Drugi naučni simpozijum Saveza farmaceutskih udruženja Srbije: Farmacija i priroda - kompleksne relacije i međusobni uticaji

From the idea of a pharmaceutical product, through the development of materials and technologies for their production, analysis, and control, application in different patient populations, to the proper disposal and destroying of pharmaceutical waste, everything is connected and has an impact on the soil, water, and air, as well as to all living beings on this planet. Intending to invite the colleagues to consider how their pharmacy practice, science, and education can impact nature and global environmental trends, Pharmaceutical Association of Serbia has organized the 2nd SFUS scientific symposium, entitled Pharmacy and the Nature - Complex Relations and Mutual Impacts on 28th October 2021, in the conference center of the Science and Technology Park Belgrade, with the presence of more than 60 participants. Within the Symposium, the introductory lecture was held by Prof. Dr. Nada Kovačević, along with eight invited lectures, three oral presentations, and thirty-two poster presentations.Od ideje za farmaceutski proizvod, preko razvoja materijala i tehnologija za njihovu proizvodnju, analizu i kontrolu, primene kod različitih populacija pacijenata, do pravilnog odlaganja i uništavanja iskorišćenog i neiskorišćenog materijala i proizvoda, sve je povezano i ima uticaj na zemlju, vodu i vazduh, kao i na sva živa bića na ovoj planeti. Sa ciljem da se bolje razmotri na koji način aktivnosti u okviru farmaceutske struke, nauke i obrazovanja mogu da utiču na prirodu i glabalna ekološka kretanja, održan je 2. naučni simpozijum pod naslovom Farmacija i priroda – kompleksne relacije i međusobni uticaji. Simpozijum je organizovao Savez farmaceutskih udruženja Srbije i održan je 28. oktobra 2021. godine u konferencijskom centru Naučno-tehnološkog parka Beograd, uz prisutvo više od 60 učesnika. U okviru Simpozijuma je održano jedno uvodno predavanje, osam predavanja po pozivu, tri usmena saopštenja i prikazane su trideset i dve poster prezentacije

Specifičnosti farmakokinetike kod starijih pacijenata

Aging represents a very complex biological process that implies specific changes in body composition and physiological functions. Aging can affect drug absorption, distribution, metabolism, and excretion leading to significant changes in plasma drug concentrations, and consequently in drug efficacy and safety profile. Since usually elderly patients suffer from different diseases which require polypharmacy, clinically significant drug interactions are common. When considering setting up the initial or modified drug regimen, individual pharmacokinetic parameters' values are needed. In this article, the newest information regarding clinical pharmacokinetics of drugs in geriatric population of patients is presented.Starenje predstavlja složen biološki proces, koji podrazumeva specifične promene u sastavu i fiziološkim funkcijama organizma. Starost može uticati na procese resorpcije, raspodele, metabolizma i izlučivanja leka uslovljavajući tako značajne promene u koncentraciji leka, a samim tim i promene u efikasnosti i bezbednosti terapije. Kako su u populaciji starijih pacijenata često prisutne pridružene bolesti, od kojih neke zahtevaju hroničnu terapiju, pacijenti su primorani na kombinovanu hroničnu terapiju, što povećava rizik od klinički značajnih interakcija lekova. Pri razmatranju potrebe za postavljanjem ili korigovanjem režima doziranja lekova, neophodna je procena individualnih vrednosti farmakokinetičkih parametara kod pacijenta. U ovom radu su predstavljena dosadašnja saznanja u oblasti kliničke farmakokinetike u gerijatrijskoj populaciji pacijenata

PROSTORNA I VREMENSKA VARIJABILNOST CVJETANJA HRASTA LUŽNJAKA (Quercus robur L.)

