Úvodní slovo k tématu čísla

Ivana Tašková

Klin Farmakol Farm. 2025;39(4):192-193  

Retrospective evaluation of remdesivir effectiveness in the treatment of COVID-19 disease during the second wave of the pandemic

Lucia Žigová, Orsolya Hrubá, Andrea Gažová

Klin Farmakol Farm. 2025;39(4):194-198 | DOI: 10.36290/far.2025.049  

The COVID-19 pandemic has posed unforeseen challenges to healthcare systems and prompted intensive research into novel therapeutic strategies. Remdesivir, a nucleoside analogue with an approved indication for the treatment of COVID-19, has been included in numerous clinical trials aimed at evaluating its efficacy. While some of these studies suggested a potential clinical benefit, others failed to demonstrate a clear effect on mortality reduction or shortening of hospital stay. The aim of this retrospective study was to evaluate whether the administration of remdesivir during the second pandemic wave influenced clinical outcomes in hospitalized patients...

The importance of therapeutic monitoring of theophylline

Kristina Pechandová

Klin Farmakol Farm. 2025;39(4):199-205 | DOI: 10.36290/far.2025.069  

Theophylline, a worldwide known and long-used bronchodilators in the treatment of lung diseases, has a narrow therapeutic range. The considerable interindividual variability in its pharmacokinetic parameters, the weak correlation between dose and plasma concentration, and the close relationship between plasma concentration and clinical effect make it a suitable candidate for therapeutic drug monitoring. Theophylline is mainly used in the treatment of pulmonary diseases, but its expected bronchodilator effect is only exerted when higher plasma levels are reached. During treatment, their regular determination is necessary to optimize therapy. High levels...

TDM as a tool for pharmacogenetic patient profiling: a case report of phenoconversion

Ivana Tašková, Nicole Šafářová

Klin Farmakol Farm. 2025;39(4):206-212 | DOI: 10.36290/far.2025.073  

Pharmacogenetics and therapeutic drug monitoring (TDM) are essential tools of personalised medicine in psychiatry. While pharmacogenetic testing enables the prediction of genetically determined enzyme activity, TDM provides a direct view of actual plasma drug concentrations and individual pharmacokinetics. These two methods are complementary; TDM can be utilised not only for dose optimisation but also to estimate the patient's metabolic phenotype or detect phenoconversion - a situation where the observed metabolic profile does not align with the genotype-predicted enzymatic activity. This case report details a patient with obsessive-compulsive disorder...

Induction of CYP3A4 by metamizole confirmed by TDM: a case study with quetiapine

Ivana Tašková

Klin Farmakol Farm. 2025;39(4):213-217 | DOI: 10.36290/far.2025.071  

Metamizole is an analgesic and antipyretic with a long history of clinical use, although some of its pharmacological properties, including its safety profile, remain incompletely understood. Recent studies indicate that metamizole is a moderate inducer of cytochrome P450 enzymes (CYP), particularly CYP3A4 and CYP2B6, which may result in altered plasma concentrations of concurrently administered drugs that are substrates of these enzymes. This article presents a case report of a patient whose regular administration of meta­mizole led to a marked decrease (approximately 75%) in quetiapine plasma concentration, consistent with the moderate induction of...

Linezolid and therapeutic drug monitoring: Is it time for routine TDM?

Irena Murínová

Klin Farmakol Farm. 2025;39(4):218-222 | DOI: 10.36290/far.2025.075  

Therapeutic drug monitoring (TDM) has traditionally been used primarily for antibiotics with a narrow therapeutic index, such as aminoglycosides and vancomycin, or for drugs with complex pharmacokinetics, such as voriconazole. For most other antibiotics, its use has been limited to specific cases. However, in the context of the growing prevalence of multidrug-resistant pathogens and the limited development of new antibiotics, there is an increasing need to reconsider this approach. TDM is now seen not only as a tool for improving safety but also as a key strategy for optimizing efficacy, limiting the development of resistance, and thereby extending...

Pharmacotherapie of neuropathic pain

Dana Vondráčková

Klin Farmakol Farm. 2025;39(4):223-228 | DOI: 10.36290/far.2025.066  

Neuropathic pain is one of the most severe and difficult pain to treat with significant impact on health-related quality of life. The international associations IASP and EFIC have issued recommendations for the pharmacotherapy of this pain, which are based on recommendations in most countries. The three basic lines of choice as defined by the Clinical Standard for Pharmacotherapy of Neuropathic Pain include antidepressants, gabapentinoids, anticonvulsants, and weak or strong opioids. In addition, local treatment (capsaicin, lidocaine, botox) is recommended. For individual neuropathic pain syndromes, the recommendations slightly differ. The main differences...

A brief overview of pharmacotherapy in palliative medicine - part two

Miroslav Žiaran

Klin Farmakol Farm. 2025;39(4):229-235 | DOI: 10.36290/far.2025.070  

The second part of the overview of pharmacotherapy in palliative medicine focuses on the treatment of additional symptoms that significantly impair patients' quality of life - dyspnea, nausea and vomiting, constipation, diarrhea, hiccup, and cachexia. The article provides an overview of the etiopathogenesis of these conditions, non-pharmacological interventions, and in particular pharmacological approaches, highlighting their efficacy, safety, and practical application in clinical practice. Emphasis is placed on the need for an individualized approach, appropriate titration of medications, and multidisciplinary collaboration. The text is again intended...

Vasoactive drugs in the treatment of erectile dysfunction: current concepts

Markéta Rafajová

Klin Farmakol Farm. 2025;39(4):236-240 | DOI: 10.36290/far.2025.051  

Erectile dysfunction is a widespread health problem that significantly affects the quality of life of men. Pharmacotherapy is a key pillar of erectile dysfunction treatment, with vasoactive drugs, particularly phosphodiesterase type 5 inhibitors and prostaglandin E1, playing a crucial role in therapeutic approaches. This review article focuses on current concepts in the use of vasoactive drugs in the treatment of erectile dysfunction, including indications, mechanism of action, dosage, adverse effects and pharmacological interactions.

Dapagliflozin in the treatment of IgA nephropathy in a paediatric patient

Markéta Ručková, Petra Matalová

Klin Farmakol Farm. 2025;39(4):241-244 | DOI: 10.36290/far.2025.043  

IgA nephropathy is the most common primary chronic glomerulonephritis in children and adults. It manifests itself as haematuria and proteinuria. Given that approximately half of patients develop kidney failure after 20 years, the prognosis is serious. In recent years, new treatment options have emerged for adults, including SGLT2 inhibitors, endothelin receptor antagonists, and targeted-release budesonide. These drugs are not yet approved for use in children with IgA nephropathy, but SGLT2 inhibitors are approved for children with diabetes mellitus type 2 (T2DM) over the age of 10. We describe the case of a boy with IgA nephropathy and an inadequate...

Selection of an appropriate urinary spasmolytic in a geriatric patient

Lada Feřtová, Barbora Brezinová, Jaroslava Červeňová

Klin Farmakol Farm. 2025;39(4):245-248 | DOI: 10.36290/far.2025.064  

The selection of an appropriate medication for a geriatric patient is a complex process that requires careful consideration of several factors, such as the presence of all medications in the patient's pharmacological history, age-related changes in pharmacokinetics and pharmacodynamics, the patient's functional status, and comorbidities. Special attention should also be given to the medication regimen itself (including dosage forms), ensuring maximum support for patient adherence to pharmacotherapy. This case study discusses an individualized approach to urinary spasmolytic selection in a multimorbid geriatric patient. This article provides comparison...