Slovo úvodem

MUDr. Ivana Kacířová, Ph.D.

Klin Farmakol Farm. 2016;30(2)  

Therapeutic monitoring of vancomycin in clinical practice

Hana Suchánková, Martina Machačová, Tereza Herodesová

Klin Farmakol Farm. 2016;30(2):4-8 | DOI: 10.36290/far.2016.012  

Introduction and objective: Routine therapeutic drug monitoring (TDM) of vancomycin is recommended in clinical practice in order to optimize dosing and drug exposure. Recent guidelines on vancomycin TDM recommend monitoring of only through concentrations with rather higher target ranges for dosage adjustment. The aim of the study was to evaluate the practice of vancomycin TDM in University Hospital in Olomouc and to assess the potential influence of new recommendations on dosing strategies. Methods: A retrospective analysis of vancomycin plasma levels determined during a two-year period was performed. Values with uncertain sample timing and...

Therapeutic monitoring of antiepileptic drugs, part I - general principles, “old” antiepileptics

Milan Grundmann, Ivana Kacířová

Klin Farmakol Farm. 2016;30(2):9-15 | DOI: 10.36290/far.2016.013  

Therapeutic drug concentration monitoring has been used as a tool to optimize treatment of epilepsy for almost 60 years. The concept of the method rests on the assumption that clinical effects correlate better with drug concentrations than with the dose. It seeks to optimize the seizure suppressing effects of antiepileptic drugs while minimizing their adverse effects by managing their medication regimen with the assistance of information on the concentration of antiepileptic drugs in the serum, plasma or saliva. For most antiepileptic drugs, “reference ranges” have been reported which define the serum concentrations at which most...

Therapeutic monitoring of antiepileptic drugs, part II - “new” antiepileptics, special groups of patients

Ivana Kacířová, Milan Grundmann

Klin Farmakol Farm. 2016;30(2):16-22 | DOI: 10.36290/far.2016.014  

Therapeutic drug concentration monitoring was initiated for a number of antiepileptic drugs and currently is used to establish optimal therapy regimens for individual patients with epilepsy. The “newer” antiepileptic drugs generally have probably fewer adverse effects, more predictable pharmacokinetics, and wider therapeutic margins than “old” drugs. However, routine therapeutic drug monitoring is often used, particularly for lamotrigine, levetiracetam, stiripentol, and zonisamide, mainly due to inter-individual variation in metabolism and clearance. For other drugs, therapeutic drug monitoring may be clinically useful...

Analýza vývoje používání antiepileptik u těhotných žen s epilepsií v Moravskoslezském kraji

Ivana Kacířová, Milan Grundmann

Klin Farmakol Farm. 2016;30(2):23-28 | DOI: 10.36290/far.2016.015  

Aim: Little is known about the consumption of antiepileptic drugs in pregnancy in the Czech Republic, particularly for newer agents. In our previous paper, we discussed long-term trends in the utilization of antiepileptic drugs during pregnancy in a group of 235 women between 1991–2006. Currently, we continue to investigate the long-term trends in antiepileptic drug use in pregnant women. Method: A retrospective study analysed data from 208 pregnant women receiving antiepileptic drugs between January 2007 and May 2016. The request forms for routine therapeutic drug monitoring were used as the data source. Mono- versus polytherapy, the utilization...

Vitamin D and multiple sclerosis

Kateřina Langmaierová, Marta Vachová

Klin Farmakol Farm. 2016;30(2):29-31 | DOI: 10.36290/far.2016.016  

Multiple sclerosis is often referred to as a disease of the temperate zones. The incidence of multiple sclerosis in the population correlates with the distance from the equator. In this context, association of the occurrence of this disease is examined with the actual level of vitamin D in the human organism. The article explores the relationship between vitamin D deficiency and the relapses of multiple sclerosis. It summarises the development of findings in this area in the recent years.

Symptomatic treatment of gouty arthritis

Hana Ciferská, Lenka Petrů, Jan Vachek

Klin Farmakol Farm. 2016;30(2):32-37 | DOI: 10.36290/far.2016.017  

Gouty arthritis belongs to the group of crystal-induced arthropathies and is among the most common inflammatory joint diseases that is often associated with a wide range of metabolic diseases. Timely diagnosis and initiation of adequate treatment reduces the duration of gouty attack. The gold standard is articular puncture, if technically feasible, with analysis of the articular aspirate with demonstration of sodium urate crystals. If this is not feasible, diagnosis can be made based on the ACR (American College of Rheumatology) classification criteria that are a combination of clinical symptoms and paraclinical examinations. The treatment...

Hypolipidemic drugs and their effect on endothelial function: a review of results of clinical trials

Lukáš Dobiaš, Monika Laššánová, Viera Kristová

Klin Farmakol Farm. 2016;30(2):38-45 | DOI: 10.36290/far.2016.018  

Endothelial dysfunction, the term commonly describing the impairment in its vasodilatory capacity, is the first stage of athero- sclerosis which can be detected before the first morphological changes of vessels occur. It is a good predictor of cardiovascular events, independent of the presence of traditional cardiovascular risk factors. Despite this, its use has not reached widespread clinical acceptance. Endothelial dysfunction is present in patients with various types of dyslipidemia and there is a growing body of evidence that it can be reversed by various pharmacological approaches. Many hypolipidemics have been described to exert endothelium-protective...

Skin discoloration as an adverse effect of treatment with sunitinib in a pediatric patient with osteosarcoma

Lenka Součková, Pavel Mazánek, Peter Múdry

Klin Farmakol Farm. 2016;30(2):46-49 | DOI: 10.36290/far.2016.019  

Sunitinib as a multikinase inhibitor is indicated for the treatment of unresectable and/or metastatic malignant gastrointestinal stromal tumor (GIST) in adults after failure of imatinib treatment due to resistance or intolerance. Another indication is the treatment of advanced/metastatic renal cell carcinoma (MRCC) or treatment of unresectable or metastatic, well-differentiated pancreatic neuroendocrine tumours (pNET) with disease progression in adults. There is also clinical experience with the use of sunitinib in pediatric oncology patients, e.g. with refractory solid tumors, GIST. The article describes the course of treatment of osteosarcoma...