Clinical Pharmacology and Pharmacy, 2011 (vol. 25), issue 3

Editorial

Pharmacovigilance in a changing world

Ronald H.B.Meyboom

Klin Farmakol Farm. 2011;25(3):102-111

Nežádoucí účinky léků v časopise Klinická farmakologie a farmacie

doc. MUDr. Karel Urbánek, Ph.D.

Klin Farmakol Farm. 2011;25(3):99

Original articles

Tolerability of cyclosporine A treatment in patients with rheumatoid arthritis (RA), systemic lupus erythematosus,

David Suchý, Milan Grundmann, Václav Vyskočil, Soňa Loudová, Otto Mayer

Klin Farmakol Farm. 2011;25(3):112-115

psoriatic arthritis and other rheumatic diseases Objective: To evaluate the effect of cyclosporine A treatment on renal function tests and kalemia in RA and other rheumatic patients treated with cyclosporine during a period of 3 months. To establish the effect of cyclosporine treatment on blood pressure and selected biomarkers using ambulatory blood pressure monitoring (ABPM). Methods: The investigated group consisted of 29 patients with rheumatoid arthritis and other rheumatic diseases who were treated with CSA for three months. The authors evaluated the effect of CSA treatment (a mean dose of 2 mg/kg/day) on renal function test and kalemia....

Dosage of vancomycin during continuous renal replacement therapy

Jana Zahálková, Jan Strojil, Naděžda Petejová, Karel Urbánek, Milan Grundmann, Ivana Kacířová

Klin Farmakol Farm. 2011;25(3):116-121

The aim of the study: To analyze the influence of continuous venovenous hemofiltration (CVVH) on efficacy of vancomycin dosage in critically ill septic patients (pts). Using pharmacokinetic modelling we tried to find an individual dosing regimen for the first day and to optimize pts´ chance of achieving sufficient AUC/MIC90 values. Method: We investigated 15 septic pts with acute renal injury on CVVH, who were treated with vancomycin either 1.0 g every 12 hours (stage I – injury, n = 9) or 1.0 every 24 hours (stage F – failure, n = 6). CVVH was performed with high-flux polysulfone membrane, filtration rate 45 ml/kg b.w./h. and pre-...

Main topic

Drug risk assessment: development of terminology

Milan Kriška

Klin Farmakol Farm. 2011;25(3):122-125

The aim of this review is to inform the readers about the development of basic terminology of adverse drug reactions, pharmacovigilance and risk monitoring for the needs of everyday clinical practice.

Anticholinergic effects of drugs in elderly patients

Agáta Mačugová, Magdaléna Kuželová, Lenka Kostková, Veronika Drobná, Ján Luha, Andrej Dukát, Ján Murín, Kamil Stratený, Martin Wawruch

Klin Farmakol Farm. 2011;25(3):126-130

Elderly patients represent a special group of population regarding the occurrence of adverse drug reactions. The adverse drug reactions often remain unrecognised due to their non-characteristic symptoms and polymorbidity of elderly patients. In case of manifestation of adverse drug reaction sometimes additional medication is added instead of adjustment of the dose of drug or its withdrawal. Anticholinergic effects of medications represent a typical example of such often unrecognised adverse drug reactions. These drugs may cause peripheral adverse drug reactions, e.g. dry mouth, constipation, urinary retention, tachycardia, mydriasis, inability...

Cardiovascular risk of non-steroidal anti-inflammatory drugs - clinical impact and possible mechanisms

Zoltán Varga, Viera Kristová, Milan Kriška

Klin Farmakol Farm. 2011;25(3):131-137

Non-steroidal anti-inflammatory drugs are medicines with analgesic, antipyretic and anti-inflammatory effects. Their effects are achieved by reducing the synthesis of prostanoids. Inhibition of prostanoid production is responsible for a substantial risk of adverse effects. The risk of adverse effects affecting the gastrointestinal tract and the kidneys has long been recognised. The possibility of increased blood pressure and development/worsening of heart failure during treatment is also known for decades. Increased incidence of acute myocardial infarction in clinical trials with rofecoxib drew attention to possible cardiotoxicity of selective...

Adverse drug reactions specific to childhood

Petra Langerová, Jiřina Zapletalová, Karel Urbánek

Klin Farmakol Farm. 2011;25(3):137-141

Good knowledge of adverse drug reactions (ADRs) is crucial for safe use of medication. ADRs are a common clinical problem in both pediatric and adult medicine that can lead to significant morbidity. More than 9 % of hospitalized children suffer some adverse reactions to therapy and up to 4 % of all their hospital admissions are caused by ADRs. The toxicity of many medicines in children is different to that seen in adults. Indeed, there are some groups of pediatric patients, such as neonates, in whom drug toxicity appears to be relatively common. About 70 % of drugs prescribed to the pediatric population are prescribed off-label. The risk of...

Review articles

Probiotics in treating liver disease

Jan Lata, Jana Juránková

Klin Farmakol Farm. 2011;25(3):142-143

The World Health Organization defines probiotics as "live microorganisms which when administered in adequate amounts confer a health benefit on the host." The paper provides a basic review of indications of probiotics in hepatology – treatment of liver encephalopathy, non-alcoholic steatohepatitis, prevention of complications of liver cirrhosis and infection after liver transplantation.

Ertapenem and his position among other carbapenems

Jiří Beneš

Klin Farmakol Farm. 2011;25(3):144-149

Ertapenem belongs to carbapenem antibiotics. Nevertheless it differs from other carbapenems registered in the Czech Republic (imipenem, meropenem, doripenem) in two important features: (a) low efficacy against Pseudomonas aeruginosa a Acinetobacter spp.; thus ertapenem is predestined for treatment community-acquired infections rather than nosocomial infections; (b) relatively long half-time that enables once daily dosing. Thus, ertapenem is a good choice for treatment of mixed community-acquired infections and/or for treatment of infections caused by E. coli, Klebsiella spp., or other bacteria producing extended-spectrum beta-lactamases (ESBL,...

Case reports

Eating disorder in young man with hypertension and compensation of hypertension a case report

Ivana Kacířová, Milan Grundmann

Klin Farmakol Farm. 2011;25(3):150-152

Introduction: Our case report shows a young obese man with hypertension and eating disorder on the strength of hypolipidemic diet. Drastic loss of weight was followed by necessity of discontinuation of antihypertensive therapy and improvement of blood lipids. Method: The patient was observed in our out-patient practice and his blood pressure was measured in lying, sitting and standing position. Clinical examinations were performed to clarify a reason of loss of weight and the blood levels of lipids were analyzed. Results: During 26 months the weight decreased about 51 kg, waistline about 45 cm and BMI from 32 to 17. Blood pressure was decreased...