BACKGROUND: Although biologic agents are very effective, long-term comparative studies demonstrating their safety relative to one another are still lacking. METHODS: A total of 124 patients with psoriasis were followed up for 30 months; 74 received anti-TNF-alpha inhibitors (adalimumab, etanercept, infliximab), 33 were on ustekinumab, and 17 were treated with secukinumab. The rates of adverse events in these groups were recorded and statistically analyzed. RESULTS: Infliximab-treated patients showed a high occurrence of asymptomatic, but increased liver enzymes, fatigue, and respiratory as well as dermatologic infections. Adalimumab-treated patients were more often affected by musculoskeletal disorders and infections of all types. Patients treated with secukinumab presented with higher rates of cardiovascular disorders as well as respiratory and dermatologic infections. The group receiving etanercept was more often diagnosed with musculoskeletal and reproductive disorders, specifically menstrual disorders. The rates of therapy discontinuation and serious adverse events did not reach statistically significant values. CONCLUSION: A higher incidence of adverse events was observed among adalimumab-, and infliximab-treated patients, with ustekinumab found to have the safest profile. Our results demonstrate that a personalized approach, including evaluation of a patient's risk profile, is necessary before commencing a biologic. Further research is warranted to confirm the findings of our study.
- MeSH
- Adalimumab * adverse effects therapeutic use MeSH
- Dermatologic Agents adverse effects therapeutic use MeSH
- Adult MeSH
- Etanercept * adverse effects therapeutic use MeSH
- Antibodies, Monoclonal, Humanized * adverse effects therapeutic use MeSH
- Infliximab * adverse effects therapeutic use MeSH
- Cohort Studies MeSH
- Middle Aged MeSH
- Humans MeSH
- Antibodies, Monoclonal adverse effects therapeutic use MeSH
- Prospective Studies MeSH
- Psoriasis * drug therapy MeSH
- Ustekinumab * therapeutic use adverse effects MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
OBJECTIVES: The aim of this review is to describe the effects of analgesics on sleep. DATA SOURCES: Systematic search of the databases of PubMed and the Cochrane Library was performed between January and September 2021. REVIEW/ANALYSIS METHODS: The search included all articles on the topic published during the past 20 years (2000-2020). The search strategy was developed using a controlled vocabulary of known studies meeting the inclusion criteria and focused on the following terms: chronic pain, pain, sleep disturbance, insomnia, analgesic, analgesic medication, antidepressants, antiepileptic drugs, nonsteroidal drugs, opioids, and quality of life. Two reviewers independently considered the studies for inclusion in the review, assessed the risk of bias, and extracted data. DESIGN: Review and analysis. RESULTS: A total of 37 studies met the inclusion criteria: 15 analyzed the effects of opioids, 6 those of nonsteroidal anti-inflammatory drugs and acetaminophen, and 16 the effects of adjuvant analgesics. CONCLUSIONS: Sleep quality may be adversely affected by a variety of medications used in clinical practice, including those used in analgesic indications. The class of analgesics most affecting sleep quality are opioids.
- MeSH
- Analgesics adverse effects MeSH
- Anti-Inflammatory Agents, Non-Steroidal therapeutic use MeSH
- Chronic Pain * drug therapy MeSH
- Quality of Life MeSH
- Humans MeSH
- Analgesics, Opioid adverse effects MeSH
- Sleep Initiation and Maintenance Disorders * drug therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Léky vyvolané perikarditidy nejsou časté, ale závažné onemocnění, protože případná tamponáda perikardu může ohrozit život pacienta. Vzhledem k tomu, že nabídka nových léků se neustále rozšiřuje, zvyšuje se i podíl léčiv schopných perikarditidu vyvolat. Autoři vyhodnotili práce s touto tematikou uvedené v databázi PubMed a doplnili informacemi z databáze VigiBase. Ve svém článku autoři uvádějí současné poznatky o mechanismech vzniku i stupni rizika vzniku léky vyvolané perikarditidy. Uvádějí relevantní informace o jednotlivých lécích rozdělených do sedmi skupin. U některých léčiv je riziko vzniku perikarditidy vysoké a při léčbě těmito přípravky je nutné toto riziko brát v úvahu.
