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Drugs and possibility of their elimination in sewage waters
Křivánková, Zuzana ; Repková, Martina (referee) ; Vávrová, Milada (advisor)
This bachelor thesis deals with issue of increasing consumption of pharmaceuticals and its influence on the environment. In the Czech Republic the pharmaceuticals from the benzodiazepine group are still widely prescribed and used by patients. There was tracked four representatives of this group alprazolam, bromazepam, diazepam and oxazepam which are indicated for therapy of insomnia, psychiatric diseases but also like a general anesthetics or antiepileptics. Presence of this pharmaceuticals is being repeatedly confirmed in wastewaters and surface waters troughout the whole Europe and other developed countries even though their negative effects for the water ecosystem are known. The target od this thesis is to optimalizethe methods for determination of choosen pharmaceuticals in watewaters in Brno and surrounded area. There was also evaluatedthe hazard level for water ecosystem related to the presence of pharmaceuticals in target matrices which were the wastewaters from wastewater treatment plants in towns Brno – Modřice and from two another towns in south Moravia. Concentrations of the pharmaceuticals were tracked in the influents and effluents. The analytes were isolated from the matrices by solid-phase extraction (SPE) and quantificated by ultra-high performance liquid chromatography (UHPLC) with detection by the diode array (DAD).
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Co-use of opioid analgesics with alcohol and/or benzodiazepines in patients with chronic non-cancer pain
Nováková, Daniela ; Mravčík, Viktor (advisor) ; Koutská, Kateřina Olga (referee)
Background: The problem of the simultaneous use (co-use) of benzodiazepines (BZD) and/or alcohol in patients with a diagnosis of chronic non-cancer pain (CHNCP) using strong opioid analgesics (OA) is still poorly mapped in the Czech Republic. Aims: To map the prevalence of co-use of BZDs and alcohol among patients with CHNNB taking long-term prescription OA. To determine differences between co-using groups and not-co-using patients and to determine predictors of co-use. Design and setting: The research is based on a secondary analysis of data collected in the period from March 2019 to December 2019 in the form of an anonymous questionnaire survey among patients of nine pain treatment centers in the Czech Republic. For research purposes, clinical and sociodemographic data related to co-use obtained from a semi-structured (anamnestic) questionnaire and data from the standardized questionnaires Screener and Opioid Assessment for Patients with Pain (SOAPP-R), Opioid Risk Tool (ORT) and Emotional Thermometers (ET) were analyzed. Particpants: The sample consisted of 305 respondents older than 18 years with diagnosed chronic pain and treated with strong OA for at least three moths. Measurements: Descriptive analysis was performed using descriptive statistics methods. Mann- Whitney test, chi-square test,...
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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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Development of the circadian system after systemic potentiation of GABAergic transmission in early ontogenesis
Dušek, Jakub ; Bendová, Zdeňka (advisor) ; Mareš, Pavel (referee)
The circadian system is the evolutionary response of organisms to repetitive geophysical conditions and allows organisms to devote their energy to solving sudden changes. Although the circadian system developed to help organisms survive and thrive in dynamic conditions, system itself is sensitive to external changes. During critical developmental period of the mammalian CNS, the neonatal period, the circadian systém is significantly vulnerable. Benzodiazepines, pharmaceuticals widely prescribed for half a century, interfere with GABAergic transmission, which is critical type of signaling for the functioning of the circadian systém. The purpose of this thesis is to determine whether and how the development and functioning of the circadian system is altered after administration of a drug from the benzodiazepine class, clonazepam, during the critical developmental period. This thesis examines changes in the expression profile of selected genes in the hippocampus, olfactory bulb and frontal cortex of two ontogenetic stages of rats. Results of this work suggest that benzodiazepines administred in the neonatal period disrupt the development of the circadian system and that these changes, particularly in the hippocampus, persist for certain time. Key words: circadian system; circadian rhythms;...
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Rationality of benzodiazepines use in older patients
Magátová, Adriana ; Fialová, Daniela (advisor) ; Lukačišinová, Anna (referee)
Institution/department: Charles University, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy Title of diploma thesis: Rationality of benzodiazepine use in older patients Supervisor: Assoc. Prof. Daniela Fialová, PharmDr. Ph.D. Author: Adriana Magátová Introduction: Benzodiazepines are one of the most commonly prescribed potentially inappropriate drugs (PIMs) in geriatric patients in Europe and are responsible for common problems associated with risky drug prescription in older age (eg, cognitive impairment, falls, orthostatic hypotension, drug dependence, and others). Physiological and pathophysiological changes associated with the aging process, as well as frequent polymorbidity and polypharmacotherapy, are associated with more frequent occurrence of drug-related complications in older age. With the growing proportion of geriatric population, the importance of preventing drug complications in older adults increases. The aim of this study was to compare prescribing habits in the use of BZD and in the use of drug combinations with sedative potential and to determine the association of their use with drug-related risks in geriatric patients in community pharmacy practice in Spain (SP) and the Czech Republic (CZ) and in groups of patients assessed in various healthcare settings...
