Opinions, knowledge, perception of risks and compliance of patients using non-prescription drugs and dietary supplements I. Author: Hana Obrová1 Tutor: Josef Malý1 1 Department of Social and Clinical Pharmacy, Charles University in Pague, Faculty of Pharmacy in Hradec Králové Introduction: A part of the health knowledge everyone of us should be the self-medication. The assortment of OTC drugs and dietary supplements is still being spread in the Czech Republic. It carries benefits and risks. Objectives: The aim of the study was to investigate current opinions, attitudes and knowledge of patients from the Czech Republic about OTC drugs. Methods: The data were collected at the hospital in Svitavy and at the Department of occupational medicine in Svitavy. The interviews were performed in April and July 2013. The data were analysed and described by means of the frequency analysis in Microsoft Excel 2007. Results: The answers were obtained from 169 respondents (44,0 % women and 56,0 % men). The average age of the patients was 50 years. 54,0 % of the patients preferred self-medication before the visit of the doctor. 85,0 % of the patients used at least one OTC drug in the last year. 77,0 % of the patients agreed with the statement that the self-medication could have some risks. The...

Attention should be paid to pharmacotherapy in the orthopedic department mainly because patients at this department make up a risky group, they are older and often tend to use more types of drugs at the same time. Nursing at the orthopedic department is both mentally and physically demanding. Nurses administer medication to patients throughout the whole day, that is why lack of certain medication may occur in this department, the same way they would with all routine procedures. Be it conscious or unconscious. The thesis sets its objective to map out the issue of pharmacotherapy in the orthopedic department. Further, to map out factors that may influence the origin of complications when administering medication to patients in the orthopedic deartment, and suggest improvements in the process of pharmacotherapy in the orthopedic department. A qualitative research via participant observation and semi-structured interviews carried out with the nurses and patients of the orthopedic department, was used. The results of this survey prove that nurses do have basic theoretical knowledge in the area of pharmacotherapy. At the same time certain shortcomings were discovered, i.e. this theoretical knowledge is not being applied in practice. Most surprising were the results in the area of patient identification before administering medication, this step not always being abode by the nurses as a part of medical error prevention. Quite on the contrary, it can be said, based on the results, that nurses do have excellent knowledge and skills in pain reduction. This is proven by both participant observation and the happiness of patients themselves. Partial results have been presented at a seminar in the orthopedic department, and they have been passed on to the management of this department. The resulting shortcomings have been used as aid material. The diploma thesis was written so as to serve as material of information to beginner or existing nurses at the orthopedic department as well.

BACKGROUND: Despite the high number of methamphetamine users in the Czech Republic, the treatment is still only abstinent. Pharmacotherapy in terms of substitution treatment is not yet in place. No study has yet been conducted to examine the views of workers working with methamphetamine users on the possibility of introducing substitution treatment for methamphetamine dependence in the Czech Republic. OBJECTIVE: The aim of the practical part was to map the opinions of outpatient staff on the possibility of introducing substitution treatment for methamphetamine dependence. The monitored area included the evaluation of the success of the treatment of methamphetamine dependence in outpatient settings, disparity in working with users by substance use, percentage of methamphetamine users in the facilities, the suitability of drug addiction to methamphetamine for clients of outpatient facilities and position of substitution treatment for methamphetamine, according to respondents. METHOD: The sample was elected on the basis of deliberate targeted selection through the institutions. Data capture was performed using a semi-structured interview method, which was recorded using audio recording and then transcribed. The data capture method was used to analyze the data. FILES: The research team consisted of...

Institution/department: Charles University, Faculty of Pharmacy in Hradec Kralove, Department of Social and Clinical Pharmacy Title of diploma thesis: The rational use of proton pump inhibitors among geriatric patients in the Czech Republic Supervisor: Assoc. Prof. Daniela Fialova, PharmDr. Ph.D. Author: Ivana Geletova Introduction: The dynamic process of ageing requires adequate attention at a global level, mainly in the area of providing a proper healthcare. Ageing process is specific by significant involutional changes and is often complicated by higher polymorbidity and polypharmacotherapy. Therefore, it is necessary to eliminate the negative impact of possible drug-related and nondrug-related risk factors and to ensure the rational use of medicines. Proton pump inhibitors (PPIs) are one of the most frequently prescribed classes of drugs in older adults, administered especially for the treatment of gastrointestinal tract (GIT) disorders associated with increased secretion of gastric acid and/or impairment of GIT or as a preventive treatment of potential drug-related and other gastropathies. This diploma thesis focused on evaluating the prevalence of use of PPIs among geriatric patients in acute, ambulatory and pharmacy settings of healthcare in the Czech Republic, in the EUROAGEISM H2020...

Institution/department: Charles University, Faculty of Pharmacy in Hradec Kralove, Department of Social and Clinical Pharmacy Title of diploma thesis: Evaluation of the rationality of prescribing of selected potentially inappropriate medications in ambulatory geriatric patients Supervisor: Assoc. Prof. Daniela Fialova, PharmDr. Ph.D. Author: Roman Lestina Introduction: Rational therapy in the geriatric population is an essential area due to the ever-increasing percentage of geriatric patients in the population. Due to the frequent polypharmacotherapy in these patients, including possible polypragmatism, it is important to constantly monitor potential drug problems and address potential drug risks in a timely manner. As an auxiliary tool in rational geriatric pharmacotherapy, expert groups have defined many potentially inappropriate medications (PIMs), which often contribute to drug reactions in the elderly, and which should be given more attention in clinical practice. This diploma thesis focused on 10 selected, most frequently used PIMs in the geriatric outpatient clinic of the University Hospital in Hradec Králové, and its aim was to monitor how often these drugs are prescribed in high-risk situations in geriatric patients (i.e., in the presence of symptoms, laboratory results and diseases, which...