Though not common, drug-induced pericarditis is a serious condition, since pericardial tamponade, should it develop, may be life-threatening. As the number of drugs is constantly expanding, so does the proportion of those capable of causing pericarditis. The authors reviewed the relevant literature in the PubMed database and complemented it with information from the VigiBase database. In their article, the authors present current knowledge about the mechanisms of origin and level of risk of drug-induced pericarditis and discuss relevant information on individual drugs divided into 7 classes. Some medicines are associated with a high risk of developing pericarditis, a fact to be taken into account when treating patients with these agents.
- Keywords
- ceritinib,
- MeSH
- Dasatinib adverse effects toxicity MeSH
- Protein Kinase Inhibitors adverse effects toxicity MeSH
- Clozapine adverse effects toxicity MeSH
- Humans MeSH
- Drug-Related Side Effects and Adverse Reactions MeSH
- Pentostatin adverse effects toxicity MeSH
- Pericarditis * chemically induced MeSH
- Sulfasalazine adverse effects toxicity MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
INTRODUCTION: Understanding how different comorbidities and epidemiological factors are related to psoriasis severity can help us estimating patients' clinical outcome. AIM: Establish possible prognostic factors of severe psoriasis. METHODS: Three groups of patients were included: 118 were on topical therapy, 83 used conventional systemic drugs, and 112 were treated with biological agents. Based on the fact that patients on topical therapy have a lower grade of disease severity than patients treated systemically, we compared a variety of comorbidities and epidemiological parameters between the three groups. RESULTS: Patients treated more aggressively have an increased risk of cardiovascular disease (p = .044), suffer more from depression (p = .020), hyperuricemia (p = .031) and nonspecific noninfectious liver disease (p = .005). Male gender (p < .001), increased height (p < .001), early age of disease onset (p < .001), viral upper respiratory infections (p = .049) and periods of hormonal changes (p = .045) are associated with these therapies. CONCLUSION: Psoriasis severity is directly related to an increased risk of cardiovascular disease, depression, hyperuricemia and nonspecific noninfectious liver disease. Male gender, increased height, early age of disease onset, viral upper respiratory infections and periods of hormonal changes seem to be prognostic of higher degrees of psoriasis severity. We are pioneering the use of increased height and puberty, menopause/andropause as independent prognostic factors of psoriasis severity.
- MeSH
- Biological Factors therapeutic use MeSH
- Dermatologic Agents * therapeutic use MeSH
- Hyperuricemia * drug therapy MeSH
- Respiratory Tract Infections * drug therapy MeSH
- Cardiovascular Diseases * epidemiology MeSH
- Humans MeSH
- Liver Diseases * drug therapy MeSH
- Psoriasis * drug therapy epidemiology MeSH
- Severity of Illness Index MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Acyclovir is an antiviral drug frequently used in clinical practice. It is indicated for the treatment of infections caused by herpes simplex virus and varicella zoster virus. The drug has a good safety profile; however, severe side effects may rarely occur during therapy. These include renal failure as a major risk factor for neurotoxic side effects potentially developing within 24-48 hours of therapy initiation. The paper presents the cases of two patients developing neurotoxic side effects while treated for herpes zoster. The aim of the authors is to highlight the potential for developing neurotoxic side effects in high-risk groups such as the elderly, patients with impaired renal function or multiple comorbidities on polypharmacy, or those using nephrotoxic drugs. Acyclovir use could lead to renal impairment and an increase in its plasma and CNS concentrations with severe neuropsychiatric side effects. The neurotoxic side effects are reversible after therapy withdrawal. Thus, in patients developing mental impairment or showing other neurological symptoms during acyclovir therapy, the patient should be promptly assessed for potential drug neurotoxicity, their therapy should be discontinued and drug elimination with forced diuresis or hemodialysis considered. Early recognition of acyclovir neurotoxic side effects can significantly improve a patient's prognosis.
