[Polypragmasia and interdrug interactions as risk factors of falling in elderly patients.]

This article presents the results of the analysis of data from patients over 75 years of age from a multidisciplinary hospital with cardiovascular disease and comorbid conditions. Pharmacotherapy of gerontological patients with multiple risk factors for falls was analysed in terms of the presence of polypragmasy and drug-drug interactions hazardous to the risk of falls. In the group of patients who experienced a fall in hospital compared to patients without a fall, the prescription lists audit showed a predominance of medicines (drugs) and drug combinations compromised by an increased risk of this serious adverse event. An audit of prescriptions of patients at increased risk of falls as a means of combating polypharmacy and identifying drugs that may cause falls can be conducted using the «Traffic light classification of FRIDs¼ and drug checkers to identify clinically relevant combinations. The use of these clinical and pharmacological tools can improve the quality and safety of medical care in a hospital setting.

Peculiarities of Pharmacokinetics and Bioavailability of Some Cardiovascular Drugs under Conditions of Antiorthostatic Hypokinesia.

We studied pharmacokinetics and bioavailability of verapamil, propranolol, and ethacizine in healthy volunteers after single oral administration under normal conditions and on the second day of simulated antiorthostatic hypokinesia modeling some effects of microgravity. Under conditions of antiorthostatic hypokinesia, a tendency to a decrease in half-elimination period, mean retention time, and volume of distribution and an increase in the rate of absorption, ratio of maximum concentrations, and relative rate of absorption of verapamil and propranolol were revealed. For ethacizine, a statistically significant increase in the time of attaining maximum concentration and volume of distribution and a decrease in the maximum concentration, rate of absorption, ratio of maximum concentrations, and relative rate of absorption under conditions of antiorthostatic hypokinesia were found.

Experimental and Clinical Pharmacokinetics of Fluoxetine and Amitriptyline: Comparative Analysis and Possible Methods of Extrapolation.

The pharmacokinetics of two fluoxetine capsulated dosage forms and two amitriptyline tablet forms after a single oral intake was studied in dogs and healthy volunteers. High significant correlations were detected between plasma concentrations of fluoxetine (r=0.96, p<0.00001, n=11) and amitriptyline (r=0.78, p<0.0224, n=8) in dogs and volunteers. A correlation of medium strength (though insignificant) was detected between nortriptyline concentrations in the plasma of dogs and volunteers (r=0.69, p<0.199, n=5). The bioavailability parameters of the test drugs in dogs and volunteers did not differ. Similar trends of fluoxetine and amitriptyline pharmacokinetic parameters were revealed in volunteers and animals. Methods for extrapolation of experimental pharmacokinetics parameters of fluoxetine and amitriptyline obtained on dogs for humans are proposed and validated.

[Possibilities of pharmacokinetic modelling of venotonics illustrated by an example of flavonoids]. / Vozmozhnosti farmakokineticheskogo modelirovaniia venotonikov na primere flavonoidov.

Studying the structure of flavonoids, as well as the processes of their absorption, metabolism, distribution and elimination is of interest from the point of view of the inter- and intra-specific variability of pharmacokinetic parameters obtained both in laboratories and clinical conditions. Pharmacological application of flavonoids appears to be limited due to peculiarities of the structure and metabolism, thus requiring search for ways to improve their absorption. Discussed in the article are peculiarities of metabolism of flavonoids, methods of correcting the effect of variability of pharmacokinetic parameters on bioavailability and in the long run on realization of the clinical effect. The use of micronization is regarded as the most optimal and currently acceptable method of increasing bioavailability of flavonoids.

[Therapeutic Monitoring Plasma Imatinib to Improve Results of the Treatment of Chronic Myeloleukosis].

The achievement of early cytogenetic and molecular responses is the major objective of therapy and a main prerequisite for the favourable long-term outcome of the disease. The maintenance of dose intensity and management of adverse events are keys to successful treatment of chronic myeloid leukemia (CML) with imatinib. Therapeutic monitoring and testing the drug level in blood are the efficient tools for the treatment of patients with CML and can be usedfor analysis of treatment failure or suboptimal response to therapy, suspected noncompliance, drug interactions or unexpected adverse reactions.

[Psychopharmacotherapy for depression in rheumatic patients].

AIM: To study attitude towards the disease in rheumatic patients during antidepressant therapy and during further follow-up. SUBJECTS AND METHODS: Examinations were made in 122 patients with degenerative joint and vertebral column disease (DJVCD) and in 30 patients with rheumatoid arthritis (RA) and concomitant affective disorders during antidepressant therapy for 3 months. RESULTS: Statistically significant differences were found between all components of the type of attitude towards disease (TATD) in patients with DJVCD or RA before the use of antidepressants. In the patients with RA, the mean value of adaptive types of TATD was significantly lower and that of disadaptive types significantly higher. After 3 months of treatment, the TATD profiles came closer. Only three components (anosognosia, hypochondriasis, and dysphoria) in the pattern of TATD remained significantly different after 6-month therapy. CONCLUSION: According to the TATD data, both the patients with DJVCD and those with inflammatory diseases of the locomotor apparatus showed unidirectional changes in attitude towards disease with a significant increase in the adaptive components and a reduction in the disadaptive ones.

Experimental and clinical pharmacokinetics of amitryptiline: comparative analysis.

Pharmacokinetics of two amitriptyline tablets, Amitryptiline Nycomed and Amitryptiline, was investigated clinically and experimentally after a single oral dose of 50 mg. A statistically significant correlation between amitryptiline serum concentrations in dogs and healthy humans (r=0.683, p<0.006) was established. In humans, standartized values of peak concentration and area under the concentration curve were significantly higher, specific volume of distribution and total clearance were lower, and half-life and mean retention time were significantly higher than in dogs. Characteristics of apparent bioavailability in dogs and healthy people did not statistically differ.