- Publikační typ
- abstrakt z konference MeSH
The compliance of patients receiving long-term acetylsalicylic acid therapy was tested by determining plasma levels of salicylic acid by HPLC. The same determination was performed in a control group of untreated patients. Almost 20 % of the examined patients were not using the prescribed therapy.
Cíl práce: cílem práce bylo vyhodnotit výskyt neuropsychiatrických změn v souboru hospitalizovaných pacientů s patologickými koncentracemi digoxinu v plazmě a jejich korelaci s ostatními projevy digitalisové intoxikace. Použitá metoda: provedli jsme analýzu klinických a laboratorních údajů včetně farmakoterapie z dokumentace pacientů hospitalizovaných za posledních 36 měsíců. Výsledky: u 171 pacientů jsme zaznamenali plazmatické koncentrace nad 2 ng/ml, klinické projevy intoxikace jsme zjistili u 106 pacientů a byly vyjádřeny u všech s plazmatickou koncentrací nad 3 ng/ml. Neuropsychiatrické projevy jsme zaznamenali u 15 % pacientů s patologickými koncentracemi digoxinu v plazmě. Závěry: neuropsychiatrické projevy jsou nespecifické, jejich diagnóza může být obtížná, zejména u starých nemocných. Menší výskyt v našem souboru je dán retrospektivním hodnocením. Rizikovým faktorem intoxikace byl vysoký věk a porucha renálních funkcí. Vzhledem k současně užívaným lékům se na zvýšených koncentracích digoxinu mohly významně podílet lékové interakce.
Aim of study: The aim of the study was to determine the incidence of neuropsychiatric changes in a group of patients hospitalized with pathological plasma digoxin levels and to correlate these changes with other manifestations of digitalis intoxication. Method: We analyzed clinical and laboratory data including drug therapy data obtained from the medical records of patients hospitalized over the last 36 months. Results: Plasma digoxin levels above 2 ng/ml were seen in 171 patients, clinical manifestations of intoxication were demonstrated in 106 patients, and present in all patients with plasma levels above 3 ng/ml. Neuropsychiatric manifestations were noted in 15 % of all patients. Conclusions: Neuropsychiatric manifestations are not specific, and they may be difficult to diagnose, especially in elderly patients. Their lower incidence in our group of patients is due to the retrospective nature of our analysis. Risk factors of intoxication included very old age and renal dysfunction. Because of the concomitant use of drugs, drug interactions may have played a significant role in the elevated digoxin levels.
INTRODUCTION: Production of endothelial nitric oxide declines with advancing age. On the other hand, ageing itself is associated with a mild degree of chronic inflammation. Besides, asymptomatic infectious and non-infectious inflammation is frequent in old age. All this may lead to an increased formation of nitric oxide via inducible nitric oxide synthase. The plasma levels of nitric oxide metabolites in older age groups are not known. The aim of our study was to determine the plasma levels of metabolites of nitric oxide (nitrite and nitrate) and to correlate them with the levels of inflammation markers in clinically healthy individuals aged over 80. METHODS: The plasma levels of nitrite/nitrate as well as erythrocyte sedimentation rate, and the levels of C-reactive protein and tumor necrosis factor alpha were determined in a group of 30 clinically healthy individuals aged over 80 years. Results were compared with those obtained in a control group. RESULTS: Nitrate levels were increased and the levels of inflammation markers were significantly higher compared with those in a control group. CONCLUSIONS: The levels of nitric oxide metabolites in elderly, clinically healthy individuals may be increased due to inflammation (Tab. 2, Fig. 1, Ref. 32). F
AIM: The ineffectiveness of antiplatelet treatment with aspirin is a widely discussed problem today. It is usually described with individual diseases. In old age, the patient is polymorbid and uses numerous treatments. This work enquires into how polymorbidity and polymedication can have an influence on the anti-aggregation effect of aspirin. METHODS: A group of 508 patients, who used 100 mg aspirin daily, was examined. Clinical and laboratory tests were carried out on all, and pharmacotherapy analysis was conducted. Selected, concurrently used medicines were divided into 12 groups. Levels of 11-dehydrothromboxane B2 (11-dTxB2) in the first morning urine sample were examined in all cases. RESULTS: Of the 508 patients, 233 patients (46%) showed insufficient suppression of urinary thromboxanes. In the resistant group, a statistically significant negative correlation was found with a higher concentration of C-reactive protein and smoking, from co-morbidity with atrial fibrillation and ischemic cerebral stroke in the case history. The risk of ineffective anti-aggregation therapy is increased 1.8 times by smoking and 1.6 times by ischemic cerebral stroke. Every increase in C-reactive protein by one unit increases the ineffectiveness of anti-aggregation therapy by 1.3 times. From the field of pharmacotherapy, a significant positive statistical effect on treatment with statins and nitrates occurred, and a negative effect with digoxin. The possible effectiveness and ineffectiveness of anti-aggregation treatment were not, in this study, influenced to a statistically significant degree by the presence of ischemic coronary disease, ischemic diseases of the lower limbs, arterial hypertension, diabetes and heart failure. CONCLUSION: Anti-aggregation treatment with aspirin in doses of 100 mg per day is, for a major part of polymorbid patients, insufficient. The risk of ineffectiveness of the treatment is increased by smoking, increased levels of C-reactive protein, and from comorbidities of atrial fibrillation and ischemic cerebral stroke. From the point of view of concurrently used medicines, the risk is increased by treatment with digoxin and on the other hand, reduced by treatment with statins and nitrates.
- MeSH
- agregace trombocytů účinky léků MeSH
- aplikace orální MeSH
- Aspirin aplikace a dávkování terapeutické užití MeSH
- hemodynamika účinky léků MeSH
- inhibitory agregace trombocytů aplikace a dávkování terapeutické užití MeSH
- kardiovaskulární nemoci farmakoterapie krev patofyziologie MeSH
- lidé MeSH
- senioři MeSH
- výsledek terapie MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- srovnávací studie MeSH
- Publikační typ
- abstrakt z konference MeSH
