Tikslas: Įvertinti aminoglikozidų koncentracijos tyrimo svarbą racionaliai farmakoterapijai. Nustatyti ir įvertinti amikacino ir gentamicino koncentracijų tyrimų tendencijas Limoges universitetinėje ligonineje (CHU) ir Kauno medicinos universiteto klinikose (KMUK). Metodai: Duomenys buvo gauti iš CHU farmakologijos – toksikologijos ir statistikos skyrių bei KMUK klinikinės chemijos - hematologijos laboratorijos ir statistikos skyriaus. Apskaičiuota kiek koncentracijos tyrimo tenka vienam lovadieniui per 2007 metus, įvertintos gentamicino ir amikacino ištirtų koncentracijų duomenys bei paskirtos dozės. Duomenų statistinė analizė buvo atlikta naudojant MS Office programų paketo MS Excel skaičiuoklės ir duomenų apdorojimo programos. Rezultatai: Gentamicinui buvo atlikta 400 koncentracijos tyrimų (184 atvejų Cmax koncentracijai tirti, 216 – Cmin koncentracijai tirti) . Tirti 131 ligoniai (46 moterys ir 85 vyrai), kuriems gentamicino dozė individualiai adaptuota 221 kartą. Amikacinui buvo atlikta 169 koncentracijos tyrimai (82 atvejai Cmax koncentracijai tirti , 87 – Cmin koncentracijai tirti). Tirti 62 ligoniai (24 moterys ir 38 vyrai), kuriems amikacino dozė individualiai adaptuota 92 kartus. CHU tenka 6,85×10-4 (1:1460) gentamicino koncentracijos tyrimo vienam lovadieniui ir 2,89×10-4 (1:3456) amikacino koncentracijos tyrimo vienam lovadieniui.KMUK tenka 2,77×10-5 ( 1:36089) gentamicino koncentracijos tyrimo vienam lovadieniui. Taigi, CHU 24,72 kartais lenkia KMUK gentamicino... [toliau žr. visą tekstą] / Objectives: To evaluate the importance of researh on aminoglicozids for rational pharmacotherapy. To determine and evaluate the tendencies of studies of amikacin and gentamicin concentration in Limoges University Hospital (CHU) and Kaunas University of medicine Hospital (KMUM). Methods: The data has been received from the department of pharmacology and toxicology and the department of statistics of CHU and from the laboratory of chemistry and hematology and the department of statistics of KMUK. It has been calculated how much concentration study belongs to one bed-day in the year 2007, the data of the studied concentrations of gentamicin and amikacin have been evaluated and the doses have been administered. Statistical analysis of the data has been carried out by the use of MS Excel and data processing programs of MS Office. Results: 400 concentration studies have been carried out for gentamicin (184 cases for the study of Cmax concentration, 216 cases for the study of Cmin concentration). 131 patients (46 women and 85 men), who have been individually adapted the dose of gentamicin for 221 time, have been studied. 169 concentration studies have been carried out for amikacin (82 cases for the study of Cmax concentration, 87 cases for the study of Cmin concentration). 62 patients (24 women and 38 men), who have been individually adapted the dose of amikacin for 92 times. In CHU, there is 6.85×10-4 (1:1460) of gentamicin concentration study for one bed-day and 2.89×10-4 (1:345... [to full text]

In Canada, nicotine replacement therapy (NRT) is a best practice for adult smoking cessation, but it is not recommended for use by youth smokers. Previous research has indicated that more than 20 percent of high school-aged smokers in Canada had used NRT, despite the cross-Canada requirement that youths under the age of 18 have a physician’s prescription to purchase NRT. The goal of this study was to examine both student and school-level characteristics associated with use of NRT by youths. Data from 29,296 grade 9 to 12 students who participated in the 2008-2009 National Youth Smoking Survey (YSS) were combined with Canadian census and built environment data in multilevel logistic regression models. The associations between lifetime and current NRT use with student characteristics (i.e., smoking status, social smoking connections) were examined alongside school environment factors such as urban/rural location and pharmacy density within a one kilometre radius of schools. In 2008-2009, 21.1% of youth smokers in Canada had ever used NRT and 5.1% were currently using NRT. Odds of NRT use were highest among daily smokers, boys, youths who had made multiple quit attempts, and youths who self-identified as smokers. Attending a school located within an urban area increased youths’ odds of NRT use, whereas higher density of pharmacies surrounding a school was inversely associated with NRT use. This study is the first to identify significant between school differences in NRT use. It also reveals that many youths are using NRT in the absence of a quit attempt. Further research is needed to identify school characteristics that impact NRT use, and understand how youths are accessing NRT.

