Analysis of antibiotic prophylaxis in patients with osteosynthesis of the proximal femur Author: Anna Baťková Tutor: doc. PharmDr. Josef Malý, Ph.D. Consultant: Mgr. Markéta Dlouhá Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aims: This work is part of the continuous monitoring of antibiotic prophylaxis (AP) at the Department of Traumatology, University Hospital. The aim was to analyze and compare key parameters of AP in osteosynthesis of pertrochanteric fractures with the previous investigation and the methodological guidelines of the University Hospital. Methods: This retrospective cross-sectional study took place from 1st April 2019 to 31st March 2020 at the Department of Traumatology at the University Hospital. AP was analyzed in 50 patients above 18 years of age and who underwent a pertrochanteric fracture of the proximal femur. Data was collected with a form, prepared in cooperation with the Department of Medical Microbiology, physicians and clinical pharmacists of the University Hospital. Information on the patient, surgery, indication of AP, selected antibiotic/chemotherapeutic (ATB) and its dose, time, route of administration, as well as the size, number and interval of administered postoperative doses and...

Analysis of infection therapy in paediatric department I Author: Tomáš Trávníček Tutor: doc. PharmDr. Josef Malý, Ph.D. Consultant: MUDr. Magdalena Rohanová, Mgr. Petr Domecký Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aims: Infections in newborns are one of the most frequent causes of death. The aim of this work was the retrospective analysis of bacterial infection in newborns with a birth weight ≤ 1500 g hospitalized in Paediatric Intensive Care Unit (ICU) and compare it with the latest findings published in the expect literature. Methods: The retrospective cross-sectional study took place in Paediatric ICU. The data were gathered between 07/29 and 08/10 2020. The study included patients in neonatal age with a birth weight ≤ 1500 g hospitalized in the Paediatric ICU in 2018 and 2019 with bacterial infection. The infection was proved by a positive cultivation, increased C-reactive protein and increased or reduced number of white blood cells. Information on the patient, infectious agent, laboratory tests, occurrence of risk factors for sepsis, selection of antibiotics, its susceptibility, dose, dosing interval and duration of administration, as well as the result of therapy were collected to a prepared form. The data were...

Identification and analysis of therapy used by pregnant women II. Author: Eliška Vachudová1 Tutor: PharmDr. Josef Malý, Ph.D.1 1 Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and objective: Taking medication during pregnancy often implies higher risk of adverse effects for pregnant woman as well as for the foetus. In the Czech Republic, there is not enough information for rational drug taking during gravidity yet. The purpose of the practical part was to identify and analyze therapy used by pregnant women by questionnaires, in which respondents could show their knowledge and awareness of over-the-counter drugs, medical devices, food supplements and herbal and homeopatic remedies. Methods: The data collection lasted from August 2017 to March 2018 and was performed in the form of questionnaires at the Domažlice Hospital, Department of Gynecology and Obstetrics. Nurses played a vital role to distribute the questionnaires and instruct every newly admitted woman how to fill them. The questionnaire was anonymous, contained 50 questions of open, semi-open and closed types and included introduction letter with the entrance criteria. After filling in, they were transformed into electronic ones using Google Forms. Collected data were...

8 Abstract Analysis of antibiotic administration in prophylaxis I Author: Petr Domecký Tutor: PharmDr. Josef Malý, Ph.D. Consultant: PharmDr. Lucie Hauschke, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aims: Antibiotic prophylaxis (AP) plays an important role in reduction of surgical site infection (SSI). It is the administration of an eligible antibiotic or chemotherapeutic (ATB) in a single dose, usually 30 minutes before surgery, followed by two to three doses during or after the surgery, regarding the selected ATB and the surgical procedure. The aim of this work was to analyse the AP in surgical procedures at the Masaryk Hospital in Ústí nad Labem (MNUL) in the context of the MNUL guideline (DP) and the research on available AP work. Methods: A cross-sectional observational study ran from January 2018 to March 2018 in surgical departments at MNUL. The study included patients aged ≥ 18 years who underwent surgery in a defined period (5 February 2018 to 9 February 2018) and gave their consent to the study. The practicability of the study was verified by a pilot part. Initially, a research of published studies concerning AP was carried out which provided outputs for AP establishment (PPA). Subsequently, a form for...

