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Natrural substances with toxic and allergic activity
Rapiová, Vendula ; Tůmová, Lenka (advisor) ; Kašparová, Marie (referee)
Charles University, Faculty of Pharmacy in Hradec Králové Department of Pharmacognosy Supervisor: doc. PharmDr. Lenka Tůmová, CSc. Student: Vendula Rapiová Title of Thesis: Natural substances with toxic and allergic activity Keywords: medicinal plant, allergy, side effects, toxicity The connection between herbs and mankind dates to early ages and without discussion herbal remedies were the first one to put in use. We observe significant increase of herbal remedies used in paediatric patients in last decades. The goal of this work was set to examine available information about herbal safety. The list of herbs that are dangerous or inappropriate to use in children age was made. The herbs were grouped into simple classification system of herbal safety. In addition to chapters describing herbal safety the work contains knowledge about their general use in paediatrics phytotherapy, the pros and cons of their use. To gather the data of web research and scientific literature were employed. The analysed data were published between 1968-2017 and were collected using PubMed, ScienceDirect and Google Scholar. The rate of herbal safety is classified into five specific groups - A, B, C, S and X. The analysis of results shows that the biggest group with the most represented samples in class was the class C with...
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Attitudes of patients toward the antidepressant therapy
Dvořáčková, Vendula ; Herink, Josef (advisor) ; Vopršalová, Marie (referee)
Vendula Dvořáčková Attitudes of patients toward antidepressant medication Master's thesis Charles University in Prague, the Faculty of Pharmacy in Hradec Králové Department of Biological and Medical Sciences Pharmacy Background: The master's thesis deals with evaluation of attitudes of inpatients in the psychiatric clinic of Military University Hospital Prague. The main task was to clarify the relation between therapy attitude and the prescribed medication, diagnosis and sociodemographic characteristics. Methods: The data were collected using the Drug Attitude Inventory questionnaire (Czech version by Masopust) where sum of negative and positive answers was used to determine the patient's general attitude. Patients' characteristics were acquired from a data-entry form, specific medication from the medical records. Results: In the observed group women seemed to have a more positive attitude toward the treatment compared to men, similarly to people with a higher level of education and patients between 31 - 40 years of age in comparison with other age groups. The most positive responses were observed in patients who were prescribed agomelatine, trazodone and paroxetine. People diagnosed with personal disorders or affective bipolar disorder inclined to positive answers as well, on the other hand most negative...
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Side effects of selected nautral compounds.
Tzitzili, Eirini ; Tůmová, Lenka (advisor) ; Siatka, Tomáš (referee)
in English This thesis is a review of substances contained in medicinal plants, the side effects and complications that they provoke. The adverse drug reactions are directly related to the constituents contained in each plant. Information for this work was taken from sources published from 1965 until 2013, especially from The Essential Guide To Herbal Safety and from the databases webmd.com and ncbi.nlm.nih.gov. It is discussed how the use of natural medicinal drugs affect vital organs in the human organism and in which cases their consumption is contraindicated. Central nervous, cardiovascular, urinary, gastrointestinal, endocrine, haemopoietic, respiratory, urinary systems are affected and allergic reactions are possible to occur as complications. Hypericum perforatum is typical for causing gastrointestinal irritations and Chamaemelum nobile and Achillea millefolium are found to cause dermatic complications. Finally, Piper methysticum may induce extreme sedation, since it has anxiolytic and antiepileptic properties. Keywords: side effects, contraindications, medicinal plants, uses, constituents.
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The influence of individual genetic predisposition to the pharmacokinetics and pharmacodynamics of chosen opioids
Matoušková, Olga ; Perlík, František (advisor) ; Votava, Martin (referee) ; Mičuda, Stanislav (referee)
MUDr. Olga Matoušková - the dissertation theses The influence of individual genetic predisposition to the pharmacokinetics and pharmacodynamics of chosen opioids ABSTRACT Introduction: The aim of this thesis is to study the influence of polymorphism of CYP2D6 and MDR1 on the pharmacokinetics and pharmacodynamics of tramadol in healthy volunteers using measurement. A secondary objective is to evaluate these polymorphisms in relation to the analgesic efficacy and side effects of piritramide for acute postoperative pain. Materials and methods: In two prospective work studying the influence of genetic predisposition on the pharmacokinetic and pharmacodynamic parameters of tramadol, we included a total of 90 healthy volunteers. Clinical studies on opioid analgesia and influence of genetic predisposition to the pharmaco-therapeutic effects and side effects in patients with acute postoperative pain, we included a total of 161 patients with acute postoperative pain. Polymorphism genotyping CYP2D6 and MDR1 gene we performed PCR - RFLP analysis, to determine concentrations of tramadol and metabolite, we used gas and liquid chromatography and pharmacodynamic effects of opioids was evaluated by pupilometric measurement and visual analogue scale. Results and conclusion: Variability of the opioid effect is influenced by...
