Klinická farmakologie a farmacie č. 3/2019

Redakce

Klin Farmakol Farm. 2019;33(3)  

Generic drugs: theory and praxis

Karel Urbánek

Klin Farmakol Farm. 2019;33(3):5-10  

Generic drugs are copies of original medicinal products that do not have to undergo a demanding preclinical and clinical research process for their approval. They must be chemically identical to the original product and have the identic drug formulation. The main benefit of generic medicines is their significantly lower cost, which results from cost savings on preclinical and especially clinical research and development. Without generic medicines, current health systems could not work or be funded. The very concept of generic medicines has never been challenged and the principles of their registration have in principle fully proved its worth. Changing...

Kontrola astmy v bežnej klinickej praxi pri liečbe fixnou kombináciou ICS/LABA

Štefan Laššán, Ildikó Téglás, Monika Laššánová

Klin Farmakol Farm. 2019;33(3):11-16 | DOI: 10.36290/far.2019.017  

Úvod: Pravidelná liečba fixnou kombináciou inhalačného kortikosteroidu (ICS) s dlhodobo pôsobiacim β2-sympatomimetikom (LABA) spoľahlivo preukázala v randomizovaných kontrolovaných štúdiách potenciál na dosiahnutie kontroly astmy. Je možné dosiahnuť podobné výsledky v podmienkach bežnej klinickej praxe? Metódy: V priebehu 3-mesačnej multicentrickej prospektívnej štúdie boli pacienti nespĺňajúci kritériá úplnej kontroly astmy liečení počas 3 mesiacov fixnou kombináciou ICS/LABA pod vedením ošetrujúceho lekára. Pacienti boli edukovaní s cieľom osvojenia správnej inhalačnej techniky a s dôrazom na adherenciu k liečbe. Výsledky: Zaradili sme 494 pacientov...

Contrast-associated acute kidney injury – up to date 2019

Pavlína Richtrová

Klin Farmakol Farm. 2019;33(3):17-19 | DOI: 10.36290/far.2019.018  

Contrast-induced nephropathy (CIN) and later used contrast-induced acute kidney injury (CI-AKI) have been mentioned since the 1960s.It is often considered the 3rd most common cause of kidney injury in hospitalized patients. We define CI-AKI as an increase in serumcreatinine of 25% or 44 μmol/l after 48–72 hours after administration of the contrast agent. Recently, however, our view of this diagnosishas changed. We have understood various pitfalls and bias of the results of the former studies. In this article we try to summarize theexisting knowledge, describe the missing information and try to offer nephroprotective...

Immune-related adverse events associated with immune check-point inhibitors

David Suchý

Klin Farmakol Farm. 2019;33(3):20-24 | DOI: 10.36290/far.2019.019  

Immune checkpoint inhibitors(ICIs) are monoclonal antibodies with immunomodulatory properties, that blocks inhibitors of T cells activation and function. ICIs are approved for treatment of select cancers and have shown survival benefit in some patients for more than 5 years. These therapies upregulate the immune system to enhance antitumor responses. As a consequence, they can cause immune-related adverse events (irAE) that are frequent, can affect one or more organs, can be serious, and on occasion lifethreatening. The management of these adverse events is complex, and requires a multidisciplinary approach to ensure prompt diagnosis and optimal management...

High pressure as a side effect of drugs

Jana Gregorová, Petra Holečková

Klin Farmakol Farm. 2019;33(3):25-28 | DOI: 10.36290/far.2019.020  

Drugs are often overlooked as the cause of secondary hypertension. Non-steroidal anti-inflammatory drugs – given regulatory forlong period, sex hormones – in higher doses than substitution, immunosuppressants − cyclosporine, antidepressants − venlafaxine,glucocorticoids, mineralocorticoids themselves, and drugs that lead to their excess, and some antineoplastics are associatedwith blood pressure elevation. The main focus of the paper will be on the mechanism by which vascular endothelial growth factorpathway blockers interfere with the regulation of blood pressure.

Safety of multiple sclerosis treatment in the long term in relation to teriflunomide and alemtuzumab

Yvonne Benešová

Klin Farmakol Farm. 2019;33(3):29-36 | DOI: 10.36290/far.2019.035  

The view of multiple sclerosis (MS) treatment has changed substantially in the recent years. In addition to first-choice drugs that include interferons beta, glatiramer acetate, and teriflunomide, a number of novel, very effective agents with a different mechanism of action are available. Long-term clinical data of more than 20 years confirm that treatment with interferons and glatiramer acetate is safe and not associated with serious adverse effects. However, a certain proportion of patients treated with first-choice drugs exhibit an insufficient therapeutic response. In such a case, treatment escalation is indicated. The first drug to have been approved...

Future trends in esophageal cancer treatment (prevention, biological therapy, immunotherapy, individualized therapy, novelties in surgery)

Zuzana Rábeková

Klin Farmakol Farm. 2019;33(3):37-40 | DOI: 10.36290/far.2019.021  

Esophageal carcinoma may be devided into two most frequent histopathological subtypes – adenocarcinoma and squamous cell carcinoma, which are different in their origin and biological characteristic, but also in their response to different types of the treatment. Esophageal cancer is the 8th most common maligncy and 6th most common cause of death from overall malignant disease. Searching for novel and effective methods in its prevention and treatment is very important issue, according to very low 5 – years survival rate, which is between 15–20%. The future may bring novelties in prevention of this tumor as in the area of chemoprotective...

Ceftolozane/tazobactam in treating multifocal infection caused by a multiresistant Pseudomonas aeruginosa strain in a severely burned patient

Břetislav Lipový, Markéta Hanslianová, Yvona Kaloudová, Hana Řihová, Martin Knoz, Jakub Holoubek, Ivan Suchánek

Klin Farmakol Farm. 2019;33(3):41-45 | DOI: 10.36290/far.2019.022  

Ceftolozane/tazobactam is an antibiotic combining a novel cephalosporin with a beta-lactamase inhibitor. Complicated intra-abdominal infections and complicated urinary tract infections are basic indications for the use of this antibiotic. There has also been increasing evidence of high efficacy of ceftolozane/tazobactam in treating infectious complications in other compartments, particularly in the case of infections with resistant Pseudomonas aeruginosa strains. Treatment of infectious complications caused by this pathogen is very challenging, often requiring a major compromise between an approved indication and efficacy. The case report presents...

Metamizole‑affected onset of action of filgrastim

Anna Oleárová, Katarína Jurečková

Klin Farmakol Farm. 2019;33(3):46-49 | DOI: 10.36290/far.2019.036  

Metamizole is widely used analgesic with antipyretic and spasmodic effect. Metamizole is not used in many countries because of the risk of agranulocytosis. We describe a case study of 72-years old female admitted with severe pancytopenia and treated with colony-stimulating factor filgrastim. The effect of filgrastim has been affected by the concomitant use of metamizole. The pharmacotherapy was revised and the risky metamizole was stopped. The therapy continued with two doses of filgrastim, and numbers of leukocytes and neutrophils increased satisfactorily. The therapy was supported with blood derivatives and patient has been discharged as stabilised.