Slovo úvodem

MUDr. David Suchý, Ph.D.

Klin Farmakol Farm. 2011;25(2):51  

Prescription of antiinfectives in patients treated by immunosuppressive therapy

Jan Strojil, Vladimíra Vojtová, Pavel Anzenbacher

Klin Farmakol Farm. 2011;25(2):53-58  

Introduction and aim: Patients on immunosuppression have an increased risk of infections and therefore also antiinfective utilization. Our aim was to characterize the differences between these patients and individual immunosuppressants. Methods: We analyzed prescription in the University Hospital Olomouc between 2005 and 2010, a total of 191,313 patients (average age 42 years, 51 % women), of whom 2,229 (1.2 %) fulfilled the criterion of at least 180 days of immunosuppressive treatment. Results: Patients on immunosuppressive treatment received 10 % of all antiinfective DDDs and over 30 % of the total cost of antiinfective drugs. The structure...

Safety of antiepileptic drugs and it´s relation to the quality of life in paediatric patients with epilepsy

Ľubomír Virág, Miroslav Murgaš, Magdaléna Kuželová

Klin Farmakol Farm. 2011;25(2):59-63  

Purpose: To analyse safety of antiepileptic drugs (AEDs) and its impact on quality of life in paediatric outpatients with epilepsy. Methods: The present study was a retrospective survey conducted at the Outpatient Department of Paediatric Neurology in Nitra, Slovakia. The study population comprised 293 patients (148 girls and 145 boys; a mean age of 10.9). The data were collected retrospectively from patient´s medical record. All adverse effects (AEs) were characterised with respect to their probability and severity. QOLIE-AD-48 questionnaire was used to assess quality of life prospectively (10/2005–01/2009). Chi-square test was conducted...

Overview of current treatment options in antiresorptive

Václav Vyskočil

Klin Farmakol Farm. 2011;25(2):64-70  

We currently have four groups of drugs with a purely antiresorptive effect: 1. the oldest and longest-studied drug, which is undoubtedly Calcitonin 2. the group of selective blockers of estrogen receptors, represented by Raloxifene 3. the group of bisphosphonates of II. and III. generation in oral and intravenous modifications 4. the biological treatment, where is the sole representative of denosumab The author analyzes studies that have monitored these drugs, including results on the fractures reduction.

Vitamin D

Václav Vyskočil

Klin Farmakol Farm. 2011;25(2):72-75  

The author describes the metabolism of vitamin D and the mechanism of its action in the body, while paying attention not only to skeletal but also to non-skeletal effects of vitamin D, ie. effect on the immune system and affecting of the autoimmune and cancer diseases. In a similar way, author examines the active metabolite, which, unlike the classical vitamin D has the effect not only in the absence of the substance in the body, but even at its normal levels, especially in terms of muscle strength, coordination and interference of the speed of neuromuscle transmission.

Certolizumab and treatment of rheumatoid arthritis

Jan Zeman

Klin Farmakol Farm. 2011;25(2):76-78  

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease with frequent systemic manifestations. The introduction of biological therapy of RA is a great progress. This treatment targets directly the pathogenesis of this disease. Certolizumab pegol is a novel humanized monoclonal antibody that neutralizes tumor necrosis factor alfa (TNF-alfa). In contrast to other drugs it does not contain a Fc fragment of immunoglobuline – it consists of a Fab fragment conjugated with two molecules of a polyethylene glycol. In clinical trials, effectivity of this drug was proved both as monotherapy and in combination with methotraxate. Certolizumab...

Tocilizumab - the contribution of interleukin-6 blockade

Pavel Jeremiáš

Klin Farmakol Farm. 2011;25(2):80-85  

Tocilizumab (TCZ) is a novel biological drug blocking effect of interleukin-6, important pleitropic cytokin, that plays important part in etiopatogenesis of rheumatoid arthritis and other inflammatory diseases. In travenous tocilizumab is given to patiens with rheumatoid arthritis at dose of 8 mg/kg every four weeks. Clinical trials confirmed effect of tocilizumab in different groups (insufficient response to methotrexate, other conventional disease-modifying antirheumatic drugs, failure of tumor necrosing factor inhibitors). Tocilizumab is the first biological drug with proven higher clinical effect in monotherapy compared with methotrexate....

Treatment of peripheral neuropathic pain

Jan Lejčko

Klin Farmakol Farm. 2011;25(2):85-86  

Neuropathic pain (NPB) is almost always long and difficult one among the modifiable forms of chronic pain. The clinical picture is very varied and individually specific. Moreover of the antineurophatic agents with the potential to affect the substance of the specific pathophysiology of acute abdomen is the credo of contemporary pharmacotherapy. For most types of ACC are now the first choice of most gabapentinoids. Recently, several new options appeared effective local treatment of peripheral NPB. This treatment option is especially for patients with extensive polymorbid pharmacotherapy, the overall optimal solution.

Comments on 5-fluorouracil - based anticancer chemotherapy innovations

Jiřina Martínková, Miloš Hroch, Jiří Grim

Klin Farmakol Farm. 2011;25(2):87-91  

5-fluorouracil (5-FU) is used for adjuvant (postoperative) and neoadjuvant (preoperative) cytostatic therapy. Dose is determined by body surface (mg/m2) in spite of the fact that a linear relationship between the dose and systemic clearance has not been proven so far. A good message is kinetically guided approach for adjuvant therapy, which focuses on 5-FU pharmacokinetic monitoring followed by individual dose adjustment. This strategy confined to 5-FU i. v. infusion was proven to be more effective in ensuring an appropriate treatment course with minimized toxicity and optimized therapeutic outcome. The target exposure (AUC- area under the...

Gastrointestinal bleeding due to warfarin drug interactions with ciprofloxacin

Jiří Holý, Pavel Havránek

Klin Farmakol Farm. 2011;25(2):92-94  

The authors document case history of an 81 years old male patient suffering from chronic bronchitis, diabetes mellitus of 2nd type and chronic coronary artery disease who was taking warfarin because of chronic atrial fibrillation. The patient was using 3 different types of antibiotics during the hospitalization, the last one was ciprofloxacin. On the 4th day of using of ciprofloxacin the patient started to suffer from the extreme elevation of INR with bleeding to gastrointestinal tract. The bleeding was cured non-invasively; the treatment of oral anticoagulation was stopped. After an exclusion of other possible causes the authors explain the...