Prevalence lékových interakcí v populaci kriticky nemocných je vysoká, ale často se jedná o potenciální lékové interakce s omezenou klinickou významností. Cílem tohoto sdělení je popsat mechanismus a management nikoliv nejčastějších, ale dle autorů klinicky nejvýznamnějších interakcí. Do přehledu jsme zahrnuli interakci karbapenemů a valproátu, inhibitorů CYP 3A4 a tikagreloru, enterální výživy a levodopy, kombinace léčiv prodlužujících QT interval a inhibitorů CYP 3A4 a kvetiapinu.
The prevalence of drug interactions in the critically ill is high, but these are often potential drug interactions of limited clinical relevance. This paper aims to describe the mechanism and management of not the most frequent but, according to the authors, the most clinically significant interactions. These top five interactions include carbapenems and valproate, CYP 3A4 inhibitors and ticagrelor, enteral nutrition and levodopa, combinations of QT prolonging drugs, and CYP 3A4 inhibitors and quetiapine.
- MeSH
- Enteral Nutrition MeSH
- Cytochrome P-450 CYP3A Inhibitors pharmacology MeSH
- Carbapenems pharmacokinetics pharmacology adverse effects MeSH
- Valproic Acid pharmacokinetics pharmacology MeSH
- Drug Interactions * MeSH
- Levodopa pharmacokinetics pharmacology MeSH
- Humans MeSH
- Drug-Related Side Effects and Adverse Reactions prevention & control MeSH
- Quetiapine Fumarate pharmacology MeSH
- Long QT Syndrome chemically induced etiology MeSH
- Ticagrelor pharmacology adverse effects MeSH
- Check Tag
- Humans MeSH
BACKGROUND: To assess whether hypoxia, as can be found in obstructive sleep apnea syndrome, is causally associated with the development of heart failure through a direct effect on calcium leakage from the sarcoplasmic reticulum. METHODS: The impact of hypoxia on sarcoplasmic reticulum calcium leakage and expres- sion of RyR2 (ryanodine receptor2) and SERC2a (sarcoplasmic reticulum Ca2+ATPase 2a) was investigated together with the outcomes of JTV-519 and S107 treatment. HL-1 car- diomyocytes were cultured for 7 days on gas-permeable cultureware under control (12% O2) or hypoxic (1% O2) conditions with or without JTV-519 or S107. SRCL was assessed using a Fluo-5N probe. Gene and protein expression was analyzed using qPCR and western blotting. RESULTS: Hypoxic exposure increased sarcoplasmic reticulum calcium leakage by 39% and reduced RyR2 gene expression by 52%. No effect on RyR2 protein expression was observed. Treatment with 1μM JTV-519 reduced sarcoplasmic reticulum calcium leakage by 52% and 35% under control and hypoxic conditions, respectively. Administration of 1 μM JTV-519 increased RyR2 gene expression by 89% in control conditions. No effect on SRCL, RyR2, or SERC2a gene, or protein expression was observed with S107 treatment. CONCLUSION: Hypoxia increased sarcoplasmic reticulum calcium leakage which was ame- liorated by JTV-519 treatment independently of gene or protein expression. JTV-519 rep- resents a possible treatment for obstructive sleep apnea-associated HF.
Autoři prezentují svoje zkušenosti s emočně nestabilními adolescentními pacienty, s projevy sebepoškozování a suicidálního chování, případně dalšími psychopatologickými symptomy. Diskutují otázky osobnostního vývoje v adolescenci, rizikové okolnosti, které projevy emoční nestability zhoršují, a zabývají se možnostmi terapeutického ovlivnění.
The authors present their experiences with emotionally instable adolescent patients, with signs harm and suicidal behavior, possibly with other psychopatological symptoms. They discuss the issues of development in adolescence, risk circumstances that intensify the manifestations of emotional instability and discuss the possibilities of therapeutic influence.
