Klinická farmakologie a farmacie č. 4/2019

Redakce

Klin Farmakol Farm. 2019;33(4)  

Medication errors at intensive care units: nurses‘ knowledge and attitudes

Pavlína Štrbová, Eleonora Dostálová, Karel Urbánek

Klin Farmakol Farm. 2019;33(4):4-11 | DOI: 10.36290/far.2019.026  

Medication errors are among the most frequent causes of adverse events in hospitals. They occur more frequently at intensive care units (ICUs) than other types of hospital departments. Aim: The main objective of this study was to determine the level of nurses‘ knowledge about correct use of medications at ICUs. Methods: A questionnaire regarding high­‑risk medications was used to evaluate nurses‘ knowledge, and the experienced administration errors were reported by nurses working at ICUs for adult patients. Results: A total of 240 respondents participated in the research. As far as their knowledge, in 23 % was found sufficient...

Pharmacotherapy in pregnancy

Tomáš Binder

Klin Farmakol Farm. 2019;33(4):12-19 | DOI: 10.36290/far.2019.027  

The article deals with the rules for selection of a medicinal product during pregnancy and lactation. An updated FDA categorization of medicinal products is presented in terms of their fetal safety and division of pregnancy into discrete, pharmacotherapy-specific periods of time. These are the major criteria determining the selection of a medicinal product. Administration of drugs shown to have teratogenic or toxic effects on the developing embryo and fetus is, except for very specific situations, contraindicated. Also mentioned are additional factors that need to be taken into account when selecting a medicinal product during pregnancy and lactation....

Therapeutic drug monitoring in pregnancy

Ivana Kacířová, Milan Grundmann

Klin Farmakol Farm. 2019;33(4):20-23  

Therapeutic drug monitoring is a specific method of clinical pharmacology for monitoring of pharmacotherapy using measurement of drug serum concentrations followed by interpretation of erudite clinical pharmacologist (eventually clinical pharmacist) and good cooperation with clinician. The concept of the method rests on the assumption that clinical effect correlates better with drug concentration than with the dose. Pregnancy is associated with significant physiological changes that alter the pharmacokinetic of drugs (absorption, distribution, metabolism and excretion) and potentially affect both their efficacy and safety. These variations occur during...

Principles of pharmacotherapy during breastfeeding

Eva Jirsová

Klin Farmakol Farm. 2019;33(4):24-29 | DOI: 10.36290/far.2019.028  

The article aims at recommendations how to assess the risk of drugs, taken by the mother, to her breastfed child. Some amount of drug present in breast milk always carries possible risks for an infant, however, these risks should be weight to benefits of breastfeeding itself. Breastfeeding offers big advantages for health state, healthy growth and development of the child, but also for the health of the mother. Therefore, it should not be prematurely terminated due to mother´s therapy without any concrete serious reason. During the assessment of possible risks for the infant it is necessary to study all available data on the transfer of the drug into...

Risk minimization and three pillar theory for drugs that inerease the risk of falls

Jiří Vlček, Sylva Bártlová, Iva Brabcová, Martin Doseděl, Hana Hajduchová, Aleš Kuběna, Josef Malý, Valérie Tóthová, Jan Vosátka

Klin Farmakol Farm. 2019;33(4):30-34 | DOI: 10.36290/far.2019.029  

Falls are adverse events and they can do a harm of patients. Falls are more risky for elderly and about 25 % of visitors to emergency department are as a result of the fall and about one quarter of them are admitted to the medical ward. Fall is an multifactorial event and there are many risk factors influenceable and non-influenceable, internal and external ones. Medicine are part of influenceable risk factors. The goal is to introduce general view on risk minimization management, to explain theory of three pillars in relationship to medicines with fall potential and to of fall and to identify their risk factors. We linked falls to different types...

Angiotensin converting enzyme inhibitors in nephrology

Věra Čertíková Chábová

Klin Farmakol Farm. 2019;33(4):35-38 | DOI: 10.36290/far.2019.030  

Angiotensin converting enzyme (ACE) inhibitors are antihypertensive drugs used also for treatment of heart failure and decrease of proteinuria in renal diseases. However, the renin-angiotensin-aldosterone system is very complex and there are more drugs with similar effects, such as angiotensin II receptor blockers. These drugs have less side effects and that is why they are preferred nowadays. This cannot change the fact that ACE inhibitors, beside blood pressure lowering, can slow down the rate of glomerular filtration loss and decrease the risk of cardiovascular complications and mortality. All guidelines for hypertension treatment list them as first...

Prolonged oxacillin infusion in a patient with staphylococcal bacteraemia

Martin Vodička, Ilja Ryšavý

Klin Farmakol Farm. 2019;33(4):39-41 | DOI: 10.36290/far.2019.038  

Oxacillin is effective in treating sepsis caused by methicillin sensitive staphylococcus aureus (MSSA). Given its short elimination half-life, safety profile, stability, and the types of infections treated, oxacillin is a suitable candidate for prolonged infusion administration. Its dosage in chronic kidney disease (CKD) is still a matter of expert discussion. The text presents a case of a polymorbid patient with end-stage renal disease and hypoalbuminemia who was admitted to the intensive care unit (ICU) for MSSA-caused sepsis. The sepsis was successfully treated with standard intermittent intravenous dosage of two grams of oxacillin in a 15 minute...