TY  - JOUR
TI  - Research on drug interactions and efficacy optimization of combined medication for elderly patients with ischemic cerebrovascular disease in Guangxi Zhuang Autonomous Region
AU  - Chen, Jiaguan
AU  - Li, Weili
AU  - Pan, Nengzhen
AU  - Liu, Zhanxi
AU  - Cai, Zhiling
JO  - Pakistan Journal of Pharmaceutical Sciences
JF  - Pak. J. Pharm. Sci.
PY  - 2026
DA  - 2026/09
VL  - 39
IS  - 9
SP  - 2630
EP  - 2637
KW  - Elderly ischemic cerebrovascular disease
KW  - Combined medication
KW  - Drug effects
KW  - Aspirin
KW  - Clopidogrel
KW  - Omeprazole
AB  - Background: The incidence of ischemic cerebrovascular disease (ICVD) among the elderly in Guangxi is higher than the national average. The Zhuang ethnic group, the dominant ethnic group in the region, has unique genetic backgrounds and medication habits, often taking antiplatelet drugs and digestive system medications simultaneously, increasing the risk of drug interactions. Objectives: To explore combined medication characteristics and optimize regimens for elderly ICVD patients in Guangxi, focusing on ethnic genetic differences and drug interactions. Methods: A retrospective analysis included 2,135 elderly ICVD patients (873 Zhuang, 1,262 Han) from 2019–2022; 807 patients received a prospective stratified regimen in 2023. CYP2C19 genotypes, platelet function and clinical outcomes were analyzed. Results: Zhuang patients had a higher CYP2C19*3 allele frequency (28.7% vs. 19.2%, P=0.004) and clopidogrel resistance rate (34.1% vs. 14.7%, P<0.001). The aspirin + clopidogrel + omeprazole regimen (51.3% usage) increased stroke recurrence risk (HR=2.81). The stratified regimen boosted efficacy to 89.2%, reduced severe bleeding by 57.3%, and lowered the 6-month recurrence rate from 15.7% to 8.3% (all P<0.01). Conclusion: Elderly Zhuang ICVD patients show distinct CYP2C19 genotypes associated with clopidogrel resistance. A genotype-liver/kidney function stratified regimen improves efficacy and safety, supporting precision medication in ethnic minority areas.
DO  - 10.36721/PJPS.2026.39.9.246.1
ER  -