- MeSH
- Aripiprazole therapeutic use MeSH
- Fluoxetine therapeutic use MeSH
- Borderline Personality Disorder * diagnosis therapy MeSH
- Family Conflict psychology MeSH
- Humans MeSH
- Adolescent MeSH
- Suicide, Attempted * MeSH
- Quetiapine Fumarate therapeutic use MeSH
- Self Mutilation therapy MeSH
- Sertraline therapeutic use MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Antipsychotic Agents pharmacology therapeutic use MeSH
- Adult MeSH
- Risk Assessment MeSH
- Remission Induction MeSH
- Cardiometabolic Risk Factors MeSH
- Humans MeSH
- Lurasidone Hydrochloride pharmacology therapeutic use MeSH
- Metabolic Side Effects of Drugs and Substances MeSH
- Adolescent MeSH
- Quetiapine Fumarate pharmacology therapeutic use MeSH
- Recurrence MeSH
- Schizophrenia * drug therapy classification MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
- Publication type
- Newspaper Article MeSH
- MeSH
- Antipsychotic Agents * adverse effects MeSH
- Adult MeSH
- Humans MeSH
- Quetiapine Fumarate administration & dosage therapeutic use MeSH
- Activated Protein C Resistance etiology complications MeSH
- Risk Factors MeSH
- Schizophrenia drug therapy complications MeSH
- Thromboembolism * chemically induced prevention & control therapy MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Antidepressive Agents pharmacology therapeutic use MeSH
- Antipsychotic Agents pharmacokinetics pharmacology adverse effects MeSH
- Depressive Disorder drug therapy complications MeSH
- Flupenthixol administration & dosage adverse effects MeSH
- Middle Aged MeSH
- Humans MeSH
- Neuroleptic Malignant Syndrome diagnosis etiology drug therapy MeSH
- Parkinson Disease * diagnosis drug therapy complications MeSH
- Parkinsonian Disorders * etiology drug therapy complications MeSH
- Psychotic Disorders drug therapy complications MeSH
- Quetiapine Fumarate pharmacology MeSH
- Anxiety Disorders drug therapy complications MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
Psychóza pri Parkinsonovej chorobe sa manifestuje najčastejšie zrakovými halucináciami a bludmi u pacientov s Parkinsonovou chorobou. Výskyt iných typov halucinácií je omnoho nižší a môže poukazovať na inú diagnózu. Zriedkavo sa u pacientov môžu vyskytnúť bimodálne halucinácie. V našej kazuistike prezentujeme prípad pacientky s Parkinsonovou chorobou, u ktorej sa popri zrakových halucináciách vyskytovali súčasne aj sluchové halucinácie, ktorých príčinou je vzácny atypický Charles Bonnetov syndróm vznikajúci pri dlhodobej a závažnej poruche sluchu.
Psychosis in Parkinson´s disease manifests most often with visual hallucinations and delusions in people with Parkinson´s disease. Prevalence of other forms of hallucinations is much lower and may suggest an alternative diagnosis. Rarely bimodal hallucinations can occur. We report a case of a patient with Parkinson´s disease with visual hallucinations along with coexisting auditory hallucinations which are caused by rare atypical Charles Bonnet syndrome arising from longstanding and profound deafness.
- MeSH
- Antiparkinson Agents administration & dosage MeSH
- Hallucinations physiopathology therapy MeSH
- Comorbidity MeSH
- Humans MeSH
- Parkinson Disease * diagnosis drug therapy complications MeSH
- Psychotic Disorders diagnosis etiology MeSH
- Quetiapine Fumarate administration & dosage MeSH
- Risk Factors MeSH
- Aged MeSH
- Charles Bonnet Syndrome * diagnosis complications physiopathology therapy MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Quetiapin je atypické antipsychotikum, které je účinné a dobře snášené v léčbě schizofrenie a afektivních poruch. V článku na základě několika kazuistik ukazujeme jeho terapeutický potenciál v léčbě těchto psychických poruch včetně doporučeného dávkování u jednotlivých diagnostických okruhů.
