150 let České farmaceutické společnosti ČLS JEPJakou roli bude hrát lékárník v systému poskytování zdravotní péče?

prof. PharmDr. Martin Doležal, Ph.D.

Prakt. lékáren. 2021; 17(3): 143 | DOI: 10.36290/lek.2021.029  

Drug induced gynecomastia

Daniel Bobek, Martin Šíma, Ondřej Slanař

Prakt. lékáren. 2021; 17(3): 147-149 | DOI: 10.36290/lek.2021.030  

Gynecomastia is a common finding in a male population. Regarding the literature we can estimate that approximately 3-16 % of male population has drug induced gynecomastia. Drugs are causing gynecomastia by variety of mechanisms, some of them are yet to be found. It is not surprising that among hormonal medications there are plenty of drugs with gynecomastia as an adverse effect. Other well-known drugs which can induce gynecomastia are spironolactone, omeprazole, some calcium channel blockers, some antiretroviral drugs, some antipsychotics, ethanol and alkylating agents. There are also lot of drugs which are speculated to cause a gynecomastia, however...

Intravitreal implants for the treatment of uveitides

Michaela Brichová

Prakt. lékáren. 2021; 17(3): 150-152 | DOI: 10.36290/lek.2021.031  

Intravitreal implants are used to treat uveitides either alone or in combination with systemic therapy. In the case of corticoid implants (dexamethasone, fluocinolone acetonide), they significantly reduce the need for systemic therapy and thus the frequency of side effects. Ganciclovir implant in cytomegalovirus retinitis eliminates the need for repeated intravitreal injections. The benefits of this form of treatment significantly outweigh the risk and severity of local side effects (cataract, glaucoma, retinal detachment).

Treatment options for pharmacoresistant depression in routine clinical practice

Eva Češková, Petr Šilhán

Prakt. lékáren. 2021; 17(3): 153-156  

Most psychiatrists consider depression to be pharmacoresistant in the setting of an inadequate response to two adequate antidepressant courses. For research purposes and for the testing of various pharmacotherapeutic strategies, several models involving more degrees of pharmacoresistance have been proposed. The present article deals with the treatment options for pharmacoresistant depression in routine clinical practice. They include antidepressant switching, augmentation, and combinations. In patients with severe depression and suicidality, fast-acting antidepressants are an option. The most widespread method of augmentation is that with second-generation...

Vitamins D, C and zinc are essential for function of immune system and enhancement of protective immunity

Jan Krejsek

Prakt. lékáren. 2021; 17(3): 158-162 | DOI: 10.36290/lek.2021.033  

The immune system is an integral part of protective inflammatory response with aims to eliminate invasion of pathogenic microorganisms and to eliminate self tissue damage. The potential to participate in protective immune reaction is given to all body cells. The protective strategy is multilevels. The first line is physiological microbiota which is inhabiting all epithelial structures of our body and skin. The second line is formed by epithelial linings which are interacting with both physiological microbiota and components of immunity. The third line of defence is innate immunity including its cellular substrate, namely dendritic cells, macrophages,...

Treatment of multiple sclerosis from the pharmacist´s perspective

Miroslav Turjap, Olga Nedopílková

Prakt. lékáren. 2021; 17(3): e03-e14 | DOI: 10.36290/lek.2021.040  

Multiple sclerosis (MS) is an autoimmune chronic progressive inflammatory disease of the CNS that results in irreversible damage to axons and myelin with atrophy of the brain and spinal cord, resulting in gradual disability. The treatment of patients suffering from MS in the Czech Republic is concentrated in 15 highly specialized MS centres. MS is treatable in most patients, and timely treatment can delay disease progression and improve patients' quality of life. Pharmacotherapy is an essential modality in the treatment of MS. This article provides brief information on the treatment of multiple sclerosis from the pharmacist´s perspective. More space...

Drug interactions in preoperative examination of urologic pacient

MUDr. Ekaterina Sabitova

Prakt. lékáren. 2021; 17(3): e15-e21  

Urologic pacients required multifactorial pharmacological treatment. In perioperative periode increasing number of concomitantly taken medications elevate the risk of drug interactions. Drug interaction is changing of the effekt of a one drug by another drug or substance. According to the causing mechanism, drug interactions are divided into farmaceutical, farmakokinetic a farmakodynamic. Drug interactions can result in serios reduction of therapeutical effekt or increasing of drugs concentracion with its toxic effekt. Urolog should be informed about potential dangerous drugs combination and try to predict them.

Pharmacokinetic and pharmacodynamic interactions of antiepileptic drugs

Milan Grundmann, Ivana Kacířová

Prakt. lékáren. 2021; 17(3): e22-e34  

Approximately 30 % of patients with epilepsy are refractory to monotherapy and are invariably prescribed two or more antiepileptic drugs to control seizures. Because of the long-term nature of epilepsy treatment, it is inevitable that patients will be prescribed nonepilepsy drugs to treat comorbidities. Furthermore, patients with epilepsy may use over-the-counter medications. For these reasons, the propensity of drug-drug interactions is high.