Climate change, as well as biotic and abiotic stress environmental factors and the exploitation of oak forests have the greatest impact in reducing the pedunculate oak areas. These factors on one side reduce the pedunculate oak living area, while on the other side they create unfavorable conditions for its renewal. In the last decades, there has been an attempt to change this situation, primarily by planting appropriate provenances and more resistant varieties. Knowledge of the phenological variability is one of the essential elements useful in separation of genotypes better adapted to changing environmental conditions.One of the phenological studies of the pedunculate oak implied the analysis of the pollination time as one of the intermediate phase of the flowering phenophase. Observations were carried out in two populations at two locations in the area of Belgrade (Serbia), "Ada Ciganlija" and "Bojčinska šuma", a total of 58 trees (29 trees per location) in three consecutive years (2004, 2005, 2006). According to the ANOVA results differences between locations and years were statistically significantly (all p <0.0001). Time of pollination in the location of "Bojčinska šuma" was earlier compared to location "Ada Ciganlija" in all three years of observation. The obtained time difference gives rise to the assumption that there are different varieties of the pedunculate oak: the "early" and the "late" one. According to the phenological pattern of population, the majority of trees maintain the same trend from year to year, i.e. remain in the same phenological group (labeled as "early", "average" and "late"), or change it for one phenological level, suggesting the genetic influence on the expression of this trait. Since those populations are located in similar environmental conditions, obtained differences between them can be regarded as a consequence of intraspecific variability of the pedunculate oak and of the genetic structure of population.U radu je analizirana individualna i populacijska varijabilnost polinacije kao međufaze fenofaze cvjetanja lužnjaka. Istraživanja su obavljena na 58 stabala u dvije populacije lužnjaka na dva lokaliteta na području Beograda (Srbija) tijekom tri uzastopne godine (2004, 2005, 2006). Populacije se nalaze u oblasti umjereno-kontinentalne klime, na staništima koja odgovaraju lužnjaku, mješovite su strukture, raznodobne, vegetativnog i sjemenog porjekla, starosti 60–120 g. Promatranje je vršeno jedanput tjedno u travnju/svibnju. Lužnjak na analiziranim lokalitetima, uzimajući u obzir sva stabla i godine promatranja, počinje cvjetati najranije 7. travnja a najkasnije 2. svibnja. Cvjetanje na lokalitetu "Bojčinska šuma" događa se oko tjedan dana ranije u odnosu na lokalitet "Ada Ciganlija". Statističkom obradom potvrđen je značajan učinak lokaliteta, godine i individue. Prema fenološkom obrascu populacija i podeli u odnosu na vrijeme cvjetanja, većina stabala na lokalitetu "Bojčinska šuma" pripada fenološkoj grupi "rani" lužnjak, a na lokalitetu "Ada Ciganlija" grupi "kasni" lužnjak. Tijekom godina promatranja, najveći broj stabala ostajao je u istoj fenološkoj grupi ili se mijenjao samo za jednu razinu. S obzirom da se populacije nalaze u sličnim sredinama i stanišnim uvjetima, dobivene razlike mogu se smatrati posljedicom unutarvrsne varijabilnosti lužnjaka i genetičke strukture populacije. Genetička stabilnost fenofaze cvjetanja korisna je u odabiru "ranih" i "kasnih" formi lužnjaka u procesu individualne selekcije pod utjecajem promjene klimatskih čimbenika

Farmakokinetika gastrointestinalnih lekova od značaja za racionalnu farmakoterapiju

