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Changes in renal functions in older age and adjustments of drug dosing in seniors
Sidorenko, Daria ; Fialová, Daniela (advisor) ; Pokladníková, Jitka (referee)
Institution/department: Charles University, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy Title of diploma thesis: Changes in renal functions in older age and adjustments of drug dosing in seniors Thesis supervisor: doc. PharmDr. Daniela Fialová, Ph.D. Thesis consultant: PharmDr. Eliška Dvořáčková, Ph.D. Author: Daria Sidorenko Introduction: Aging of the population is a natural process, when older age is often accompanied by a physiological or pathological decrease in renal functions. It is reported that at the age of 85 years and older, up to 50% of patients have a significant decrease in renal functioning, which requires adjustment of the dosage of drugs. Thus, the correct choice of drug regimen and dose adjustment of drugs in decreased renal functions is important especially in older age, when at the same time there is a more frequent occurrence of severe drug reactions caused also by other pharmacological changes and other risk factors. The aim of the thesis was to determine which drugs with the need for dose adjustment are most often prescribed in the Czech sample of patients of the EuroAgeism H2020 project, whether the dosage regimens for these drugs are correctly determined with respect to renal functions, and in which cases the most common drug errors...
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Evaluation of the rationality of prescribing of selected potentially inappropriate medications in ambulatory geriatric patients (II.)
Želivská, Nela ; Fialová, Daniela (advisor) ; Pokladníková, Jitka (referee)
Institution/Department: Charles University, Faculty of Pharmacy in Hradec Kralove, Department of Social and Clinical Pharmacy Title of diploma thesis: Evaluation of the rationality of prescribing of selected potentially inappropriate medications in ambulatory geriatric patients (II.) Diploma thesis supervisor: Assoc. Prof. Daniela Fialova, PharmDr. Ph.D. Author: Nela Zelivska Introduction: The percentage of geriatric patients in the population is constantly increasing, thus the importance and need for knowledge of rational geriatric pharmacotherapy in everyday clinical practice is also on the rise. Polymorbidity and polypharmacotherapy are very common in geriatric patients, for this reason it is also necessary to regularly review drug regimens in older age and address potential drug- related problems. Criteria for potentially inappropriate medications in the aged (PIMs) have been defined by expert groups as a helpful tool to improve the rationality of drug prescribing in older adults. The risks of PIMs in older patients often outweigh their benefits or there is insufficient scientific evidence of adequate efficacy/safety of these drugs in older adults, for which reason the use of PIMs in older patients should be limited and their rationality of prescribing regularly monitored. This diploma thesis...
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Evaluation of the use of anticholinergic drugs in older age
Ščešňák, Juraj ; Fialová, Daniela (advisor) ; Pokladníková, Jitka (referee)
Introduction Anticholinergic (ACH) medications and medications with partial anticholinergic activity (AA) are prescribed in older patients particularly for the treatment of psychiatric, gastrointestinal, and genitourinary disorders, but also for other disease conditions. AA of combined drug regimens leads to ACH burden, which should be reduced as much as possible in seniors to avoid worsening of geriatric syndromes and other negative health outcomes. The aim of this diploma thesis was, in the first part, to summarize and review all currently published original and modified ACH drug scales, and to create a simple comprehensive tool for the assessment of ACH drug burden in older adults useful not only in clinical practice, but also in research. Furthermore, the focus of this diploma thesis was to describe the prevalence of use of ACH drug regimens and to document associations between administration of AA drug regimens and health problems in geriatric patients. Methods In this study, the search was conducted in 4 different electronic databases: PubMed (N = 582), MEDLINE (N = 518), Scopus (N = 423), and Web of Science (N = 420) to identify all the ACH drug burden scales published between 2000-2022 and to compile a list of AA medication assessed by these scales. The search strategy was created by using...
