INTRODUCTION Cardiovascular diseases (CVD) are currently on the first place among the causes of death worldwide and also in the Czech Republic (CR). The most common causes of death among CVDs are disorders associated with atherosclerosis (ATS) and the prevalence of atherosclerosis and their complications increases with increasing age. The aim of this diploma thesis was to document CVS morbidity in geriatric patients in the sample of FIP7 program of the EUROAGEISM H2020 project, mainly the prevalence of CVS disorders associated with ATS, and to evaluate the controll of risk factors associatedwith general risks of progression of ATS. METHODS The data collection for this theses was carried out in the CR from September 2018 to January 2019 in patients in acute care at the age of 65 and older at geriatric wards in Hradec Králové (HK) and Brno. Patients involved in the study were those admitted to hospitalization at the time of data collection, were complying with inclusion criteria and undersigned the informed consent. The Ethics committee of the Faculy of Pharmacy, Charles University and ethics committee of participating healthcare facilities approved the project. Information have been obtained using the questionnaire for comprehensive geriatric assessment which is the secured instrument of the...

INTRODUCTION: In the world population, the number of seniors with very heterogeneous health care is increasing. Because of the aging of the organism they are much more sensitive to adverse effects of drugs, therefore geriatric care is more visitors and safety pharmacotherapy. It thus seeks to prevent risky medicines available in geriatric patients. Many explicit targets have been disclosed that can be reserved for the potentially endangered by the elderly. Diuretics are among the classes of drugs that are often prescribed in the geriatric population but which pose significant risks to the geriatric patient. Problems with their unpleasant effects, but also poor indication or combination with minimal drugs. OBJECTIVE: The main aim of this thesis was to describe the frequency and rationality of prescribing diuretics in seniors treated in geriatric outpatient clinics. The use of diuretics in appropriate and potentially inappropriate indications, the occurrence of changes accompanying adverse reactions (including laboratory changes in electrolytes and metabolic parameters) and whether these problems are controlled were monitored. The risks of hyponatraemia associated with diuretic therapy and the use of SIADH-inducing drugs were also assessed in more detail. METHODICS: This thesis was based on the...

Title: Analysis of the use of potentially inappropriate cardiovascular drugs in seniors in acute care in the project EUROAGEISM H2020 Author: Petra Gajdošová Department: Department of Social and Clinical Pharmacy Supervisor: Assoc. Prof. PharmDr. Daniela Fialová PhD. ABSTRACT INTRODUCTION: Population aging is a global problem for which all health and social systems of all countries needs be prepared, including the Czech Republic. It is assumed that in 2050 every third citizen of the Czech Republic will be 65 years and older. The group of seniors is characterized by high polymorbidity and polypharmacotherapy. Prescription of drugs is also very complicated in seniors due to changes accompanying aging (at the level of pharmacokinetics, pharmacodynamics and homeostasis). The aim of this diploma thesis was to determinate the prevalence of potentially inappropriate medications (PIMs) from the cardiovascular system (CVS) using the best-known explicit criteria of PIMs in the Czech sample of seniors in acute care assessed during the FIP7 program of the EUROAGEISM H2020 project. METHODOLOGY: Data collection was held during the FIP7 program of the EUROAGEISM H2020 project in acute care in seniors aged 65 years and over in two health facilities in Brno and Hradec Králové (HK) in the Czech Republic from August 2018 to...

Analysis of the effect of pharmacotherapy on the risk of falls in inpatents III Author: Tereza Honsová Tutor: PharmDr. Josef Malý, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction: Falls are frequent and unwanted events happening in healthcare facilities. The falls have a multifactorial character. The prevention is the best way how to improve a quality of healthcare and a quality of the patient's life. All of the doctors, clinical pharmacists and nurses can help to realize it by cooperating with each other, working with professional information and by individual attitude to each patient. Objective: The aim of this study was to analyze the effect of the fall risk-increasing drugs to falls in hospitalized patients and to recommend the right interventions to prevent the fall. Methodology: For the analysation, classification and quantification of the fall risk-increasing drugs, drug related problems and interventions a special online database was created. All of the doctors, clinical pharmacists and nurses were collecting details about the pacients and about how the fall happened. Fall risk-increasing drugs and drug-related problems were then analyzed by clinical pharmacists. Potential interventions were suggested. Also other...

Introduction: As the population is aging and the number of the seniors is rising, the importance of knowledge and methods of geriatry and gerontology grows bigger. The seniors represent highly specified group of patients whose health care and treatment should be paid especial attention. Multimorbidity, polypharmacotherapy and an enlarged risk of adverse drug events often make such treatment more complicated. Complex geriatric assessment and acceptance of principals of geriatric prescription both represent key values of rational treatment. This thesis is dedicated to the issue of insomnia and rating of sedative/hypnotic treatment in the czech sample of seniors in acute care. Methodology: The data for this thesis were collected between the years 2018-2019 within EUROAGEISM H2020 project. They include information on 438 patients 65 years of age and older which was collected from three geriatric medical acute care centres in Czech republic (Prague, Brno, Hradec Králové) and gained from the medical documentation combined with the information from patient and medical staff themselves, which were interviewed with use of standardized questionnaire of the EUROAGEISM H2020 research project. The questionnaire was composed from sociodemographic characteristics, assesment of functional ability, nutrition state...