BACKGROUND: The prevalence of cholelithiasis in developed countries is high and its cause is multifactorial, with a negligible proportion of drug-induced cholelithiasis. METHODS: Relevant studies were identified by PubMed, Google Scholar and Science Direct. Reference lists of retrieved articles were also reviewed. The most relevant and up-to-date information was incorporated. RESULTS: There is a wide range of drugs that can induce lithiasis. While the risk of developing lithiasis is high with some drugs (ceftriaxone, atazanavir, somatostatin analogues), it is lower or even questionable with others. Some drugs precipitate in the bile and may account for up to 100% of the weight of the stone. CONCLUSION: Cholelithiasis can be induced by a wide range of drugs with different mechanisms of action. The aim of the article is to draw attention to this lesser known fact and the need to take into account the risk of developing lithiasis prior to therapy initiation.
- MeSH
- Ceftriaxone adverse effects MeSH
- Cholelithiasis * chemically induced MeSH
- Humans MeSH
- Lithiasis * complications MeSH
- Bile MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Polymedikace je spojena s vyšším výskytem negativních zdravotních ukazatelů včetně pádů, morbidity i mortality. I přes vynakládanou snahu je řešení této problematiky stále neuspokojivé. Dvě hlavní příčiny polymedikace jsou stárnutí populace a její polymorbidita, a na druhé straně rozvoj farmakoprůmyslu a dostupnost širokého spektra léčiv. Obě příčiny, tj. stárnutí populace i dostupnost léčiv, mají každoročně stoupající trend. Autoři pojednávají o hlavních nedostatcích při zkoumání uvedené problematiky, jako jsou nejednotně používaná terminologie, metodologické nedostatky při získávání dat, neexistence doporučených postupů pro léčbu polymorbidních pacientů apod. Diskutují o tom, zda polymedikace je příčinou nebo markerem zvýšené křehkosti, pádů a mortality. V závěru kriticky hodnotí možné řešení polymedikace v budoucnu – personalizovanou medicínu.
Polymedication is associated with a higher incidence of negative health indicators including falls, morbidity and mortality. Despite efforts, the solution to this problem is still unsatisfactory. The two main causes of polymedication are population aging and polymorbidity and, on the other hand, the development of the pharmaceutical industry and the availability of a wide range of medicines. The authors discuss the main shortcomings in the investigation of this issue, such as inconsistent terminology used, methodological shortcomings in data acquisition, lack of recommended guidelines for the polymorbid patients treatment, etc. They discuss whether polymedication is the cause or marker of increased falls, frailty and mortality. In the end they critically evaluate possible solution of polymedication in future – personalised medicine.
- MeSH
- Precision Medicine MeSH
- Comorbidity MeSH
- Humans MeSH
- Polypharmacy * MeSH
- Practice Guidelines as Topic MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Agrimonia eupatoria L. is an herb of the Rosaceae family, widely used in traditional (folk) medicine for its beneficial effects. Its water extracts (infusions and decoctions) are used in the treatment of airway and urinary system diseases, digestive tract diseases, and chronic wounds. Phytochemical analyses of Agrimonia eupatoria L. identified a variety of bioactive compounds including tannins, flavonoids, phenolic acids, triterpenoids and volatile oils possessing antioxidant, immunomodulatory and antimicrobial activities. The authors review the available literature sources examining and discussing the therapeutic and pharmacological effects of Agrimonia eupatoria L. at the molecular level in vitro and in vivo.
- MeSH
- Agrimonia * chemistry MeSH
- Anti-Infective Agents isolation & purification therapeutic use MeSH
- Antioxidants isolation & purification therapeutic use MeSH
- Phytochemicals isolation & purification therapeutic use MeSH
- Immunologic Factors isolation & purification therapeutic use MeSH
- Humans MeSH
- Plant Extracts isolation & purification therapeutic use MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- Publication type
- Meeting Abstract MeSH
- Publication type
- Meeting Abstract MeSH