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Patients experience of acupuncture treatment
Kameníková, Lucie ; Pokladníková, Jitka (advisor) ; Mencáková, Andrea (referee)
Charles University, Czech Republic, Faculty of Pharmacy in Hradec Králové Student: Lucie Kameníková Tutor: PharmDr. Jitka Pokladníková, Ph.D. Title of Diploma Thesis: Patients' experience with acupuncture treatment Background: Acupuncture, as well as other methods used in complementary and alternative medicine (CAM), are on the rise. So far, there has not been a study conducted in the Czech Republic which describes patients' awareness and experience with acupuncture and other CAM methods and their attitudes to future use of these methods after having been treated with them. Aim: The aim of the thesis was to evaluate the experience of patients suffering from migraines with acupuncture. The areas covered were the patients' awareness of acupuncture, their motivation to try acupuncture as an alternative treatment method, their experience with other CAM methods as well as the likelihood of them undergoing another acupuncture treatment in the future. Methods: Semi-structured interviews with selected patients were conducted between September 19th 2015 and May 18th 2016. The interviews were coded in MAXQDA 12 programme and then evaluated using the content analysis method. Results: The thesis identifies topics connected to patients' awareness of CAM including acupuncture. It also defines the reasons for...
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Ageing of the population and selected aspects of risky drug prescribing in senior age (II.)
Zpěváková, Gabriela ; Fialová, Daniela (advisor) ; Pokladníková, Jitka (referee)
Institution/department: Charles University, Faculty of Pharmacy in Hradec Kralove, Department of Social and Clinical Pharmacy Title of diploma thesis: Ageing of the population and selected aspects of risky drug prescribing in senior age (II.) Supervisor: Assoc. Prof. Daniela Fialova, PharmDr. Ph.D. Author: Gabriela Zpevakova INTRODUCTION: Ageing of the population in developed and developing countries is accompanied with increasing proportion of seniors. Because of age-related physiological and pathological changes, polymorbidity is very common in older patients and often accompanied with polypharmacy and higher risk of drug-drug interactions (DDIs). Moreover, age-related changes in drug pharmacokinetics and pharmacodynamics contribute to higher clinical significance of various DDIs. The aim of this diploma theis was to determine the prevalence and most common DDIs in the Czech sample of seniors assessed during the EuroAgeism H2020 project in three different settings of care - acute, ambulatory care and in community pharmacies. The secondary aim of the thesis was also to thoroughly describe mechanisms of most common DDIs, their clinical relevance and available evidence. METHODOLOGY: For determining the prevalence of DDIs we used Czech data of seniors 65+ (in total N=1602) collected during the...
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ANALYSIS OF PRESCRIBING OF BENZODIAZEPINES IN SENIORS IN THE EUROAGEISM 2020 PROJECT AND POSSIBILITIES OF THE USE OF DEPRESCRIBING METHODS
Balala, Kristián ; Fialová, Daniela (advisor) ; Pokladníková, Jitka (referee)
Introduction: These days we encounter the rising trend of population ageing. Seniors belong to group of patients with specific health-social needs, in which is necessary in following decades support more health care using knowledge of geriatric and gerontology. One of the new approaches, applied in geriatric, clinical pharmaceutical praxis, is the method of deprescribing as well, based on decreasing of drug burden in elderly. The goal of this diploma thesis was to evaluate rationality of benzodiazepine prescription (one of the most frequently used potentially inappropriate medication in elderly) of seniors in European group of EuroAgeism ESR7 H2020 project, especially taking BZD in non-geriatric doses, non-geriatric length of use and risky drug combinations. Another goal of thesis was to specify, how many seniors would be potentially indicated to the method of deprescribing, and how difficult it would be for application of this method due to difficulty of medication misconduct and expected success/failure of this method. Methodology: Data for this diploma thesis were collected between years 2019 and 2021 within the research project EUROAGEISM ESR7 H2020 based on the international cross-sectional study which was carried out in patients in age 65 years and more, examinated in regionally different...
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Evaluation of the racionality of pharmacotherapy in geriatric patients in ambulatory and acute care- analyses of pain treatment and use of opioids
Slaná, Adriana ; Fialová, Daniela (advisor) ; Pokladníková, Jitka (referee)
Institution/department: Charles University, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy Title of rigorous thesis: Evaluation of the rationality of pharmacotherapy in geriatric patients in ambulatory and acute care- analyses of pain treatments and use of opioids Supervisor: Assoc. Prof. Daniela Fialová, PharmDr. Ph.D. Author: Adriana Slaná Objectives: The core issue in geriatric treatment is the selection of the most appropriate and the safest drug regimen. Geriatric patients often suffer from multiple disorders and particularly seniors with unresolved pain tend to use polypharmacy, often irrationally. This study focused on the description of pain prevalence and use of opioids in seniors in two settings of care (acute and ambulatory care) in the Czech Republic and on analyses of negative outcomes associated with use of opioids in combined drug regimens. Methods: Data were collected during 2018-2019 in various healthcare facilities in the Czech Republic as the part of EUROAGEISM H2020 ESR7 project. Prospective study included assessments of 1152 patients who were 65 years or older in acute (N=589) or ambulatory (N= 563) care in 4 cities (Prague, Brno, Hradec Králové and Opava). Data were collected through the standardised questionnaire, using interviews with patients and...