Although much progress in the pharmacotherapeutic treatment of gastrointestinal diseases has been made during recent years, a lot of research is still needed in order to elucidate exact disease mechanisms, and to develop corresponding drugs. From the treatmens of Helicobacter pylori infections which are still far from ideal, through pharmacotherapy of irritable bowel syndrome which is not satisfactory, to directon for recognition and integration of important factors in pharmacotherapy of inflammatory bowel disease (genetic, infectious, immunologic and inflammatory), there are many open questions. The pharmacotherapy research today goes towards development of new drugs and vaccines based on the discovery of new receptors, appreciation of influence of important general and individual factors of diseases, as well as preventive and pharmacoeconomic treatment considerations. Pharmacokinetic principles considerations are necessary within all the pharmacotherapy ways, in order to develop drugs and drug products of better pharmacokinetics, and to provide individualized, effective and safe, as well as economic (rational) pharmacotherapy.Iako je tokom poslednjih godina učinjen veliki progres u farmakoterapiji gastrointestinalnih oboljenja, još uvek je potrebno mnogo istraživanja da bi se razjasnili egzaktni mehanizmi bolesti i razvili odgovarajući lekovi. Od tretmana infekcije sa Helicobacter pylori, koji se još uvek smatraju daleko od idealnih, preko farmakoterapije iritabilnog sindroma creva koja je nezadovoljavajuća, do usmeravanja na uvažavanje faktora značajnih za farmakoterapiju inflamatornog oboljenja creva (genetički, infektivni, imunološki i inflamatorni), još je mnogo otvorenih pitanja. Farmakoterapijska istraživanja danas idu u pravcu razvoja novih lekova i vakcina zasnovanih na otkriću novih receptora, uvažavanju uticaja značajnih opštih i individualnih faktora bolesti, kao i preventivnim i farmakoekonomskim razmatranjima lečenja. Razmatranje farmakokinetičkih principa je potrebno u okviru svih farmakoterapijskih pravaca, u cilju iznalaženja lekova i preparata bolje farmakokinetike i sprovođenja individualizovane, efikasne i bezbedne, kao i ekonomične (racionalne) farmakoterapije

Farmakokinetika inhalacionih kortikosteroida

The inhaled corticosteroids have improved asthma therapy significantly. The inhaled route allows the delivery of relatively small doses directly to the airway, providing a high local concentration and minimizing systemic adverse effects. Knowledge of pharmacokinetic properties of inhaled corticosteroids (deposition in respiratory system, rate of absorption, first-pass effect oral bioavailability, distribution and elimination) is a prerequisite for successful asthma therapy. Inhaled corticosteroids show various levels of oral bioavailability and significant differences in the rate of absorption. Rate of absorption is one of the most relevant properties of inhaled corticosteroids as it reflects pulmonary residence time and therefore duration of availability in the lungs. Significant hepatic first-pass metabolism of the swallowed dose of some corticosteroids (fluticasone propionate, budesonide) reduces oral bioavailability and systemic adverse effects. Pharmacokinetic properties could also be applied to predict and explain the systemic adverse effect profiles of inhaled corticosteroids. Taking into consideration the revealed differences in pharmacokinetic properties of inhaled corticosteroids enable individual therapeutic approach, better efficacy and safety of asthma treatment

Uloga farmaceuta u terapiji kardiovaskularnih bolesti

Sweeping changes continue to reshape the practice of pharmacy. The pharmacy professional needed today is a knowledgeable drug expert and skilled, persuasive communicator. Such pharmacist embraces a practice model-pharmacy care. Pharmacists play a major role in reducing the risk of vascular events via various interventions: promotion of health, prevention of disease, patient counseling for pharmacological and/or non-pharmacological treatment, support of adherence... Adherence to cardiovascular therapy is essential to optimal therapeutic outcomes. The common factors affecting adherence to cardiovascular therapy are: complexity of regimens, polypharmacy, frequent dosing times of some medicines, non-apparent effects on discontinuing medication, declined capability with increased age and patients health beliefs. The pivotal role of the pharmacist in optimizing adherence to cardiovascular therapy encompasses many actions: assessing the adherence problem, identifying predisposing factors, providing comprehensive counseling, and recommending specific adherence strategies targeted to the patient ,s needs