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Development of prostate cancer radiotherapy from the 80s to the present day
SUCHANOVÁ, Markéta
Prostate cancer (CaP) remains the most common cancer diagnosed in men. This desease has worldwide increasing incidence. In the Czech Republic incidence has tripled during the last 20 years. The increase of the mortality is much more slower, but CaP is still the third leading cause of cancer-related death in men. CaP treatment management options may include active surveillance, radical prostatectomy, brachytherapy and external beam radiation therapy. The radiotherapy occupies an irreplaceable position. It is used as a curative therapy for clinically localized CaP with a low and intermediate risk. In the case of high risk CaP and locally advanced tumors are often treated with the addition of the hormonal therapy, which enhances tumor control and overall patient's survival. The radiotherapy is also used in some cases as an adjuvant treatment following a radical prostatectomy, as well as a salvage therapy in a biochemical relapse or as a palliative treatment if the cancer progresses. The aim of this study is to provide an overview of the development of CaP radiotherapy from the 80s till the present day. The specific objective of the study is to assess the incidence of the radiation-related complications (RRC) in patients with CaP treated with IMRT and PT. Among the methods of processing this thesis was using secondary data analysis. Practical information were obtained during the visits to the Department of the Radiation Oncology at the Hospital Ceske Budejovice a.s. (NCB) and the Proton Therapy Center Czech s.r.o. (PTC). During these visits was observed the radiotherapeutic treatment of the patients with CaP and valuable information were obtained through interviews with Mrs.Vančurová, MD and Mr. Vítek, MD., Ph.D., MBA This study analysed the incidence of the acute and late RRC in patients with CaP treated in these facilities. The acute and late side effects was assessed for GU and GI toxicity using RTOG / EORTC score. The specific problems were measured with the CTCAE v.4.0 scale. The overall incidence of the RRC was subjected to the statistical hypothesis testing using a two-sample unpaired t-test. The examined sample consisted of the 30 patients with CaP irradiated at NCB and the 30 patients from PTC with low, intermediate and high risk CaP. It was found that for the patients from NCB the rectum mean dose was 40,7 Gy and the mean dose of bladder was 39,4 Gy. For the patients treated at PTC the mean dose to the rectum was 13,2 Gy and to the bladder 11.1 Gy. This is related to the incidence of the RRC. Acute GU and GI toxicities Grade 2+ occurred in 33 % and 23,3 % of the patients treated in NCB. With a median follow-up of 22 months there was late GU toxicity Grade 2+ in 13,3 %. Late GI toxicity Grade 2+ occurred in 26,7 %, which exceeds incidence of the RRC described in the literature. Incidence of late GI toxicity Grade 3 and 4 was also increased, it appeared in 10 % (3 patients). Furthermore in one case cancer reoccurred and metastasized one and half year after the radiotherapy. In PTC no acute or late Grade 3+ toxicities were observed. Acute GU and GI toxicities Grade 2 occurred in 13,3 % and 6,7 %. After median follow-up of 21,5 months there was incidence of late GI toxicity Grade 2 3,3 %, late GU toxicity appeared only Grade 1 in 13,3 %. There was found statistically significant difference in occurrence of RRC in patients treated in NCB and PTC. The hypothesis that PT reduces the incidence of the radiation side-effects compared to the IMRT technique in the patients with the prostate cancer was confirmed. The prostate can move greatly during the day. It is recommended using CBCT, which is part of new linear accelerators at NCB, to check the position of the prostate before each irradiation. This study provides an overview of the treatment of CaP and may serve to increase of awareness of the RRC. The main contribution can be seen in the comparison of a standard approach with a promising alternative.
