Betablokátory v kardiologii editorial

Jiří Vítovec

Klin Farmakol Farm. 2025;39(3):133  

Adverse effects of oral anticoagulant therapy in hospitalized patients

Orsolya Hrubá, Lucia Žigová, Peter Jackuliak, Juraj Payer, Ján Kyselovič, Andrea Gažová

Klin Farmakol Farm. 2025;39(3):134-140 | DOI: 10.36290/far.2025.054  

Aim of the study: To retrospectively evaluate the incidence of adverse effects of oral anticoagulant therapy (warfarin vs. direct oral anticoagulants - DOACs) in hospitalized patients who died during their hospital stay in a selected clinical department, with an emphasis on analyzing INR values, antidote administration, and the nature of clinical complications. Methods: Between 2010 and 2022, a total of 46,521 hospitalizations were recorded at the 5th Department of Internal Medicine, Faculty of Medicine, Comenius University, and University Hospital Bratislava. Among these, 5,380 ended with the patient's death. Out of these, 461 patients were identified...

Beta-blockers in acute coronary syndrome: current evidence and clinical implications

Anna Chaloupka

Klin Farmakol Farm. 2025;39(3):141-144 | DOI: 10.36290/far.2025.055  

Beta-blockers (BBs) have long been a cornerstone of therapy for acute coronary syndrome (ACS). With the advent of reperfusion strategies and modern pharmacotherapy, however, particularly in patients with preserved left-ventricular ejection fraction (LVEF), the role of beta-blockers has become a matter of expert debate. This review summarizes the properties and the role of betablockers in the treatment of acute coronary syndrome, the current guidelines and key randomized trials, and offers a pragmatic framework for the modern indication and duration of beta-blocker therapy across the ACS spectrum.

Beta-blockers in the treatment of chronic coronary artery disease

Martin Ambroz, Ondřej Ludka

Klin Farmakol Farm. 2025;39(3):145-149 | DOI: 10.36290/far.2025.056  

Beta-blockers (BB) represent one of the key groups of drugs in the treatment of chronic coronary artery disease. Pharmacological treatment with BB includes symptom-controlling therapy and prognosis-improving therapy in certain groups of patients. The benefit of BB has been demonstrated in patients with reduced left ventricular ejection fraction (LVEF), but there is a lack of clear data from randomised clinical trials in patients with LVEF > 40 %. Recent studies REDUCE-AMI and ABYSS have attempted to assess the effect of BB in this patient group, but the results were quite contradictory. Chronic coronary artery disease is a heterogeneous disease...

Beta-blockers in the treatment of arterial hypertension

Karel Lábr, Monika Špinarová

Klin Farmakol Farm. 2025;39(3):150-154 | DOI: 10.36290/far.2025.057  

Beta-blockers represent a traditional class of antihypertensive drugs, whose role in the treatment of arterial hypertension has evolved significantly over recent decades. While they are no longer recommended as first-line therapy for uncomplicated hypertension, they remain a key treatment option in certain clinical scenarios - particularly in patients with concomitant ischemic heart disease, a history of myocardial infarction, heart failure, tachyarrhythmias, or increased sympathetic activity in younger individuals. This review aims to summarize the mechanism of action of beta-blockers, evaluate available clinical evidence of their efficacy, compare...

Betablockers in the treatment of heart rhythm disorders

Dominik Broniš, Irena Andršová, Tomáš Novotný

Klin Farmakol Farm. 2025;39(3):155-159 | DOI: 10.36290/far.2025.058  

Beta-blockers represent a fundamental component in the treatment of cardiac arrhythmias due to their ability to suppress the effects of the sympathetic nervous system and stabilize heart rhythm. They are primarily used for heart rate control in atrial fibrillation, and they also reduce the risk of ventricular arrhythmias and sudden cardiac death, particularly in patients with ischemic heart disease or heart failure. Thanks to their long-established efficacy, good tolerability, and favorable impact on survival, beta-blockers maintain a strong position in clinical practice. Advances in personalized medicine and genetic profiling of patients further open...