Introduction: The American College of Clinical Pharmacy (ACCP) Pharmacotherapy Didactic Curriculum Toolkit was created by the 2008 ACCP Educational Affairs Committee to provide guidance to schools and colleges of pharmacy for didactic pharmacotherapy curricular development. The toolkit was revised and updated by the 2016 ACCP Educational Affairs Committee. Objectives: In accordance with the ACCP Board of Regents decision to update the toolkit every 3 years, the 2019 ACCP Publications Committee was charged with updating the 2016 toolkit to guide adequate disease state inclusion and depth of pharmacotherapy coverage in pharmacy curricula. Methods: The committee retained the competency-based tier definitions and organization of the 2016 toolkit. Multiple literature resources were reviewed to assess medical conditions responsive to drug therapy for inclusion in the 2019 toolkit. The committee also reviewed the tier designation for all toolkit entries for appropriateness, given recent advances in medical care and evolving patient care responsibilities of clinical pharmacists. Updates to the toolkit were made by consensus with electronic voting when required. Results: The 2019 toolkit contains 302 topics, including 94 (31%) tier 1, 133 (44%) tier 2, and 75 (25%) tier 3 entries. There are 26 additional topics in the updated toolkit, including 12 new tier 1 topics that are generally treated with nonprescription medications. Eleven new topics were added to tier 2, and 20 topics were added to tier 3 (including 11 topics in the Oncologic Disorders section). The tier classification of some conditions was changed to reflect current pharmacy practice expectations. Conclusion: As with the 2016 toolkit, the large number of tier 1 topics will require schools and colleges to employ creative teaching strategies to achieve practice competence in all graduates. The large number of tier 2 topics highlights the importance of postgraduate training and experience for pharmacy graduates desiring to provide direct patient care.

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Analysis of the Effect of Pharmacotherapy on the Risk of a Fall I. Author: Klára Šturcová1 Tutor: Josef Malý1 1 Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Pague Introduction: Falls of hospitalized patients are one of the most common problems in health institutions. In terms of prevention of falls it is necessary to analyze all the factors that might have contributed to the emergence of a fall and subsequently minimize these risk factors. Objectives: The aim of the thesis was to analyze the possible drugs and other causes of falls of patients hospitalized in a certain rehabilitation institution. Methods: The data were collected from 21 March to 31 July 2014 in an institution providing rehabilitation care. The evaluated group consisted of patients who fell during the hospitalization in this period. The data about the fall, personal and drug anamnesis were transferred to an electronic form and subsequently evaluated by means of the frequency analysis, converted into graphs and tables and discussed. Results: 67 patients experienced 79 falls. Women experienced 53 % of falls; men experienced 47 % of falls. 87 % of the patients fell once, 9 % of the patients fell twice, 4 % of the patients fell three times. 58 % of all falls were experienced by...

Drug interactions of gastrointestinal remedies Author: Marek Lapka Tutor: Josef Malý1 1 Department of Clinical and Social Pharmacy, Charles University in Prague, Faculty of Pharmacy in Hradec Králové Background: Drug interactions may be a serious cause of toxicity and undesirable drug effects. There is a direct proportion to side effect incidence caused by drug interactions and number of used drugs. The issue is a significant constituent of pharmaceutical care. The aim of dissertation: The aim of the thesis was to process available information, suggest a posible solution and create compact overview which can be taken into consideration by pharmacist in order to achieve optimal pharmacotherapy. Methods: Drug combinations, which interactions had clinical evaluation from "moderate severity" to "major severity" were collected from the fundamental information source, Vademecum infopharm aplication. Only currently registered drugs to 1st September 2013 by State Institute for Drug Controle were chosen and then medicinal products of which route of administration enables systemic effect. Furthermore the combination was compared with Micromedex database or Stockley's Drug Interactions Pharmaceutical Press, or both. Pubmed database (www.pubmed.gov) with entering key words "drug interaction", "basic drug" and...

