Clinical Pharmacology and Pharmacy, 2021 (vol. 35), issue 2
Original articles
The effect of valproic acid on plasma level of carbamazepine and carbamazepine-10, 11-epoxide in long-term treatment with slow-release drug formulations in pediatric patients: the importance of TDM
Blanka Kořístková, Milan Grundmann, Hana Brozmanová, Ivana Kacířová
Klin Farmakol Farm. 2021;35(2):49-53 | DOI: 10.36290/far.2021.008 
The effect of valproic acid (VPA) on plasma level of carbamazepine (CBZ) and carbamazepine-10,11-epoxide (CBZ-E) in long-term treatment was evaluated. Method: A total of 262 samples were obtained predose from 175 pediatric patients (< 15 years). Daily dose (PDD), dose related to bodyweight (DBW), plasma levels (PL) of CBZ, CBZ-E, CBZ level/dose ratio, CBZ-E level/dose ratio and CBZ-E/CBZ ratio, the distribution of PL according to the therapeutic range 4–9 mg/L, and seizure frequency were compared. A detailed analysis was done in 11 individuals who served as their own control. Results (given as mean ± SD): Patients...
Main topic
Modern trends in pharmacological treatment heart failure
Jiří Vítovec, Jindřich ©pinar, Lenka ©pinarová
Klin Farmakol Farm. 2021;35(2):54-59 | DOI: 10.36290/far.2021.009
ACE inhibitors and betablockers are the cornerstone of the treatment of heart failure, MRA should be added. Angiotensin receptor blockers (ARB) are indicated in the case of ACE inhibitors intolerance. Renin angiotensin blockers and betablockers should be given in maximal tolerated doses. Diuretics are given to the symptoms relieve – dyspnoe or oedema. Digoxin is indicated in selected patients. There are 3 new promising groups of drugs: 1. Angiotensin Receptor-Neprilysin Inhibitor – ARNI – Sacubitril/Valsartan can replace the ACE-I according to the results of the PARADIGM-HF trial. 2. Sodium–glucose co-transporter-2...
Cardiotoxicity of cancer tretament
Jiří Vyskočil, Michal Furdek, Katarína Petráková
Klin Farmakol Farm. 2021;35(2):60-68
In our aging population the incidence of cancer is increasing in the elderly. Therefore we are facing new challenges especially considering incidence of cardiovascular diseases (CVD) in this patients’ population. Overall survival of cancer patients has significantly improved therefore cancer has become a chronic disease. We are therefore facing an increasing number of patients who either may develop a new CVD or their current CVD may deteriorate. Cancer treatment may lead to congestive heart failure (CHF) per se, by anthracycline or antiHER2 therapy direct cardiac toxicity or by number of other cardiac conditions due to medical...
Atherosclerotic cardiovascular diseases and clinical significance of treatment with inclisiran
Vladimír Blaha
Klin Farmakol Farm. 2021;35(2):69-73 | DOI: 10.36290/far.2021.011
Inclisiran is a novel lipid-lowering drug utilizing synthetic siRNA that inhibits the hepatic production of PCSK9. It is the first representative of an innovative concept of treating elevated levels of low-density lipoprotein cholesterol (LDL-C). The efficacy and safety of treatment with inclisiran is assessed in the ORION program of clinical trials. Inclisiran, administered once in six months, has been shown in phase 2 and 3 trials to reduce LDL-C by approximately 50% and to be effective in both patients with atherosclerotic cardiovascular disease and those with a high cardiovascular risk, including patients with heterozygous familial hypercholesterolemia....
Hypertension chronotherapy: does dosing antihypertensive medication at bedtime determine cardiovascular prognosis?
Tomáą Baka, Peter Stanko, Fedor ©imko
Klin Farmakol Farm. 2021;35(2):74-77 | DOI: 10.36290/far.2021.012
Arterial blood pressure (BP) undergoes variable changes over 24 hours conforming to physiological daily rhythms. Disruption of the natural BP circadian rhythm is associated with worsened cardiovascular disease (CVD) prognosis. Increased nocturnal BP or at least insufficient BP decline at night, i.e. non-dipping, may be associated with morphological and functional alterations of peripheral organs and even with a higher incidence of major CVD events. Hypertension chronotherapy means the application of antihypertensive treatment in order to maintain the daily BP variability in terms of reduced nocturnal BP (thus also maintaining sufficient nocturnal BP...
Review articles
Drug interactions of antiepileptic drugs Part 2: interaction with drugs of other indication groups
Blanka Kořístková, Milan Grundmann
Klin Farmakol Farm. 2021;35(2):78-87 | DOI: 10.36290/far.2021.013
Drug interactions of antiepileptic drugs are mostly connected with enzymatic induction or inhibition. The interaction on level of absorption, plasma-protein binding of renal excretion is less frequent. Pharmacodynamic interaction of antiepileptics with other drugs is seldom synergistic with a possibility of declination of dose. The increase of adverse drug reactions is more common. Purely pharmacodynamic interaction was described with oxcarbazepin, perampanel and pregabalin. The new antiepileptics have lower interaction potential - most of them are excreted either via kidney or extrahepatal (e. g. gabapentin, lacosamide, levetiracetam, topiramate,...
Oral manifestations of pharmacological treatment of systemic diseases
Beáta Bolerázska, Anna Birková
Klin Farmakol Farm. 2021;35(2):88-93 | DOI: 10.36290/far.2021.014
In the aging population, the number of prescription drugs for the treatment of systemic diseases is also constantly increasing. In particular, the desired or therapeutic effect of the drug is expected during pharmacological therapy. As the volume of pharmacotherapy in the population increases, it can be predicted that the incidence of adverse reactions, including oral ones, will also continue to increase. These manifestations can also be confused with the onset of a new disease, which causes a delay in causal treatment with the possible emergence of serious complications. Several diseases have been identified that can help a physician determine the...
Metamizole (dipyrone)
Jitka Rychlíčková, Hana Jurečková
Klin Farmakol Farm. 2021;35(2):94-98 | DOI: 10.36290/far.2021.015
Metamizole has been known and used for almost 100 years, yet several unknowns are still associated with its use. This paper focuses on a more detailed description of this drug's kinetics to provide necessary information for estimating adequate dosing in patients with impaired kidney or liver functions. In this area, not only the summaries of product characteristics but also the literature are relatively austere. Furthermore, we would like to draw attention to the potential for cross-reaction with nonsteroidal anti-inflammatory drugs, which may not be obvious at first glance. In clinical practice, it can be easily overlooked. Subsequently, we discuss...
Case reports
Dyskinesia induced by orphenadrine in fixed combination with diclofenac in two patients with advanced Parkinson's disease
Michal Minár, Jana ©vantnerová, Simona Stanková, Peter Matejička
Klin Farmakol Farm. 2021;35(2):99-100 | DOI: 10.36290/far.2021.016
Orphenadrine has been used for treatment of both parkinsonism and musculoskeletal diseases for more than 50 years. Anticholinergic mechanism of action is the main reason for side effects. We report on two patients with advanced Parkinson's disease in whom combined analgetic medication diclofenac/orphenadrine led to worsening of fluctuations and onset of severe dyskinesia.