Title: The Use of Physiotherapy in Spasticity Management Objectives: The purpose of this thesis is to provide a summary of present findings on spasticity, with particular regard to its pathophysiological mechanisms and clinical manifestations, and to present an overview of medical and physiotherapeutic approaches applied in its treatment. Furthermore, it aims at making a research in physiotherapeutic methods and techniques used for reduction of spasticity. The thesis shall present relevant studies, provide their comparison and critically evaluate the effect of methods and techniques examined in them. Methods: This thesis is a descriptive analysis based on a literature review. Results: Based on the research findings, it may be concluded that physiotherapy has proven to be effective in reducing spasticity. However, it is not possible to determine whether the techniques to reduce spasticity are more effective than techniques without this primary purpose. The examined studies have shown that the choice of physiotherapeutic practices to reduce spasticity was not influenced by disease etiology. Moreover, the same techniques and methods were applied in pediatric and adult patients, regardless of diagnosis. The relationship between reduced spasticity and change in motor function is unclear and our research...

55 Abstract Frequency of selected genetic polymorphisms of cytochrome P450 in the Czech population and the influence of CYP2C9 genotype on the hypolipidemic effect of fluvastatin Introduction: One of the main factors of genetically determined variability in response of humans to administered drugs are differences in catalytic activity of metabolizing enzymes, which are caused mainly by genetic polymorphisms in cytochrom P450 family enzymes. This thesis consists of two parts and it is presented as a commentary to the original papers. The first aim was to investigate the frequency of functionally important variant alleles of three main isoenzymes of cytochrome P450 gene: CYP2D6, CYP2C9, CYP2C19, throughout the Czech population, predict the prevalence of poor metabolizer phenotypes, and then to compare the results to the data from other populations. Secondly, we analysed the correlation between the CYP2C9 genotype and cholesterol-lowering effect of fluvastatin in human hypercholesterolemic patients. Methods: Genotypes were determined by PCR-RFLP. The presence of alleles CYP2D6*1, *6, *5, *4, *3, and gene duplication was analysed in 233 healthy volunteers, CYP2C9*1, *2 and*3 in 254 subjects and CYP2C19*1, *2 and *2 in 218 subjects. Eighty seven patients on fluvastatin therapy, and 48 patients on monotherapy...

55 Abstract Frequency of selected genetic polymorphisms of cytochrome P450 in the Czech population and the influence of CYP2C9 genotype on the hypolipidemic effect of fluvastatin Introduction: One of the main factors of genetically determined variability in response of humans to administered drugs are differences in catalytic activity of metabolizing enzymes, which are caused mainly by genetic polymorphisms in cytochrom P450 family enzymes. This thesis consists of two parts and it is presented as a commentary to the original papers. The first aim was to investigate the frequency of functionally important variant alleles of three main isoenzymes of cytochrome P450 gene: CYP2D6, CYP2C9, CYP2C19, throughout the Czech population, predict the prevalence of poor metabolizer phenotypes, and then to compare the results to the data from other populations. Secondly, we analysed the correlation between the CYP2C9 genotype and cholesterol-lowering effect of fluvastatin in human hypercholesterolemic patients. Methods: Genotypes were determined by PCR-RFLP. The presence of alleles CYP2D6*1, *6, *5, *4, *3, and gene duplication was analysed in 233 healthy volunteers, CYP2C9*1, *2 and*3 in 254 subjects and CYP2C19*1, *2 and *2 in 218 subjects. Eighty seven patients on fluvastatin therapy, and 48 patients on monotherapy...

The submitted thesis deals with the theme of a neurodegenerative autoimmune disease, the sclerosis multiplex. Although this serious disease has become an object of intensive research in recent decades and there is an inexhaustible quantity of literature available, we haven't yet fully identified the causes of this disease as well as we haven't found such kind of effective treatment that would lead to the permanent recovery of patients. I focused my interest on two main spheres: first, the description and comparison of practices in terms of pharmacotherapy giving priority to its benefits to patients, second, the view of another important but not always appreciated part of therapy, physiotherapy or rehabilitation; the main point is studying of processes and actions from the pedagogical point of view.

The aim of this dissertation thesis was to study the factors affecting drug distribution and elimination and to use these factors to individualize dosing. The work consists of three thematic areas: estimation of the volume of distribution and subsequent dosing of selected drugs (vancomycin, amikacin, phenobarbital) using body size descriptors; estimation of clearance and subsequent dosing of selected drugs (vancomycin, amikacin, phenobarbital, perindopril) using renal function status markers; and the impact of drug interactions on the distribution and elimination of phenobarbital. The thesis summarizes original papers on these topics. Individual pharmacokinetic parameters were calculated for each patient based on their demographic and clinical characteristics, dosing records and measured serum drug levels. The relationships between distribution volume/drug clearance and body size descriptors/renal functional status markers were examined by regression analysis. Vancomycin volume of distribution was best predicted by the total body weight. Loading dose of 10.7 mg/kg of total body weight was optimal in patients taking continuous vancomycin and would lead to reducing of median time to reach target concentrations from 17 to 1 hour. On the contrary, amikacin volume of distribution was most associated...