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Using the IGRT and IMRT methods to treat prostate gland carcinoma and their side effects
KŘIVSKÁ, Klára
Prostatic carcinoma is a disease with a continuously increasing number of newly diagnosed cases all over the world. According to the commonly available statistic data it is the most frequent tumour disease of men. As far as oncological causes of death are concerned, it occupies the second place, after lung cancer. The situation in the Czech Republic corresponds to this trend. The incidence in this country has almost tripled in the last two decades. On the other hand, the number of deaths due to prostatic carcinoma decreases and it is approximately one third lower now. This very significant difference is given especially by the possibility of examination for the prostate-specific antigen (PSA) within the framework of preventive medical check-ups at general practitioners or at other specialists. The modern treatment of prostatic carcinoma, whether it concerns radical (curative) treatment or support (palliative) treatment, also has had an indisputable positive effect. According to the data obtained from the statistics managed by the National Cancer Registry from 2009, the number of newly diagnosed prostatic carcinomas in the Czech Republic reached 119.3 cases per 100,000 men. The death rate was 28.5 cases per 100,000 men. In conversion to absolute numbers from 2009 it means that 6154 men were diagnosed with a prostatic carcinoma and 1472 men died of it. Great success of modern treatment is confirmed also by a percentage expression of survival of patients after the end of treatment. In the time period of the last thirty years, the overall five-year survival for men with a prostatic carcinoma has increased from 68% to the current almost 100%. This means that an overwhelming majority of patients still live after five years from the diagnosis of their disease. Treatment of prostatic carcinoma has included the conform radiotherapy since the time of its introduction. The pioneers of this therapy are Japanese scientists Umegaki and Takahashi, who invented, in the 1960s, the first rotational conform radiation technology. It is more often associated with introduction of computer tomography (CT) into ordinary clinical practice. It was only in 1983 when a 3D planning system was presented, which then facilitated further development of tumour-conform radiotherapy. It was established that the doses from conventional techniques (e.g. a box) are not sufficient for the patients, do not lead to recovery and, quite on the contrary, they even increase the risk and major development of side effects. The advanced method of intensity-modulated radiation therapy (IMRT), which started to be applied in practice in the 1990s, achieved much better results. Besides a change in the beam shape it enables a change in the beam intensity as well. This can be achieved in cooperation with a multi-leaf collimator (MLC) which changes the shape of its lamellas dynamically and thus it modifies and transfers its beam. Method IMRT better and more accurately shaped beam and thereby more saving to surrounding healthy tissue
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Arrow poisons, their us in toxicology and medicine
BÁRTOVÁ, Lucie
Abstract The introduction of physiologically and therapeutically effective drugs in anaesthetic treatment has meant a significant change. Their discovery has thus contributed to a minimisation of their negative effects on a living organism. As a result, anaesthesiology has become more controllable and safer. These new drugs translate into more comfort for the patient in the course of anaesthesiology as well as his or her rapid recovery resulting in a shorter period of hospitalisation. The research of new physiologically and therapeutically effective substances is a pre-requisition of a potential higher standard of medical care. Older substances, e.g. Alkuronium and Gallamin, which, due to their undesirable effects, have come out of use, have lost their significance. Nowadays, these substances have been generally replaced by substances with an intermedial effect, e.g. Rokuronium and Cisatrakurium, which, compared with Alkuronium and Gallamin, show a minimum of undesirable effects. One of the foremost objectives of the current pharmaceutical research is to find a replacement of Sukcinylcholin, which, in spite of its known side effects, has had a non-substitutable position in urgent intubation. As a result, its use is limited to out-patient application and a certain selection of patient categories. Let us hope that we shall see a replacement of Sukcinylcholin being introduced in treatment in the near future. This would mean a final solution of problems arising from its side effects limiting its scope of application.
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Side Effects of Radiotherapy and Patients´ Awareness of these Effects
CHMELÍKOVÁ, Helena
Oncology diseases belong to one of the most serious worldwide health problems. Each third citizen of the Czech Republic has a malign tumour in the course of life. One of the main methods of oncology disease treatment is radiotherapy. Ionizing radiation is used for the treatment but it also brings some undesirable side effects. In the practical part I focused especially on patients´ awareness of undesirable side effects of the treatment. To gain information I elaborated a questionnaire, which was filled in by 250 patients from the whole Czech Republic. The research was anonymous for both patients and hospitals, where the research was carried out. The most of patients say that the gained information is sufficient. However, 57 per cent of patients add that they would appreciate more information from other resources, especially leaflets and the Internet. The other important part of the thesis is a leaflet which informs on radiotherapy itself and on side effects and possibilities of treatment.
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The application of opioids in crews of medical rescue service
MATOUŠEK, Jan
The aim set by this bachelor thesis is to survey the application of opioids in the emergency crews. To meet this objective, I posed two research questions. Research question Nr. 1: Are patients informed about the application of opioids? Research question Nr. 2: Do paramedics find out the effects of opioids administered to patients? Patients are entitled by law to information about administering any medicaments, according to Health Care of the Population Act. The back check of effects of medicaments administered is important for the check-up of the efficiency of the dose administered as well as the danger of undesired effects. Opioid substances are derived from morphine. Morphine, which is found in the juice of opium poppy, has been used throughout history to produce euphoric effects and especially as an analgesic. The reason for using analgesics is pain, and for that reason I explain here what pain is, how it is classified, measured and especially how it is soothed. Opioids are substances used for soothing severe pains for which non-opioid analgesics are insufficient. However, using these substances may result in addiction, and therefore manipulation with them is strictly controlled by law. To achieve the objective I conducted quantitative research, and data were collected by a secondary data analysis, the method of questioning and interview technique. Drawing on the research results that were obtained by observing paramedics and from interviews with their patients, it appears that it is necessary to inform patients that they are being administered an opioid substance. There are exceptional states when patients are not able to perceive such information and their consent to administering the medicine can be supposed. It was observed that paramedics make a back proof of the effects of the medicaments administered, and it was also found out that there are paramedics who, in the event that the dose of medicament is inefficient, do nothing more.
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