Psychostimulant dependence is a major public health issue in many parts of the world associated with a wide range of psychological, medical and social problems. Psychosocial interventions are the mainstay of treatment for psychostimulant problems, although their effectiveness is compromised by poor uptake and compliance. Despite increasing knowledge of the neurobiological consequences of psychostimulant use, no medications to date have been any more successful than placebo in reducing psychostimulant use in dependent patients. Modafinil is a non-amphetamine type psychostimulant that may have potential as an agonist pharmacotherapy for psychostimulant dependence. The aim of this thesis was to examine the safety, efficacy and cost-effectiveness of modafinil 200 mg/day over ten weeks plus a four session brief CBT intervention for methamphetamine and cocaine dependence through two concurrent randomised placebo controlled trials. There were no statistically significant differences between modafinil and placebo in treatment retention, medication adherence, psychostimulant abstinence, psychostimulant craving or severity of psychostimulant dependence. Methamphetamine-dependent subjects tended to provide more illicit psychostimulant negative urine samples while in treatment than those who received placebo. There appeared to be a reduction in self-reported days of psychostimulant use among methamphetamine-dependent subjects who received modafinil compared to placebo, but the effect size was too small to be statistically significant in this sample. The reduction in self-reported psychostimulant use did reach statistical significance in methamphetamine-dependent subjects with no other substance dependence. Uptake of counselling was the most significant predictor of reduced psychostimulant use post treatment, and the addition of counselling improved the cost-effectiveness of modafinil relative to placebo. Modafinil appeared to be safe, well-tolerated, and non-reinforcing in this treatment population. Compared to placebo, there was a significant increase in weight in subjects who completed the 10-week course of treatment, and a significant decrease in systolic blood pressure in methamphetamine-dependent subjects who received modafinil. The results support further trials of modafinil in methamphetamine-dependent patients, although future trials in cocaine-dependent patients from this treatment population were not likely to be viable. Modafinil appeared to be modestly effective in reducing, but not stopping, methamphetamine use in selected patients. Multi-centre trials with larger sample sizes, and measures sensitive enough to detect quantitative changes in psychostimulant use would be needed to confirm the findings. Blood pressure and weight may be important indicators of clinical outcome, and warrant particular attention in future trials, particularly given the cardio-toxicity of both methamphetamine and cocaine. Strategies to enhance medication adherence including a higher dose and counselling adherence are recommended to improve outcomes. Given the predominance of behavioural and psychosocial factors in psychostimulant dependence, it is likely that the role of medications such as modafinil will be as an adjunct to psychosocial therapy.

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...

