Asians as a group comprise > 60% the world’s population. There is an incredible amount of diversity in Asian and admixed populations that has not been addressed in a pharmacogenetic context. The known pharmacogenetic differences in Asian subgroups generally represent previously known variants that are present at much lower or higher frequencies in Asians compared with other populations. In this review we summarize the main drugs and known genes that appear to have differences in their pharmacogenetic properties in certain Asian populations. Evidence‐based guidelines and summary statistics from the US Food and Drug Administration and the Clinical Pharmacogenetics Implementation Consortium were analyzed for ethnic differences in outcomes. Implicated drugs included commonly prescribed drugs such as warfarin, clopidogrel, carbamazepine, and allopurinol. The majority of these associations are due to Asians more commonly being poor metabolizers of cytochrome P450 (CYP) 2C19 and carriers of the human leukocyte antigen (HLA)‐B*15:02 allele. The relative risk increase was shown to vary between genes and drugs, but could be > 100‐fold higher in Asians. Specifically, there was a 172‐fold increased risk of Stevens‒Johnson syndrome and toxic epidermal necrolysis with carbamazepine use among HLA‐B*15:02 carriers. The effects ranged from relatively benign reactions such as reduced drug efficacy to severe cutaneous skin reactions. These reactions are severe and prevalent enough to warrant pharmacogenetic testing and appropriate changes in dose and medication choice for at‐risk populations. Further studies should be done on Asian cohorts to more fully understand pharmacogenetic variants in these populations and to clarify how such differences may influence drug response.

Introduction Since the implementation of the Hospital Readmission Reduction Program, health systems have been working to reduce hospital readmission rates of patients with heart failure (HF). Of these efforts, the interventions with a multidisciplinary, multicomponent approach have lowered readmission rates as well as improved patient care, patient adherence, and patient outcomes. Objectives The primary objective of this study was to determine if the addition of a pharmacist to the Transitional Care Team (TCT) would decrease the number of high‐risk HF patients readmitted to the hospital before 30 days. Secondarily, this study assessed the change in self‐reported medication adherence. Methods This study was conducted at a community teaching hospital. A retrospective chart review was performed to identify HF patients who were at high risk for readmission admitted to the hospital from May 2012 to October 2013, as the historical control group. The intervention group included high‐risk patients with HF admitted from May 2014 to October 2015, who received the pharmacist‐led intervention during hospitalization and postdischarge. The pharmacist‐led intervention comprised five components: medication reconciliation, medication cost/formulary review, medication discharge counseling, providing and educating patients regarding self‐monitoring resources and postdischarge telephone follow‐up. The 8‐item Morisky Medication Adherence Scale was used to measure patients' self‐reported medication adherence at baseline, then 30 days after discharge. Results The pharmacist‐led intervention assisted in decreasing the readmission rate from 33.7% in the historical control group to 21.3% in the intervention group with a relative risk reduction of 0.696 (confidence interval: 0.488‐0.994). There was also a significant improvement in self‐reported patient medication adherence scores. Conclusion The addition of a pharmacist to the TCT that managed HF patients was associated with a decrease in the readmission rate for patients who were at high risk of readmission and improved self‐reported patient medication adherence.

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Stroke is a devastating disease associated with high morbidity and mortality. Despite the approved indication of systemic thrombolytic therapy in the United States for the acute management of ischemic stroke, its use is limited given a strict eligibility criteria and a risk for hemorrhagic transformation as a feared adverse effect. Many agents have been studied without success for neuroprotection in patients with stroke to reduce vascular injury and improve long-term functional outcomes. Minocycline is a tetracycline antibiotic that shows promise for its neuroprotective effects in multiple animal models and three human trials. It affects multiple pathways to reduce apoptosis, neuroinflammation, infarct size, and vascular injury. The aim of this review is to discuss current evidence for minocycline from pre-clinical and early clinical trials and its potential role in neuroprotection in patients with acute ischemic stroke.