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Pain treatment in cancer patients
Blažková, Marie ; Hrdina, Radomír (referee) ; Pourová, Jana (advisor)
Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of pharmacology and toxikology Candidate: Marie Blažková Supervisor: PharmDr. Jana Pourová Ph.D. Title of diploma thesis: Pain treatment in cancer patients. Cancer pain therapy is not directed against the primary disease, but strongly increases the quality of patient's life. The main aim of this thesis was to summarize pharmacological groups and substances used for this purpose. The basic groups being used for the therapy of cancer pain are opioid and non opioid analgetics. These analgesics are usually administered repetitively, sometimes in combination. The dose interval depends on pharmacologic properties of each drug, the drug form and on the patient's state. Generally, a non invasive way of administration is prefered for long term therapy, e.g. transdermal or oral drug forms are convenient. The drug forms with long lasting effect can be combined with drug forms with immediate release of the active substance (e.g. transdermal plaster and syrup or intranasal spray) for a sufficient control of the treatment of variable intensity of pain ("breaktrough" pain). The adjuvant analgesics (e.g. neuroleptics, anticonvulsants) are used in the treatment of some specific types of pains (neuropathic pain, bone pain, etc.). In some...
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Treatment of peptic ulcer
Sakač, Jiří ; Hrdina, Radomír (referee) ; Tilšer, Ivan (advisor)
Topic: Treatment of peptic ulcers Autor: Jiří Sakač Peptic ulcers represent one of the most widespread gastrointestinal disease all over the world. It occurs the most in the middle and high aged people. It is a multifactorial disease, which is developed by dysbalanc between agresive and protective factors. Its occurrence and incidence is associated with presence of the infection Helicobacter pylori in gastrointestinal tract. H. pylori is the main risk faktor for a diverse spectrum of gastrointestinal diseases, and it makes first damage of mucous membrane. Comprehensive individual treatment consist of non-pharmacological lifestyle modification and pharmacological treatment. In the treatment, there are used drugs, which inhibite secretions of the agresive hydrochloric acid (H2-receptor antagonist, proton pumps inhibitors), cytoprotective drugs (sucralfat, bismut`s salts, syntetic analogs of prostaglandins) and drugs for eradication of H. pylori - antibiotics and chemoterapeutics. Accurate diagnosis, timely and efective treatment reduce a risk of recurrence and the complications; which can endanger patient's life (bleeding, penetration, perforation); and they can accelerate final healing most of the ulcers.
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Current possibilities of the treatment of psoriasis
Zápotočný, Martin ; Kudláčková, Zděnka (referee) ; Hrdina, Radomír (advisor)
Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Pharmacology and Toxicology Candidate: Martin Zápotočný Supervisor: Doc. MUDr. Radomír Hrdina, CSc. Title of diploma thesis: Current possibilities of treatment of psoriasis Psoriasis is an uninfectious disease with a genetic predisposition. There are several types of psoriasis. Therapy is heterogenous with a different efficiency. A topical, physical and systemic treatments are used. Topical treatment is a basic treatment for psoriasis. There are keratolytics, emollients, topical corticosteroids, whose prolonged use may cause adverse effects. A vitamin D3 analogue, retinoids and cignoline are also parts of topical treatment. Physical treatment, mainly phototherapy, has thanks to its unique photobiological effect unsubstituable role in a psoriasis treatment. Recently phototherapy and photochemotherapy have been classified on the same level as systemic treatment. For cases that do not respond on standard local treatment and phototherapy, systemic treatment is reserved. We can differ drugs of the 1st line: acitretin, cyclosporine A, methotrexate and drugs of the 2nd line, that are biologics. Biopharmaceuticals present safer and more accurate interference into the pathophysiological processes of psoriasis. The aim of this...
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Effectiveness of venlafaxine in the treatment of depression
Dagisová, Ruta ; Hrdina, Radomír (advisor) ; Herink, Josef (referee)
5 ABSTRACT The objective of this analysis was to determine the efficacy and acceptability of venlafaxine in comparison with that of placebo and other antidepressants in the treatment of major depression by pooling short-term clinical trials with in-patients and out-patients. Randomised controlled trials were identified by searching of databases Pub-Med Medline and Embase. In metaanalysis were combined 15 trials, three of them were controlled by placebo and 12 by reference drugs. Clinical trials had to use either HAM-D, MADRS or the CGI-I scales as their primary outcome measure and reported response rates, defined as 50% or greater decrease in depression severity (according to the HAM-D and MADRS) or score 1 (very improved) or 2 (improved) (according to the CGI-I scale) from baseline to endpoint. Acceptability to patients was assessed by comparison of total drop-outs in two arms of the trials. For each efficacy variable (e.g. rating scales HAM-D, MADRS and CGI) and for subgroups of placebo and reference drugs were conducted partial analysis. The statistical analysis of data-sets was performed with statistical program MIX, version 1.54. To estimate size-effect was calculated parameter relative risk (RR) and to determine its reliability was 95% confidence interval was estimated. To compare response rates among...
