulm, Univ. Diss., 2005.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.

No description available.

Warfarin is a well-known anticoagulant drug that is used to prevent cardiovascular disease and blood coagulation such as thrombosis. In this study, the main aim was to investigate the photo physical characteristics of warfarin in the different molecular environments provided by sodium dodecyl sulfate (SDS) micelles by using ultraviolet absorption and fluorescence emission spectroscopic techniques. Warfarin and a structural analogue not existing in solution as a cyclic hemiketal, phenprocoumon, were mixed with different concentrations of SDS and spectral changes for these warfarin and phenprocoumon were recorded. Interestingly, results demonstrated, based on an evident increase in the absorption intensity at 273 nm and an evident blue shift in the fluorescence emission spectrum after the addition of an increasing concentration of SDS, that primarily the cyclic hemiketal isomer of warfarin was found to be solvated by SDS micelles at an apparent recorded critical micelle concentration of ~8mM.  Altogether these observations suggest that warfarin may be used as a molecular probe to explore the polarities of complex colloidal mixtures. Moreover, the possibility of using micelles for controlling the isomeric state of warfarin is interesting and can potentially be used for better controlling dosage of warfarin thereby reducing side effects.

The aim of this study was to compare effects of an individualized with a standardized risk assessment for adverse drug reactions to improve drug treatment with antithrombotic drugs in older adults. A randomized controlled trial was conducted in general practitioner (GP) offices. Patients aged 60 years and older, multi-morbid, taking antithrombotic drugs and at least one additional drug continuously were randomized to individualized and standardized risk assessment groups. Patients were followed up for nine months. A composite endpoint defined as at least one bleeding, thromboembolic event or death reported via a trigger list was used. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. In total, N = 340 patients were enrolled from 43 GP offices. Patients in the individualized risk assessment group met the composite endpoint more often than in the standardized group (OR 1.63 [95%CI 1.02–2.63]) with multiple adjustments. The OR was higher in patients on phenprocoumon treatment (OR 1.99 [95%CI 1.05–3.76]), and not significant on DOAC treatment (OR 1.52 [95%CI 0.63–3.69]). Pharmacogenenetic variants of CYP2C9, 2C19 and VKORC1 were not observed to be associated with the composite endpoint. The results of this study may indicate that the time point for implementing individualized risk assessments is of importance.