Esse estudo pretendeu fazer uma análise custo-eficácia de duas estratégias de tratamento de hiperlipidemia em pacientes HIV/AIDS, uma de carácter nutricional e a outra de carácter medicamentosa, mais precisamente com pravastatina e bezafibrato, respectivamente para casos de colesterol e triglicérides elevados, num horizonte entre 3 e 12 meses. Os dados foram coletados no CRT-AIDS de São Paulo. Encontraram-se resultados similares em termos de eficácia no caso da hipercolesterolemia, a um custo menor via abordagem nutricional. As dosagens iniciais em ambos os grupos se revelaram similares. No caso da hipertrigliceridemia, verificou-se o mesmo efeito proporcional, apesar de que se deve considerar que as dosagens iniciais eram bastante diversas, apresentando os pacientes medicados níveis mais altos de triglicérides. Essa maior custo-eficácia da abordagem nutricional aqui encontrada, deve ser ponderada, também, com as limitações encontradas no estudo, quanto à abordagem de questões como a adesão dos pacientes aos tratamentos, e características do próprio processo diagnóstico. Apesar disso, os resultados do trabalho sugerem uma especial atenção com questões ligadas à dieta e estilo de vida, não num sentido competitivo, mas complementariamente em relação às terapias medicamentosas, quando estas se fizerem necessárias. / This study intended to make a cost-efficacy analysis of 2 options for the treatment of dyslipidemia in HIV/AIDS patients, the nutritional and the medical one, more strictly with pravastatin and bezafibrate, respectively for cases of raised cholesterol and triglycerides leveis, within 3 and 12 months. The data were collected at the CRT/AIDS de São Paulo. The study found similar results in terms of effectiveness in the hypercholesterolemia groups, with a smaller cost through the nutritional strategy. The initial leveis of cholesterol In both groups were similar. In the case of the hypertriglyceridemic groups the same proportional effect was verified,although it must be considered that the initial dosages were significantly diverse, presenting the medicated patients higher leveis of serum triglycerides. The higher cost-efficacy of nutritional strategies must be weighed with the limitations of this study, as the question of compliance to the treatments and even the diagnostic processo The criteria to choose the appropriate prices were basic to the differentiation between the options and they are a point of permanent discussion by themselves. In spite of these problems the study suggests that a special attention should be given to aspects linked with diet and life style in general, not in a competitive sense, but with complementary objetives in relation with the pharmacologic therapy, if the latter be necessary.

Les thérapies anti-angiogéniques actuelles sont limitées, et cibler le métabolisme endothélial représente une nouvelle stratégie prometteuse. Parmi la famille de glycomimétiques Phostines, le composé PST 3.1a possède des propriétés anti-tumorales contre le glioblastome à la fois in vitro et in vivo. L’objectif de ce projet est d’étudier l’impact de PST3.1a sur l’angiogenèse et le métabolisme endothélial. L’angiogenèse est un processus complexe décrivant la formation de nouveaux vaisseaux sanguins à partir d’une vasculature préexistante, dirigée par des facteurs pro-angiogéniques locaux tel que le facteur de croissance endothélial vasculaire (VEGF). L’angiogenèse intervient dans différentes conditions pathologiques, et notamment la croissance tumorale. PST 3.1a (10 μM) inhibe les principales étapes menant à l’angiogenèse in vitro, parmi lesquelles la migration, la prolifération, l’adhésion et la formation de tubes. PST 3.1a réduit également l’angiogenèse in vivo dans les modèles murins et du poisson zèbre, ainsi que l’angiogenèse tumorale et la progression du glioblastome. En particulier nos résultats démontrent une diminution d’interaction entre le récepteur au VEGF 2 et la galectine 1, cette interaction étant décrite comme cruciale dans le cadre des résistances tumorales face aux thérapies anti-angiogéniques actuelles. Ces résultats fournissent une ouverture thérapeutique sur une approche innovante et originale contre les pathologies associées à une angiogenèse excessive, tel que le cancer. / Actual anti-angiogenic therapies are limited, and targeting endothelial metabolism is a new promising strategy. One of the lead compound of the Phostin family, PST 3.1a has anti-glioblastoma properties both in vitro and in vivo. The objective of the present study was to assess the effect of PST3.1a on angiogenesis and endothelial metabolism. Angiogenesis is a complex process describing the growth of new blood vessels from existing vasculature, triggered by local pro-angiogenic factors such as the vascular endothelial growth factor (VEGF). Angiogenesis takes part in various pathological conditions and particularly in tumor growth. PST 3.1a (10 μM) inhibited the main steps leading to angiogenesis in vitro including migration, proliferation, adhesion and tube formation. PST 3.1a also reduced physiological angiogenesis in both mice and zebrafish models, and pathological angiogenesis and glioblastoma progression in vivo. In addition, our results highlight the alteration of the interaction between VEGF receptor 2 and galectin-1, a binding known as a key component of the regulation of angiogenesis associated to tumor resistance.These results provide a new route towards an innovative and original approach to target angiogenesis related diseases, including cancer.