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...

Drug interactions of cardiovascular drugs and their analysis in the patients of community pharmacy II. Author: Lenka Skořepová1 Tutor: PharmDr. Josef Malý, Ph.D.1 1 Department of Social and Clinical Pharmacy, Charles university in Prague, Faculty of Pharmacy in Hradec Králové Introduction: Drug interactions are a major cause of toxicity, side effects of drugs and increase the risk of harm to the patient. The pharmacist has an indispensable role in the process of minimizing risks and resolving of drug interactions. Objectives: The aim of the thesis was to carry out a research focused on drug interactions of selected groups of cardiovascular drugs and to describe their management in clinical practice, which could be used during dispensing medicine. Then was evaluated occurrence of these drug interactions in pharmacotherapy of community pharmacy patients. Methods: With the help of selected databases were described individual drug interactions of ACEI and created their management in clinical practice. Sample of patients of community pharmacy was screened for drug interactions. The data were processed by retrospective analysis. For 12 patients with drug interactions were processed case reports and tested solution of drug interactions with using of described management of drug interactions during the...

Due to the demographic development osteopoorosis is an increasing serious medical and economical problem today in developed industrial countries including Czech republic. Fractures of the proximal femur in the elderly are one of the manifestations of the illness. Within the context of the pharmacological prevention we must consider carefully its contribution in comparison with costs of the fracture treatment in the hospital. This graduation theses deals with evaluation of expenses on the surgical treatment of these fractures and expenses on the pharmacological prevention using Fosamax. This comparison is made in economic situation in Czech republic in the end of the first decade of 21. century

The diploma thesis deals with the issue of health literacy of seniors in the field of pharmacology. The aim of the work was to find out, which skills and abilities seniors have, to understand, search and use information, services, and tools related to pharmacology. Thanks to these social and cognitive skills, seniors can have greater control over their health, they can make good decisions about their health condition, and they can maintain and support their health in general. The second aim of this thesis was to find out what problems the seniors encounter in the daily use of medicaments and what aspects make them the most difficult. With today's overusing drugs, seniors face more than one problem and it is affecting their quality of life and whole drug therapy. To achieve my goals, I have used quantitative research, using questionnaires. The examined sample was male and female from the age of 65 and the total number of respondents was 120. I set 2 goals with eight related hypotheses. Based on the gained results, out of the eight hypotheses, two of them were accepted and six of them were rejected. Based on the gained information from the research, in collaboration with graphic designer Dominika Pýchová, I created a stylized illustration (Annex 2), which could be introduced in the packaging to simplify pharmacy's using by seniors and simplify the information from information flyers. The reason, why seniors don't read the information flyers is the fact, that printed letters are too small and not readable. I was present while filling out the questionnaires and that is why I found out, that seniors would welcome better and uniform drug list which would make them easier to use. That's why I redrew the American version of the drug list, which is listed in (Annex 3). Overall research shows that half of the seniors are using more than 5 drugs, they have bigger problem of knowing the effects of drugs than knowing their names. Almost nobody knows the side effects of the drugs, as well as a clinical pharmacist who would facilitate pharmacotherapy in many cases. Practitioners do not check their patients' medication, and in many cases, when hospitalized, practitioners find out that the patient is taking unnecessary medication or even those that have not been prescribed for a long time. As long as the seniors do not improve their knowledge with help from practitioner and nurse, or by introducing of drug list's regular checks, seniors will be in alarming danger and their health literacy will not improve but it will be further reduced.

Abstarct Analysis of the Therapy in Patients with Juvenile Idiopathic Arthritis Author: Martina Procházková Tutor: PharmDr. Josef Malý, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aims: Methotrexate (MTX) is an effective and safe drug used for the treatment of juvenile idiopathic arthritis (JIA) and is well-known like a golden standart in the treatment of this serious illness. The aim of this study was analysis of therapy in patients with JIA focusing on MTX and faktors affecting its intolerance. Methods: The study was undertaken from January 2017 to February 2018 at the Department of Paediatrics and Adolescent Medicine, 1st Faculty of Medicine, Charles University in Prague. Patients younger than 18 years old, who have become ill with JIA for the first time or repeatedly between years 2015-2017 and were treated by MTX were included in this study. The prevalence of MTX intolerance was measured by "Methotrexate Intolerance Severity Score" questionaire every 3 months during regular rheumatological examinations. Simultaneously, medical records were reviewed. Data analysis was performed by means of descriptive statistics, correlation dependence and statistical signifikance of dependence was assessed with statistical two-choice...

: INTRODUCTION : Osteoarthritis (OA) is a degenerative disease that predominantly affects geriatric population. However, geriatric patients are not often treated according to specific geriatric recommendations. OA also belongs to highly prevalent disorders managed mostly by symptomatic, analgetic drug treatment. The aim of this diploma thesis was to evaluate to which extend are clinical guidelines for management of OA focused (generallly and in areas of individual pharmacotherapeutic strategies) on specific aspects of rational geriatric pharmacotherapy. Diploma thesis was completed as a recherche thesis (part I.) for follow-up studies dealing with rationality of analgetic drug treatment in older patients (rigorous thesis of M. Miklasová MS, Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, 2016). METHOD : 4 national and 3 international clinical guidelines for management of osteoarthritis in accessible languages, published between 2005 and 2014 years, were identified by literature search conducted between 9/2015- 3/2017. Following guidelines were included : czech (2012), german (2009), australian (2009), american (2012) and recommendations of international societies OARSI (2008-2010), EULAR (2005, 2007) and NICE (2014).This diploma...

Title: Ageing of the population and specific aspects of prescribing of hypnotics in older adults (II.) Student: Karolína Puldová, Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Czech Republic Supervisor: Assoc. Prof. Daniela Fialová, PharmD, Ph.D., Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové and Department of Geriatrics and Gerontology, 1st Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic Introduction: World population is ageing and rational geriatric pharmacotherapy receives increasing attention. In seniors, rational pharmacotherapy is complicated by many risk factors, especially by physiological and pathological changes accompanying ageing, polymorbidity, polypharmacy, higher risk of adverse drug events, drug interactions and other risk factors. Particularly psychotropics belong to drug classes where rational prescribing in seniors often requires respecting of different rules. This diploma thesis focuses on specific aspects of irrational prescribing of hypnosedatives in ambulatory geriatric patients, particularly in the area of use of nongeriatric doses and nongeriatric lenght of therapy. Methodology: Data collection for this diploma thesis has been conducted between 2019-2020 years in the...

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...