No período de 2008 a 2010, foi realizado o estudo de Atenção Farmacêutica, prospectivo longitudinal, com a participação de 104 pacientes diagnosticados com hipertensão arterial sistêmica, oriundos de duas unidades de saúde, do Distrito Sanitário Oeste da Cidade de Ribeirão Preto/SP. Após seis meses de estudo houve redução estatística significativa nos valores de Pressão Arterial Sistólica e Diastólica com menor dispersividade dos valores e clínica. A adesão ao tratamento aumentou ao longo do acompanhamento. Apresentou-se reduzido risco cardiovascular, com uma redução estatisticamente significativa do escore de risco Framingham. Discreta redução dos atendimentos de emergência. Apesar do sucesso deste estudo, fica em aberto se os benefícios alcançados são considerados transitórios ou permanentes. Para tanto, os pacientes foram reavaliados quanto aos parâmetros: pressão arterial sistólica e diastólica; valores de colesterol total; HDL; LDL, triglicerídeos, número de consultas em geral realizadas nessas unidades de saúde, e número de princípios ativos utilizados. Comparados os dados no período durante e após a Atenção Farmacêutica observou se que houve um aumento estatisticamente significante nos valores de pressão arterial sistólica e diastólica Com relação aos números de medicamentos prescritos houve também um aumento estatisticamente significativo, mas justificável devido à alteração na relação municipal de medicamentos essenciais entre os anos de 2009 e 2012. Quanto ao número de consultas e os resultados dos exames laboratoriais não houve diferença estatisticamente significante. Diante disso, pode se concluir que a Atenção Farmacêutica foi importante para a manutenção e manejo dos pacientes hipertensos e que o período de 30 meses após a Atenção Farmacêutica apresentou discretas alterações, principalmente nos valores de pressão arterial sistólica e diastólica e número de princípios ativos utilizados. / In the period from 2008 to 2010, a longitudinal and prospective Pharmaceutical Care study was conducted with 104 patients diagnosed with hypertension, from two health units, from the West Sanitary District of the municipality of Ribeirão Preto/SP. In this study, in the first six months of follow-up was observed a statistically and clinically significant reduction in the values of systolic and diastolic blood pressure, and with less dispersivity values. Medication adherece increased during the follow-up, a lower coronary risk was presented, with a statistically significant reduction in the Framingham Risk Score. A slight reduction in the emergency room visits was also observed. Considering the success of this study, was not decide whether the benefits obtained were considered transitory or permanent. Therefore patients were reassessed for the parameters: systolic and diastolic blood pressure; total cholesterol; HDL, LDL, triglycerides, number of consultations in general performed in those health units, and number of active moieties. Comparing data from the period during and after the Pharmaceutical Care, it was observed that there was a statistically significant increase in systolic and diastolic blood pressure. Regarding the number of prescribed medications statistically significant increase was also observed, but justifiable due to changes in the municipal list of essential medicines between the years of 2009 and 2012. Regarding the number of medical appointments and the results of laboratory tests there was no statistically significant difference. Thus, it can be concluded that Pharmaceutical Care was important for the maintenance and management of hypertensive patients and that the period of 30 months after the Pharmaceutical Care showed slight alterations, mainly in systolic and diastolic blood pressure and number of active moieties used.

No período de 2008 a 2010, foi realizado o estudo de Atenção Farmacêutica, prospectivo longitudinal, com a participação de 104 pacientes diagnosticados com hipertensão arterial sistêmica, oriundos de duas unidades de saúde, do Distrito Sanitário Oeste da Cidade de Ribeirão Preto/SP. Após seis meses de estudo houve redução estatística significativa nos valores de Pressão Arterial Sistólica e Diastólica com menor dispersividade dos valores e clínica. A adesão ao tratamento aumentou ao longo do acompanhamento. Apresentou-se reduzido risco cardiovascular, com uma redução estatisticamente significativa do escore de risco Framingham. Discreta redução dos atendimentos de emergência. Apesar do sucesso deste estudo, fica em aberto se os benefícios alcançados são considerados transitórios ou permanentes. Para tanto, os pacientes foram reavaliados quanto aos parâmetros: pressão arterial sistólica e diastólica; valores de colesterol total; HDL; LDL, triglicerídeos, número de consultas em geral realizadas nessas unidades de saúde, e número de princípios ativos utilizados. Comparados os dados no período durante e após a Atenção Farmacêutica observou se que houve um aumento estatisticamente significante nos valores de pressão arterial sistólica e diastólica Com relação aos números de medicamentos prescritos houve também um aumento estatisticamente significativo, mas justificável devido à alteração na relação municipal de medicamentos essenciais entre os anos de 2009 e 2012. Quanto ao número de consultas e os resultados dos exames laboratoriais não houve diferença estatisticamente significante. Diante disso, pode se concluir que a Atenção Farmacêutica foi importante para a manutenção e manejo dos pacientes hipertensos e que o período de 30 meses após a Atenção Farmacêutica apresentou discretas alterações, principalmente nos valores de pressão arterial sistólica e diastólica e número de princípios ativos utilizados. / In the period from 2008 to 2010, a longitudinal and prospective Pharmaceutical Care study was conducted with 104 patients diagnosed with hypertension, from two health units, from the West Sanitary District of the municipality of Ribeirão Preto/SP. In this study, in the first six months of follow-up was observed a statistically and clinically significant reduction in the values of systolic and diastolic blood pressure, and with less dispersivity values. Medication adherece increased during the follow-up, a lower coronary risk was presented, with a statistically significant reduction in the Framingham Risk Score. A slight reduction in the emergency room visits was also observed. Considering the success of this study, was not decide whether the benefits obtained were considered transitory or permanent. Therefore patients were reassessed for the parameters: systolic and diastolic blood pressure; total cholesterol; HDL, LDL, triglycerides, number of consultations in general performed in those health units, and number of active moieties. Comparing data from the period during and after the Pharmaceutical Care, it was observed that there was a statistically significant increase in systolic and diastolic blood pressure. Regarding the number of prescribed medications statistically significant increase was also observed, but justifiable due to changes in the municipal list of essential medicines between the years of 2009 and 2012. Regarding the number of medical appointments and the results of laboratory tests there was no statistically significant difference. Thus, it can be concluded that Pharmaceutical Care was important for the maintenance and management of hypertensive patients and that the period of 30 months after the Pharmaceutical Care showed slight alterations, mainly in systolic and diastolic blood pressure and number of active moieties used.