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Ageing of the population and selected aspects of risky drug prescribing in senior age (II.)
Zpěváková, Gabriela ; Fialová, Daniela (advisor) ; Pokladníková, Jitka (referee)
Institution/department: Charles University, Faculty of Pharmacy in Hradec Kralove, Department of Social and Clinical Pharmacy Title of diploma thesis: Ageing of the population and selected aspects of risky drug prescribing in senior age (II.) Supervisor: Assoc. Prof. Daniela Fialova, PharmDr. Ph.D. Author: Gabriela Zpevakova INTRODUCTION: Ageing of the population in developed and developing countries is accompanied with increasing proportion of seniors. Because of age-related physiological and pathological changes, polymorbidity is very common in older patients and often accompanied with polypharmacy and higher risk of drug-drug interactions (DDIs). Moreover, age-related changes in drug pharmacokinetics and pharmacodynamics contribute to higher clinical significance of various DDIs. The aim of this diploma theis was to determine the prevalence and most common DDIs in the Czech sample of seniors assessed during the EuroAgeism H2020 project in three different settings of care - acute, ambulatory care and in community pharmacies. The secondary aim of the thesis was also to thoroughly describe mechanisms of most common DDIs, their clinical relevance and available evidence. METHODOLOGY: For determining the prevalence of DDIs we used Czech data of seniors 65+ (in total N=1602) collected during the...
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Allergics reactions to herbal medicines in childern
Meincke, Ricarda ; Pokladníková, Jitka (advisor) ; Marešová, Helena (referee)
Background: The use of herbal medicines in children and adolescents is continually on the rise. Contrary to popular belief, herbal products (HPs) are not always a safe alternative to conventional drugs and can cause a variety of adverse events such as severe and fatal allergic reactions. In regards to herbal medicine use in children, a recently published systematic review that searched PubMed, Embase, PsycINFO and AMED included 58 studies from 19 countries and found overall herbal lifetime use to be between 0.8-85.5 % and 2.2-8.9 % for current use. Unlike most synthetically produced drugs, the adverse event profile of such "natural" preparations in children has rarely been studied. To this date, effective systems that monitor adverse drug events (ADRs) and long term side effects associated with HPs are either non-existent or still developing in many countries. Due to insufficient and inconsistent ADR reporting, little is known about the ADR spectrum of herbals in pediatric patients. Awareness of the potential of HPs to cause ADRs, particularly in children and adolescents, needs to be increased and reporting to national pharmacovigilance centers (PVCs) reinforced. Objectives: This project analyzed the worldwide adverse event data for herbal drugs related to hypersensitivity reactions as recorded in...
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Hormonal Contraception - Users'Knowledge
Křiklánová, Jana ; Marešová, Helena (advisor) ; Pokladníková, Jitka (referee)
HORMONAL CONTRACEPTION - USERS̕ KNOWLEDGE Student: Křiklánová, J. Tutor: Marešová, H. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Czech Republic Introduction: Hormonal contraception is a broadly used and very reliable birth control method. Nonetheless, it is not entirely risk-free. This thesis deals with the awareness of those risks in women who are currently using hormonal contraception or have ever used it before. Aim of the thesis: The main aim was to determine the extent of the users' awareness of hormonal contraception and its risks, undesirable side effects and contraindications, as well as their source of information. Furthermore, the awareness of the environmental impact, the reasons for using hormonal contraception and user satisfaction were examined. Methodology: The research was carried out by means of online questionnaires, which were spread among current or former users of hormonal contraception regardless of age, educational background or place of residence. 148 completed questionnaires were gathered and the data which were obtained were statistically evaluated. Results: It was discovered that women feel informed (25 %) or rather informed (44,6 %) more often than uninformed; the most frequent source of information is patient...
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