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Open access

Alenka Marušič, Igor Locatelli and Aleš Mrhar

Farmakokinetika Penicilinskih Antibiotikov: Preklop iz Intravenske na Peroralno Terapijo

Penicilinski antibiotiki delujejo baktericidno in spadajo med časovno odvisne antibiotike. Za večino penicilinov je značilna kratka razpolovna doba eliminacije. Benzilpenicilini se po peroralni aplikaciji ne absorbirajo, ampicilin in kloksacilin se sicer absorbirata, vendar slabo, medtem ko se amoksicilin skoraj v celoti absorbira. Pri slednjem je smotrno z intravenske terapije preklopiti na peroralno, če lahko s peroralno aplikacijo dosežemo plazemske koncentracije penicilina, primerljive s tistimi po intravenski aplikaciji, t. j. enako povprečno plazemsko koncentracijo penicilina v stacionarnem stanju. Posledično lahko pričakujemo enako učinkovitost obeh aplikacij. Smiselnost preklopne terapije je treba proučiti predvsem s stališča bolnika, saj ni primerna za bolnike, ki so v kritičnem stanju in imajo močno zvišano telesno temperaturo ali malabsorbcijski sindrom. Prednost preklopne terapije pa je v tem, da zmanjša pojavnost flebitisa in seps. V članku sta obravnavana dva primera preklopne terapije. Na osnovi farmakokinetičnih simulacij in indeksov učinkovitosti protibakterijskega zdravljenja je pokazana primerljivost intravenske terapije z ampicilinom in peroralne terapije z amoksicilinom, medtem ko preklopna terapija pri zdravljenju osteomielitisa s kloksacilinom ostaja nedorečena. Na podlagi predstavljenih primerov članek ilustrativno prikazuje, da ustrezna razlaga farmakokinetičnih parametrov bistveno pripomore k pravočasnemu preklopu z intravenske na peroralno terapijo s penicilinom. Takšna terapija je bolniku bolj prijazna, poleg tega pa prispeva k zniževanju stroškov za zdravljenje z zdravili v bolnišnicah ob še vedno varni in učinkoviti farmakoterapiji bakterijskih okužb.

Open access

Andreja Čufar, Igor Locatelli and Aleš Mrhar

Abstract

It is essential to identify the expectations of physicians and nurses regarding clinical pharmacy (CP) services before its introduction in a hospital, because it is known that their expectations can substantially differ from the pharmacists’ point of view. Agreement of leading physicians, nurses and clinical pharmacists about the importance of CP activities in the hospital was evaluated using five point Likert scale questionnaire. Two groups of CP activities were set; the activities related to the hospital system (first group) and the activities connected with an individual patient (second group). Total mean score of agreement of physicians with the first and second group of CP activities is 4.28 and 3.73, respectively, while these scores are lower for nurses (3.87 and 3.38 for the first and second group, respectively). Pharmacists’ total mean scores are highest, 4.57 and 4.23 for the first and second group, respectively.

Open access

Nejc Horvat, Igor Locatelli, Mitja Kos and Ana Janežič

Abstract

This study evaluated medication adherence and health-related quality of life (HRQoL) of Slovenian patients with chronic obstructive pulmonary disease (COPD) and examined the factors associated with HRQoL. Demographic and therapy information was collected from 65 patients through interviews. The St. George’s Respiratory Questionnaire and the Morisky Medication Adherence Scale were used to evaluate HRQoL and adherence, resp. A multiple linear regression model was used to assess the association between the factors and HRQoL. The mean St. George’s Respiratory Questionnaire score (range 0-100, with higher scores indicating lower HRQoL) was 41.4. COPD affected patients’ daily activities more than their social and psychological functioning. Slightly more than 53 % of the patients were optimally adherent, while 12 % were non-adherent. Patients with lower HRQoL had a larger number of medications for concomitant diseases, experienced COPD exacerbation in the last year, and had less education. No statistically significant correlation was found between medication adherence and HRQoL.