Beta-blockers in the treatment of heart failure

Monika Špinarová, Karel Lábr

Klin Farmakol Farm. 2025;39(3):160-164 | DOI: 10.36290/far.2025.059  

Heart failure is a common disease with a serious prognosis. Treatment is always complex and includes both pharmacological and non-pharmacological processes. Beta-blockers are one of the fundamental drugs in treatment of chronic heart failure with reduced ejection fraction (HFrEF). The recommended drugs include bisoprolol, carvedilol, metoprolol succinate and nebivolol. Beta-blockers should be initiated in clinically stable, euvolaemic, patients at a low dose and gradually uptitrated to the maximum tolerated dose. The only reason for not administering beta-blockers in these patients are contraindications. We do not have enough evidences for recommendation...

Treatment of multimorbid patients with multiple sclerosis

Martina Petrášová, Jan Kočica

Klin Farmakol Farm. 2025;39(3):165-170 | DOI: 10.36290/far.2025.060  

The review summarises practical principles for treating polymorbid patients with multi­ple sclerosis. Comorbidities are common and strongly influence diagnosis, prognosis, and the choice of chronic disease-modifying therapy (DMT); radiographic activity in the setting of vascular comorbidities should therefore be interpreted in the context of additional biomarkers. In highly active disease, early high-efficacy therapy (e. g., anti-CD20 antibodies, cladribine, or natalizumab) has a clear role, always coupled with rigorous pharmacovigilance. Overlapping conditions can be managed safely with parallel, comorbidity-targeted treatment (e. g., anti-CGRP for...

Nitazenes and other opioid receptor superagonists

Jitka Rychlíčková, Ema Kunová

Klin Farmakol Farm. 2025;39(3):171-173 | DOI: 10.36290/far.2025.061  

Nitazenes and spirochlorphine are synthetic opioids that have been of interest in recent years in relation to unintentional overdoses with non-fatal and fatal consequences. These substances are potent agonists, predominantly of µ-opioid receptors, and exhibit a similar potency to fentanyl. The diagnosis of overdose is complicated by the inability to detect them with standard opioid screening tests. The available literature on the treatment of nitazene and spirochlorphine intoxication is limited. The objective of this article is to highlight the existence of these agents, summarise the known information on their pharmacology, and point out possible...

Efficacy and safety of fezolinetant in the treatment of moderate to severe vasomotor symptoms in women for whom hormone therapy is considered inappropriate

Marek Lapka

Klin Farmakol Farm. 2025;39(3):174-180 | DOI: 10.36290/far.2025.062  

The phase 3b DAYLIGHT study evaluated fezolinetant, a neurokinin-3 receptor anta­gonist, in women with moderate-to-severe vasomotor symptoms (VMS) unsuitable for hormone replacement therapy (HRT). A total of 453 women aged 40-65 years were randomized to fezolinetant 45 mg once daily or placebo for 24 weeks. Fezolinetant significantly reduced the frequency and severity of VMS, improved sleep quality and menopause-related quality of life, with effects evident from week 1 and sustained throughout treatment. The safety profile was favorable and comparable to placebo, with slightly more fatigue and mild, transient liver enzyme elevations. Fezolinetant represents...

Pharmacokinetic interactions of clozapine and olanzapine: case studies of drug modifications due to CYP1A2 inhibition

Kateřina Skopalová

Klin Farmakol Farm. 2025;39(3):181-184 | DOI: 10.36290/far.2025.063  

MARTA antipsychotics are essential drugs in the treatment of psychiatric disorders; however, their efficacy and safety can be affected by drug interactions. This article focuses on interactions between antipsychotics and antibiotics, particularly through the inhibition of cytochrome P450 1A2 (CYP 1A2), which may lead to drug level changes beyond the therapeutic range. Two selected case reports from clinical practice in an inpatient psychiatric hospital illustrate the consequences of these interactions and possible solutions. Special emphasis is placed on the drug interaction between clozapine and ciprofloxacin and the necessity of therapeutic drug...