Modern trends in pharmacological treatment heart failure

Jiří Vítovec, Jindřich Špinar, Lenka Špinarová

Prakt. lékáren. 2021; 17(3): e35-e43  

ACE inhibitors and betablockers are the cornerstone of the treatment of heart failure, MRA should be added. Angiotensin receptor blockers (ARB) are indicated in the case of ACE inhibitors intolerance.  Renin angiotensin blockers and betablockers should be given in maximal tolerated doses. Diuretics are given to the symptoms relieve – dyspnoe or oedema. Digoxin is indicated in selected patients. There are 3 new promising groups of drugs: 1. Angiotensin Receptor-Neprilysin Inhibitor – ARNI – Sacubitril/Valsartan can replace the ACE-I according to the results of the PARADIGM-HF trial.  2. Sodium–glucose co-transporter-2 (SGLT2)...

Curcumin - what we already know and what is promising

Helena Nejezchlebová, Tereza Svěchotová, Soňa Ševelová, Monika Dušková, Alena Žákovská

Prakt. lékáren. 2021; 17(3): e44-e52 | DOI: 10.36290/lek.2021.044  

Curcumin and its related compounds in the rhizome of the turmeric plant (Curcuma longa L.) bring multiple benefits for the organism. Anti-inflammatory and antioxidant properties of curcumin are considered to be the most important. There are reports confirming the preventive and ameliorating effects of this substance against different adverse health complications. Studies with focus on the management of the covid-19 disease also raise hope. However, curcumin is still contraindicated in pregnant women. New formulations that improve the bioavailability of this substance further enhance the potential of curcumin.

Technology and preparation of radiopharmaceutical preparations at the departments of nuclear medicine

Andrej Kováčik, Barbora Vraníková, Kateřina Žilková

Prakt. lékáren. 2021; 17(3): 171-174 | DOI: 10.36290/lek.2021.035  

Radiopharmaceuticals represent a unique group of pharmaceutical preparations. They contain at least one radioactive isotope carrying the desired effect, and, therefore, radiopharmaceuticals are used mainly in diagnostics. This article aims to describe the methods used to obtain radionuclides suitable for nuclear medicine, to define the possible administration routes of radiopharmaceuticals, and to introduce the preparation of sterile radiopharmaceuticals at departments of nuclear medicine.

The role of systemic and local therapy in the self-treatment of hemorrhoidal disease in relation to its symptomatology

Ondřej Šimandl

Prakt. lékáren. 2021; 17(3): 175-182 | DOI: 10.36290/lek.2021.036  

We currently speak of hemorrhoidal disease as a disease of civilization. According to statistics, more than half of the population of industrialized countries suffers from the disease associated with this disease at least once in their lifetime. Despite the fact that the therapy of hemorrhoidal disease should be started only after a clinical examination by a doctor, the varied symptomatology of this disease brings patients to the pharmacy before the doctor's office. The article therefore aims to introduce the reader to the current possibilities of self-treatment of this disease and to acquaint him with recent recommendations of the European Proctological...

Cosmetic preparations in the care of incontinence patients

Barbora Vraníková, Andrej Kováčik, Petra Svačinová

Prakt. lékáren. 2021; 17(3): 184-188 | DOI: 10.36290/lek.2021.037  

Up to 47 % of Czech and Slovak patients with involuntary leakage of urine or stool suffer from accompanying skin manifestations, such as sores or incontinence dermatitis. Moreover, the prevalence and severity of dermal manifestations triple in patients with reduced mobility. Therefore, regular and sufficient hygiene of incontinent patients' intimate parts is essential for improving their comfort and quality of life. This article, which loosely follows up a series of articles on medical devices, aims to provide an overview of cosmetics specifically designed for incontinent patients, focusing on practical advice on their use and proper hygiene.

Classification and basic usage principles of preparations against sweating

Andrej Kováčik, Barbora Vraníková, Georgios Paraskevopoulos

Prakt. lékáren. 2021; 17(3): 189-192 | DOI: 10.36290/lek.2021.038  

Sweating is a physiological process by which the body manages water and minerals, secures the thermoregulation, and maintains the acidic pH of the skin. Excessive sweat production can cause considerable patients´ discomfort, mainly due to the occurrence of unpleasant odour. This article provides an overview of cosmetic/medical preparations that eliminate odour (deodorants) or reduce the extent of sweating (antiperspirants, antihidrotics) with a particular focus on their proper application.

Musculoskeletal pain: an overview of OTC topical medicinal products

Petra Matalová

Prakt. lékáren. 2021; 17(3): 193-196 | DOI: 10.36290/lek.2021.039  

Musculoskeletal disorders associated with pain are among the most common health problems faced by the human population. Topical medicinal products are a suitable form of products intended for pain management which also reduce the rates of adverse effects of the drug delivered. The choice of a topical dosage form should reflect the patient's needs and allow comfortable application. The portfolio of products for local treatment of musculoskeletal pain is broad, giving an opportunity to choose a convenient product with properties that enable comfortable application according to patient preferences and needs.

Drug problems associated with male lower urinary tract symptoms therapy

Alena Pilková, Jan Miloslav Hartinger, Petra Hrnčířová

Prakt. lékáren. 2021; 17(3): 164-169 | DOI: 10.36290/lek.2021.034  

Male urinary tract symptoms (M-LUTS) belong to common complaints that are treated with drugs from several pharmacotherapeutic groups, with different mechanism of action, different mechanism of adverse affects and associated potential drug related problems. When choosing a suitable drug, it is necessary to assess patients´ general health status and concomitant medication, in order to minimize the risk of adverse effects in predisposed individuals. The text presented here summarizes current approach to the pharmacotherapy of M-LUTS and in several case reports demonstrates possible drug-related problems associated with this therapy.