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Phytoextraction of benzodiazepines
Rychlovská, Kristýna ; Smrček, Stanislav (advisor) ; Soudek, Petr (referee)
The aim of this study was to carry out experiments with maize (Zea mays) for the purpose of finding out the efficiency of phytoextraction of chosen pharmaceuticals from the nutrient solution. The plants were cultivated for three weeks in a sterile environment. Then was added a nutrient solution enriched with chosen benzodiazepines - diazepam, flunitrazepam, nitrazepam and bromazepam - in concentration 5-10 mg/L. The samples from each plant were taken every day (24 hours) and then were analyzed with HPLC/UV. The efficiency of phytoextraction was evaluated in two ways. The first one as an percentage of a decrease of the concentration of the pharmaceuticals in the solution with time, the second one as an amount of phytoextracted pharmaceutical in milligrames per gram of the plant matter. From the standpoint of the decrease of the concentration was as the most efficient measured the phytoextraction of nitrazepam (74,7 %), less efficient diazepam and bromazepam (55,2 %, respectively 53,9 %) and the least efficient flunitrazepam (38,0 %). When converted to the mass of the plant matter the most efficient was found the phytoextraction of bromazepam (0,08 mg of drug to 1 gram of plant matter), lower efficiency by bromazepam and diazepam (both 0,02 mg) and the lowest again by flunitrazepam (0,01 mg). key...
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Evaluation of rationality and risks of pharmacotherapyin older patients in long-term care facilities
Lukačišinová, Anna ; Fialová, Daniela (advisor) ; Alušík, Štefan (referee) ; Paluch, Zoltán (referee)
Objectives Main objectives of this doctoral thesis were to review available information on pharmacological properties of benzodiazepines and their age-related changes; to evaluate the prevalence of benzodiazepine use in older patients residing in long term care facilities; to investigate the association between use of benzodiazepines and occurrence of falls in acutely hospitalized older patients; and to describe utilization of benzodiazepines in the Czech Republic. Methods A narrative review of literature focused on pharmacokinetics, pharmacodynamics, adverse effects and association of benzodiazepines with falls in older population was conducted. The evaluation of benzodiazepine use in long term care facilities was analysed in a retrospective cross-sectional study using data from the EC 7th Framework Program SHELTER project (Service and Health in the Elderly in Long Term Care). A prospective cohort study data of acutely hospitalized patients in Australia were used to evaluate association between benzodiazepines and falls. To describe utilization of benzodiazepines in the Czech Republic, data from the State Institute for Drug Control and from databases of General Health Insurance Fund were used. This dissertation thesis is a summary of published articles from above stated works and analyses. Results...
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Rationality of benzodiazepines use in older patients
Magátová, Adriana ; Fialová, Daniela (advisor) ; Lukačišinová, Anna (referee)
Institution/department: Charles University, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy Title of diploma thesis: Rationality of benzodiazepine use in older patients Supervisor: Assoc. Prof. Daniela Fialová, PharmDr. Ph.D. Author: Adriana Magátová Introduction: Benzodiazepines are one of the most commonly prescribed potentially inappropriate drugs (PIMs) in geriatric patients in Europe and are responsible for common problems associated with risky drug prescription in older age (eg, cognitive impairment, falls, orthostatic hypotension, drug dependence, and others). Physiological and pathophysiological changes associated with the aging process, as well as frequent polymorbidity and polypharmacotherapy, are associated with more frequent occurrence of drug-related complications in older age. With the growing proportion of geriatric population, the importance of preventing drug complications in older adults increases. The aim of this study was to compare prescribing habits in the use of BZD and in the use of drug combinations with sedative potential and to determine the association of their use with drug-related risks in geriatric patients in community pharmacy practice in Spain (SP) and the Czech Republic (CZ) and in groups of patients assessed in various healthcare settings...
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Benzodiazepine use in clients of harm reduction programs of SEMIRAMIS z.ú: questionnaire survey
Staš, Filip ; Vacek, Jaroslav (advisor) ; Janíková, Barbara (referee)
BACKGROUND: Abuse of psychoactive drugs shows up to 900 thousand people in Czech Republic, benzodiazepine (further referred as BZD) alprazolam abuse up to 270 thousand people. This is a long-hidden and unresolved problem that also affects people who use drugs. AIMS: The aim of this work is to describe the occurrence of benzodiazepine use among the clients of outreach program and contact center SEMIRAMIS z.ú. To fulfill it, research questions were formulated with focus on prevalence of use, sources of BZD, patterns of their use, the occurrence of risk use of BZD and knowledge of the risks associated with BZD use. METHODS: Quantitative research using a standardized questionnaire was used for data collection and processing. Sample consisted of 79 respondents from clients of the above- mentioned programs using the method of self-selection and selection by judgment. The obtained data were processed using coding, qualitative data from open questions were subjected to basic qualitative analysis. Sorted data were then analyzed and compared using descriptive-statistical methods. MAIN RESULTS: Lifetime prevalence of benzodiazepine use was 67 %, in the last year 37 % of respondents used BZD. 31 % of respondents use them daily or at least once a week. The most commonly used was Rivotril. 44 % of respondents...
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Evaluation of rationality and risks of pharmacotherapy in older patients in long-term care facilities
Lukačišinová, Anna ; Fialová, Daniela (advisor) ; Alušík, Štefan (referee) ; Paluch, Zoltán (referee)
Objectives Main objectives of this doctoral thesis were to review available information on pharmacological properties of benzodiazepines and their age-related changes; to evaluate the prevalence of benzodiazepine use in older patients residing in long term care facilities; to investigate the association between use of benzodiazepines and occurrence of falls in acutely hospitalized older patients; and to describe utilization of benzodiazepines in the Czech Republic. Methods A narrative review of literature focused on pharmacokinetics, pharmacodynamics, adverse effects and association of benzodiazepines with falls in older population was conducted. The evaluation of benzodiazepine use in long term care facilities was analysed in a retrospective cross-sectional study using data from the EC 7th Framework Program SHELTER project (Service and Health in the Elderly in Long Term Care). A prospective cohort study data of acutely hospitalized patients in Australia were used to evaluate association between benzodiazepines and falls. To describe utilization of benzodiazepines in the Czech Republic, data from the State Institute for Drug Control and from databases of General Health Insurance Fund were used. This dissertation thesis is a summary of published articles from above stated works and analyses. Results...
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