Class of 2015 Abstract / Objectives: The study aimed to increase EPS risk factor assessment when prescribers order prophylactic anticholinergics with antipsychotics. An evidence-based pharmacist checklist card was developed to aid in this decision making process. Methods: A retrospective chart review of patients admitted to the acute inpatient psychiatry units at an academic medical center was conducted to determine baseline prophylactic anticholinergic prescribing habits over a two-month period. Charts were included if the patient was at least 18 years old and ordered at least one scheduled antipsychotic during the admission. An educational intervention session introduced the pharmacist checklist card and shared baseline findings. Post-intervention data was collected during a two-month period following the intervention. The percentage of prophylactic anticholinergic orders based upon pharmacist checklist card parameters pre and post-intervention was analyzed using chi-square test. Results: There was a significant decrease in the total percentage of orders for prophylactic anticholinergics from 72.7% in the pre-intervention period to 50.8% in the post-intervention period (p<0.001). Significant changes in the percentage of orders for prophylactic anticholinergics were also found for patients at no-to-low risk for EPS (56.4% versus 31.8%, p=0.014) and at low-to-moderate risk for EPS (79.6% versus 50.8%, p=0.003). There were no significant changes observed in the percentage of orders for prophylactic anticholinergics for patients at moderate-to-high risk for EPS. A lower percentage of patients prescribed a prophylactic anticholinergic experienced adverse effects in the post versus the pre-intervention period (52.31% versus 75.27%, p=0.003). Conclusions: Significant differences were found between pre and post-intervention anticholinergic medication prescribing habits. This suggests that increased patient risk factor assessment in the form of a pharmacist checklist card is effective in decreasing orders for prophylactic anticholinergic medications not clinically indicated and reducing the incidence of adverse effects.

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...

Identification and analysis of therapy used by pregnant women III. Author: Edita Cimbálová Thesis Supervisor: PharmDr. Josef Malý, Ph.D. Thesis Consultant: Mgr. Pavel Horký Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and purpose: Therapy of pregnant women is accompanied by a variety of changes that need to be accounted for. The purpose of the theoretical part was to summarise available information in selected health issues of pregnant women. The purpose of the practical part was to identify and analyse the therapy used during pregnancy and the attitudes, opinions and awareness of women after delivery about over-the- counter drugs, medical devices and other forms of complementary and alternative medicine. Methods: The data were collected at the maternity ward of Jičín Hospital from November 2017 to February 2018 via questionnaires. The questionnaire contained information about the study and it was consisted of 50 questions of open, semi-closed and closed format focused on health issues during pregnancy, attitudes and opinions about homeopathy, herbal medicine, vaccination and the way to get informations during pregnancy. The collected data were transfered into an electronical form and subsequently analysed by methods of...

Analysis of antibiotic administration in prophylaxis II Author: Martina Bobčíková Tutor: doc. PharmDr. Josef Malý, Ph.D. Consultant: PharmDr. Anna Patková, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aims: The term antibacterial prophylaxis (AP) refers to antibiotic (ATB) administration in prevention of surgical site infection (SSI). There are many factors in population which can potentially raise the risk of the incidence of SSI. The maintenance of basic rules of the AP and knowledge, influence and timely elimination of risk factors of SSI are the most important measures which can reduce a number of postoperative SSI. The aim of this study was to analyze antibiotic administration in prophylaxis in the local hospital in the Czech Republic and compare the results to well known international guidelines (ASHP-G) and latest scientific knowledge (LSK). Methods: The cross-sectional study was conducted in October 2019. During the period from 2nd to 23rd October, the data of surgeries and used AP were collected. The patients who passed the entry criteria have been included in this study. Into prepared form, patient's identification, agreement, diagnosis, surgery type, operation date, the beginning and the end of surgery,...