Redox-Guided medication review

Boštjan Martinc*

Faculty of Pharmacy, University of Ljubljana, Aškerčeva 7, Slovenia

Refer this article

Boštjan Martinc, Redox-Guided medication review. International Journal of Therapeutic Innovation, November-December 2025, V3 – I6, Pages - 22 – 35. Doi: https://doi.org/10.55522/ijti.v3i6.0130.

ABSTRACT

Oxidative stress (OS)—an imbalance between reactive oxygen/nitrogen species (ROS/RNS) and antioxidant defences—links metabolic and neurological disorders such as type 2 diabetes, non-alcoholic fatty liver disease, Alzheimer’s and Parkinson’s diseases, and epilepsy. To synthesise mechanistic and translational evidence on oxidative stress biology, identify shared “redox hubs”(NRF2/KEAP1, NOX2, SIRT1/3–AMPK–FOXO), and outline their implications for pharmacist-led pharmacotherapy optimization and biomarker-guided medication review. Structured search (PubMed, Scopus, Web of Science, 2015–2025) following SANRA narrative-review criteria identified mechanistic and translational studies on oxidative stress, redox biomarkers, and pharmacological modulators. Across metabolic and neurological phenotypes, dysregulated redox signalling converges on three hubs: NRF2/KEAP1 (antioxidant and detoxifying control), NOX2 (enzymatic ROS source driving vascular and neural injury), and SIRT1/3–AMPK–FOXO (energy/redox integration). These nodes represent actionable pharmacotherapeutic targets informing pharmacist-led, biomarker-guided medication review. Integrating validated redox biomarkers into pharmacist-led medication review enables risk stratification, deprescribing, and precision monitoring across multimorbid populations. These findings support a pharmacist-led, biomarker-guided pharmacotherapy model integrating redox profiling into medication review and pharmacovigilance. Redox-guided pharmacotherapy provides a biologically coherent, clinically actionable framework for precision medication review in chronic disease management. Incorporating validated oxidative-stress biomarkers into pharmacist-led medication review may improve outcomes in multimorbid populations.

Keywords:

Oxidative stress; NRF2; NOX2; SIRT1/AMPK; Clinical pharmacy; Medication review.