INTRODUCTION The deepening process of demographic aging has a significant impact on all areas of the society. With increasing age, the presence of illness, as well as the amount of used drugs increases. The most commonly prescribed drugs are often proton pump inhibitors, which play an irreplaceable role in the treatment of many gastrointestinal diseases. The trend of the overuse of proton pump inhibitors as the main antisecretory drugs is mainly related to their long-term administration in the prophylaxis of concurrent use of gastrotoxic drugs. The aim of this work was to evaluate the rationality of use of proton pump inhibitors including indications, administered dosages and duration of treatment. METHODS The data collected and used in this work are a part of the FIP7 project of the EUROAGEISM H2020 program. The study involved 438 geriatric patients in acute care institutions in Brno, Prague, and Hradec Králové, who were hospitalized between August 2018 and January 2019. The inclusion criteria were age over 65 years and adherence to inclusion criteria of the study. Seniors with severe cognitive impairment (MMSE < 10 points), memory impairment, speech or hearing impairment, patients hospitalized in the intensive care unit and in the terminal stage of the disease were excluded from the study. Data...

Analysis of the effect of pharmacotherapy on the risk of fall in inpatients II Author: Nikola Szikorová Tutor: PharmDr. Josef Malý, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and objectives: Falls are one of the most common problems of hospitalized patients. Their occurrence is associated with many problems and therefore should be avoided. Effective prevention involves analyzing risk factors and implementing interventions to minimize these risks. The aim of this work was to analyze the influence of drugs and other risk factors on the fall of hospitalized patients. Methods: Data was collected from April to December 2017 in 4 hospitals in South Bohemia. Only patients who had fallen during hospitalization participated in the study. An online database was created for the study to collect patient data (personal history, medications used, laboratory values and others). Population and individual fall risk-increasing drugs were analyzed. For each individual fall risk-increasing drug, the type of drug problem that could have been the cause of a fall was classified. Risk minimization interventions have been assigned to each drug problem. In addition to fall risk-increasing drug analysis, other risk factors that increased the risk...

Title: Ageing of the population and use of low-dose drug regimens in older patients (ii.) Author: Jana Koleníková Tutor: Assoc. Prof. Daniela Fialová, PharmD, Ph.D. University: Charles University Faculty: Faculty of Pharmacy in Hradec Králové Department: Department of Social and Clinical Pharmacy Introduction: Proportion of seniors in the population is increasing worldwide, therefore rational pharmacotherapy in older adults is more emphasized. The drug pharmacokinetics and pharmacodynamics change in older age due to physiological and pathological changes, but also due to frequent polymorbidity and polypharmacotherapy. The use of certain medicines is therefore considered risky in seniors. For this reason, explicit expert criteria of medications potentially inappropriate in the aged (so called PIMs) have been created in many countries. Considering the fact that seniors were usually not included in randomized controlled trials, information about specific dosing in older adults for many medications is not stated in Summary of Product Characteristics (SmPCs) which provide basic information on effective and safe administration of medicines. The aim of the diploma thesis was to clarify whether in case of PIMs specific information about geriatric dosing is stated in SmPCs, or at least general warnings that...

BACKGROUND: Numerous methods have been devised to combat human immunodeficiency virus (HIV) replication and disease progression. Composed of an integrase strand transfer inhibitor, a pharmacoenhancer, and two reverse transcriptase inhibitors, Stribild is a relatively new combination HIV drug formulated for once-a-day dosing. METHODS: Relevant information, original research articles and reviews, were gathered primarily through the use of the PubMed database. The search was conducted without date restrictions in order to collect both historical and recent information concerning HIV, individual drugs, and combinations for a thorough overview. RESULTS: Stribild, when taken with food, provides therapeutic drug concentrations as seen through comparison with the respective individual or boosted individual drugs. Stribild non-inferiority has been shown when compared to other HIV drug combinations, ritonavir-boosted atazanavir or efavirenz each with a tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) backbone. The co-formulation also retained high viral suppression in patients switching from other regimens, such as efavirenz/TDF/FTC, raltegravir/TDF/FTC, or various ritonavir-boosted protease inhibitors with TDF/FTC. The elvitegravir and cobicistat combination was unaffected by moderate hepatic impairment; however, hepatic and renal function along with changes in bone mineral density should be monitored closely. Stribild presented with relatively few side effect occurrences, but drug interactions may pose a larger problem for continuous therapy. CONCLUSIONS: Stribild provides viral suppression, comparable to other combination HIV drugs through review of non-inferiority and regimen simplification studies, with minimal adverse effects. Although the breadth of Stribild effectiveness has begun to unfold, studies are lacking in older patients as well as adolescents.

Excerpt: Navari and colleagues (July 14 issue)1 report on the use of olanzapine for the prevention of chemotherapy-induced nausea and vomiting.