Quetiapine is an atypic antipsychotic which is effective and well tolerated in the treatment of schizophrenia and affective disorders. There are several case-reports which describe typical quea-tipine use including doses in various diagnosis in this article.
- MeSH
- Antipsychotic Agents administration & dosage therapeutic use MeSH
- Depressive Disorder drug therapy MeSH
- Humans MeSH
- Quetiapine Fumarate * administration & dosage therapeutic use MeSH
- Schizophrenia drug therapy MeSH
- Phobia, Social drug therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Case Reports MeSH
- Review MeSH
Pacienti s Parkinsonovou nemocí (PN), která je častou neurodegenerativní poruchou, trpí nejen poruchami hybnostmi, ale též duševními poruchami, včetně poruch chování a psychózou. Tyto poruchy jsou těsně spojeny s dopaminergní léčbou PN. I když příznaky těchto poruch jsou známy, řada pacientů pravděpodobně není včas diagnostikována. Dalším problémem jsou lékové interakce, neboť pacienti s PN jsou léčeni pro přidružená onemocnění obvykle jinými lékaři, kteří si nemusejí být vždy vědomi lékových interakcí antiparkinsonik nebo antipsychotik s jinými běžně předepisovanými léky. Tento článek seznamuje lékařskou veřejnost s těmito problémy a ukazuje možná řešení.
Patients with Parkinson´s disease (PN), a common neurodegenerative disorder, suffer not only from movement disorder, but also from mental disorders including behavioral disorders and psychosis. These disorders are closely related to dopaminergic treatment of PN. Despite knowledge of the clinical features of these disorders, many patients may not be diagnosed in time. Another issue are drug-drug interactions, because patients with PN are treated for associated diseases usually by other physicians, who may not always be aware, that the antiparkinsonian or antipsychotic drugs interact with other commonly prescribed drugs. This article introduces the medical public to these problems and shows possible solutions.
- MeSH
- Antiparkinson Agents * pharmacology classification therapeutic use MeSH
- Antipsychotic Agents classification adverse effects therapeutic use MeSH
- Mental Disorders etiology drug therapy pathology MeSH
- Drug Therapy, Combination MeSH
- Drug Interactions * MeSH
- Humans MeSH
- Parkinson Disease drug therapy complications psychology MeSH
- Quetiapine Fumarate adverse effects therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Pacienti s Parkinsonovou nemocí (PN), která je častou neurodegenerativní poruchou, trpí nejen poruchami hybnosti, ale též duševními poruchami, včetně poruch chování a psychózou. Tyto poruchy jsou těsně spojeny s dopaminergní léčbou PN. I když příznaky těchto poruch jsou známy, řada pacientů pravděpodobně není včas diagnostikována. Dalším problémem jsou lékové interakce, neboť pacienti s PN jsou léčeni pro přidružená onemocnění obvykle jinými lékaři, kteří si nemusejí být vždy vědomi lékových interakcí antiparkinsonik nebo antipsychotik s jinými běžně předepisovanými léky. Tento článek seznamuje lékařskou veřejnost s těmito problémy a ukazuje možná řešení.
Patients with Parkinson´s disease (PN), a common neurodegenerative disorder, suffer not only from movement disorder, but also from mental disorders including behavioral disorders and psychosis. These disorders are closely related to dopaminergic treatment of PN. Despite knowledge of the clinical features of these disorders, many patients may not be diagnosed in time. Another issue are drug-drug interactions, because patients with PN are treated for associated diseases usually by other physicians, who may not always be aware, that the antiparkinsonian or antipsychotic drugs interact with other commonly prescribed drugs. This article introduces the medical public to these problems and shows possible solutions.
- MeSH
- Antiparkinson Agents * pharmacology classification therapeutic use MeSH
- Antipsychotic Agents classification adverse effects therapeutic use MeSH
- Drug Therapy, Combination MeSH
- Drug Interactions * MeSH
- Humans MeSH
- Parkinson Disease * drug therapy complications psychology MeSH
- Quetiapine Fumarate adverse effects therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
