Klinická farmakologie a farmacie č. 2/2020

Redakce

Klin Farmakol Farm. 2020;34(2)  

Clinical pharmacology: medical specialty, academic discipline and branch of science

Karel Urbánek

Klin Farmakol Farm. 2020;34(2):41-46 | DOI: 10.36290/far.2020.010  

Clinical pharmacology in the broadest sense is a scientific discipline that deals with all aspects of the relationship between a drug and the human body. In a narrower sense, as a medical specialty, it was defined as an interdisciplinary field that integrates experimental pharmacology with clinical and laboratory disciplines in order to study and evaluate the effect of drugs in both healthy people and patients using objective methods. The aim is to optimize pharmacotherapy, both at the individual and population level. Clinical pharmacology combines three basic areas of activity: clinical work, teaching and research.

Therapeutic drug monitoring

Ivana Kacířová, Milan Grundmann

Klin Farmakol Farm. 2020;34(2):47-55 | DOI: 10.36290/far.2020.011  

Therapeutic drug monitoring is a specific method of clinical pharmacology for monitoring of pharmacotherapy using measurement of drug serum concentrations followed by erudite interpretation. The concept of the method rests on the assumption that clinical effect correlates better with drug concentration than with the dose. We would like to present informations relating to utilization of therapeutic drug monitoring method in routine clinical practice.

Laboratory methods in therapeutic drug monitoring

Hana Brozmanová

Klin Farmakol Farm. 2020;34(2):56-62 | DOI: 10.36290/far.2020.012  

An important part of therapeutic drug monitoring are laboratory methods used to determine the concentration of drugs in the whole blood of serum, plasma, or other biological matrices. The article provides an overview of routine analytical methods and the gradually increasing importance of liquid chromatography with mass detection in the analysis of drugs.

The influence of genetic and epigenetic factors as covariates of the tolerability and therapeutic response to olanzapine in the treatment of psychotic diseases

Jan Juřica

Klin Farmakol Farm. 2020;34(2):63-69 | DOI: 10.36290/far.2020.013  

Olanzapine as one of the second-generation antipsychotics, is recommended as afirst-line treatment for the first episodes of schizophrenia. Despite significant progress in the treatment of psychotic disorders, long-term remission is achieved in only 30% of patients. Due to this, there are investigated various ways to increase the success rate of the treatment and ways to predict the response of particular treatment with the aim of personalized treatment - i.e. selection of the drug with the greatest probability of remission in distinct patient. This article provides an overview of the genetic and epigenetic factors that affect pharmacokinetics of olanzapine...

Biosimilar infliximab in pediatrics

Petra Matalová, Karel Urbánek

Klin Farmakol Farm. 2020;34(2):70-73 | DOI: 10.36290/far.2020.014  

The first biosimilar for monoclonal antibody introduced into clinical practice in the European Union is infliximab CT-P13. Today, we have sufficiently robust data confirming its efficacy and safety in all indications in the treatment of adult patients. The possibility of the safe switch from the original product to biosimilar has also been proved. Biosimilar infliximab is also approved for the treatment of children with idiopathic inflammatory bowel disease from 6 years of age in whom conventional therapy has failed or is contraindicated. To date, 8 clinical studies have been published, all of which prove the efficacy and safety of biosimilar infliximab...

Monoclonal antibodies in pregnant women with inflammatory bowel disease

Barbora Pipek

Klin Farmakol Farm. 2020;34(2):74-77 | DOI: 10.36290/far.2020.015  

Crohn´sdisease and ulcerative colitis are inflammatory bowel diseases which affect mainly young people in their reproductive age. Anti-TNF treatment presents the first type of biological treatment of IBD and its safety during pregnancy is already documented by numerous observational studies. However, in recent years, the spectrum of biological treatment of IBD has expanded owing to two new monoclonal antibodies with different mechanisms of effect: vedolizumab (humanized monoclonal antibody against leukocyte integrin receptors α4β7) and ustekinumab (human monoclonal IgG1 antibody against interleukin IL 12/23 unit). Nonetheless, due to the...

Update in asthma pharmacotherapy

Štefan Laššán, Monika Laššánová

Klin Farmakol Farm. 2020;34(2):78-83 | DOI: 10.36290/far.2020.016  

Asthma is one of the most common chronic, non-communicable diseases in children and adults and it is characterised by variable respiratory symptoms and variable airflow limitation. Asthma is a consequence of and aconsequence of complex gene-environment interactions, with heterogeneity in clinical presentation and the type and intensity of airway inflammation and remodelling. The goal of asthma treatment is to achieve good asthma control in order to minimise symptom burden and risk of adverse disease outcomes. Anti-inflammatory and bronchodilator treatments are the mainstay of asthma therapy and are used in a stepwise approach. Pharmacological treatment...

New direct oral anticoagulances - new molecules in research

Anna Zatloukalová

Klin Farmakol Farm. 2020;34(2):84-88 | DOI: 10.36290/far.2020.017  

Currently, new direct oral anticoagulants (DOAC) are gradually replacing the historically most frequently used warfarin. These are two classes of drugs directly inhibiting factor Xa (Xarelto, Eliquis, Lixiana) and thrombin (Pradaxa). It offers many positives that patients themselves will appreciate. These include, in particular, no need for regular monitoring, minimal drug and food interactions, or afavorable safety profile. However, one of the drawbacks is the absence of antidotes for overdose. Only Pradaxa currently has its specific antidote - Idarucizumab. Others are in development as well as new molecules of anticoagulants themselves.

Clinical pharmacy in pediatric palliative care

Iva Kučerová, Stanislav Krysta

Klin Farmakol Farm. 2020;34(2):90-92 | DOI: 10.36290/far.2020.018  

The case report of genetically determined pharmacoresistant epilepsy in a 6 - year - old patient with infaust prognosis and palliative care. In the background of district general hospital was the child hospitalised due to respiratory infection and myoclonic seizures. The aim of palliative care and interdisciplinar cooperation were to discharge the girl from hospital to the care of mobile hospice, minimalisation of invasive inputs and the reduction of child´s stress during the stay in the intensive care unit.