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Antiaggregant Therapy and Possibility of its Monitoring in Ischaemic Heart Disease
Kašparová, Markéta ; Hrdina, Radomír (advisor) ; Gregor, Jaroslav (referee)
The effect of antiaggregation therapy is an important factor that can influence the risk of thromboembolic events. The methods of monitoring antiaggregation therapy we compared in our study. The aggregation with cationic propylgallate (CPG) as the activating substance, analyzer PFA-100, which investigates the function of primary haemostasis and measuring of TXB2 in the urine were used to monitor the effect of the therapy. The sufficient concentration of CPG (30 mol/l) in the aggregation study were confirmed. The influence of hospitalization and associated stress on the parameters of aggregation was not significant. However the decrease of parameter of aggregation (slope, %/min) after administration of a low dose of acetylsalicylic acid (ASA) was significant. The influence of stress linked to hospitalization on the detected closure time (CT), was not observed using PFA 100. Nevertheless antiaggregation therapy significantly prolonged CT measured on the collagen/epinephrine coated membrane. The concentration of the thromboxane B2 in the urine of patients treated with antiaggregation therapy was also significantly lower in the contrary to healthy donators. The methods reacted after administration of low doses ASA by modifying of measured parameters. Fifty one patients treated with long term...
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Review of the therapy of atopic dermatitis
Moravcová, Lucie ; Hrdina, Radomír (advisor) ; Jílek, Petr (referee)
REVIEW OF THE THERAPY OF ATOPIC DERMATITIS This dissertation shows the outline of present possibilities in the cure of atopic dermatitis with a view to new knowledge. The therapy's section is divided into the local therapy, system therapy and phototherapy. Every substance shows the principle of effect, averse effect, contra-indication, drug interaction and recommendation for which stadium of the illness should be indicated. Phototherapy deals with UVA, UVB and PUVA. The next part is about the most frequent complication of atopic dermatitis, the micro-organism colonized the skin. The last part shortly deals with the prevention of atopic dermatitis. The aim of the therapy of atopic dermatitis is to gain control over the symptomps of the illness and improve the life quality. The first choice's medicine are topic corticosteroids. Other posibility of choice are immunomodulators, pimecrolimus and tacrolimus. Very important is also using of emolients in all stadiums of the illness. The great hope for the therapy of AD represents inhibitors of phosphodiesterase, antagonists of leukotriene, interferon-γ, intravenous immunoglobulin and monoclonal antibodies.
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The study of cell adhesion molecule expression in blood vessels in rabbit model of anthracycline cardiotoxicity.
Bajerová, Monika ; Hrdina, Radomír (referee) ; Nachtigal, Petr (advisor)
The aim of this thesis was to evaluate possible changes of cell adhesion molecules expression in rabbit arteria femoralis sinistra after the administration of Daunorubicin. We focused on the expression of VCAM-1 and ICAM-1. Chronic anthracycline cardiotoxicity was induced by administration of daunorubicin (3 mg/kg=50 mg/m2 i.v., 1x week) for the period of 10 weeks. We focused on the monitoring VCAM-1 and ICAM-1 expression in rabbit left femoral artery. Ten daunorubicin group was compared with the control rabbits. The animals were killed 24 hours after the administration of daunorubicin. Immunohistochemical analysis showed no expression of VCAM-1 in any control or experimental groups. Very weak expression of VCAM-1 was detected in control and experimental groups. However we can not propose, that this expression might not have any biological effect. In conclusion the administration of daunorubicin did not affect either VCAM-1 or ICAM-1 expression in rabbit left femoral artery suggesting that endothelial dysfunction in this artery is not triggered by daunorubicin treatment in vivo.
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Severe gastrointestinal bleeding in association in myocardical infarction treatment.
Fukanová, Lenka ; Kudláčková, Zděnka (advisor) ; Hrdina, Radomír (referee)
Author: Lenka Fukanová Title: Severe gastrointestinal bleeding in association in myocardical infarction treatment Diploma thesis Charles University in Prague Pharmaceutical faculty in Hradec Králové Study field: Pharmacy ABSTRACT Objective: One of severe complications during the treatment of myocardial infarction can be haemorrhage into the digestive system. Aim of the study: Evaluation of gastrointestinal hemorrhage in association with different therapeutic strategies of myocardial infarction in the First Department of Internal Medicine Olomouc University Hospital. Methods: Retrospective analysis of patients suffering from myocardial infarction who started to bleed into gastrointestinal tract during the course of myocardial infarction. Administration of blood transfusion was criterion of significant hemorrhage. Data for processing were obtained from archives of the First Department of Internal Medicine as well as from Olomouc University Hospital information system and the Department of Blood Transfusion information system. The research was finally targeting 28 patients. Thirteen women (46.3 %) and fifteen men (53.57 %). The average age was 75.93. Results: There were 8911 patients with acute myocardial infarction in the First Department of Internal Medicine Olomouc University Hospital from 1998 to 2009....
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