Farmakokinetički aspekti doziranja lekova u pedijatriji

Clinical trials in paediatric patients are limited due to certain practical, ethical and regulatory aspects. Accordingly, after performing pharmacokinetic (PK) and efficacy/safety clinical trials in adults, clinical trials in paediatrics might be carried on by taking into consideration physiological characteristics of neonates, infants, children and adolescents. Physiological changes are reflected in maturation of functional organs and they change PK processes in quantitatively and/or qualitatively manner in comparison to adults that affect drug dosing regimen. The major differences in PK are observed in neonates and infants, while PK in children and adolescents are approaching those in adults and they are easier to predict. When defining dosing regimen both PK characteristics of drug and specific pharmacodynamic features has to be considered. Values of PK parameters, as well as doses are usually based on age, body weight and body surface area. In clinical practice it is recognised concomitant use of age and body weight based dosing regimens. However, clinical practice revealed an evidence for the need to individually adjust dosing regimen to each patient according to his physiological and disease characteristics.Određena praktična, etička i regulatorna ograničenja postoje kada su u pitanju kliničke studije koje uključuju pedijatrijsku populaciju pacijenata. Zbog toga se studije uobičajeno sprovode nakon ispitane farmakokinetike (FK) i efikasnosti/bezbednosti leka u odraslih uz razmatranje fizioloških karakteristika novorođenčadi, odojčadi, dece i/ili adolescenata u zavisnosti od podgrupe pacijenata kojoj je lek namenjen. Fiziološki procesi koji obuhvataju sazrevanje funkcionalnih organa utiču na FK procese i njihov uticaj može biti kvantitativno i kvalitativno različit u odnosu na odrasle, utičući tako na režim doziranja leka. Najveće razlike u FK procesima u odnosu na odrasle pacijente uočene su kod novorođenih beba i odojčadi, dok se kod dece FK procesi približavaju procesima kod adolescenata i odraslih, i lakše ih je predvideti. Specifičnosti u FK leka neophodno je uzeti u obzir prilikom definisanja optimalnog režima doziranja leka, uz razmatranje eventualnih specifičnosti u farmakodinamici leka kod pedijatrijskih pacijenata. Vrednosti FK parametara i režimi doziranja se najčešće definišu na osnovu godina, telesne mase ili površine tela. U kliničkoj praksi se pri definisanju početnih režima doziranja leka koriste godine i telesna masa. Međutim, prepoznata je potreba da se pacijent prati i da se režim doziranja individualno prilagodi svakom pacijentu prema njegovim fiziološkim i karakteristikama bolesti

Gojaznost kao faktor farmakokinetičke varijabilnosti

Increased prevalence of obesity of the population in the recent years suggests that health professionals will be, in the near future, in a position to provide daily health care services to the obese patients. This population of patients represents a major challenge for health systems, because obese patients are, unfortunately, often excluded from the clinical trials during drug development, and the data on the pharmacokinetics (PK) and pharmacodynamics (PD) of drugs in this population of patients are scarce and incomplete. Since different degrees of obesity may qualitatively and/or quantitatively change the PK of drug, clearly there is a need for the descriptors of size of the organism that best describes the changes in the composition of the organism in obese patients. It is also necessary to define the scalar descriptor that gave the best prediction values of the key PK parameters dosage regimen. This paper provides an overview of the different ways to assess the degree of obesity that are legitimate from the aspects of the PK, then physiological changes that are reflected on the PK processes, and finally this paper gives the examples of individualization of dosage regimen of certain drugs in the obese patients.Povećana prevalenca gojaznosti stanovništva poslednjih godina ukazuje da će zdravstveni radnici u skoroj budućnosti biti u situaciji da svakodnevno pružaju usluge zdravstvene zaštite gojaznim pacijentima. Ova populacija pacijenata predstavlja veliki izazov za zdravstveni sistem, jer su nažalost gojazni pacijenti često isključeni iz kliničkih studija tokom razvoja leka, te su podaci o farmakokinetici (FK) i farmakodinamici (FD) lekova u ovoj populaciji pacijenata malobrojni i nepotpuni. Imajući u vidu činjenicu da različit stepen gojaznosti može na kvalitativno i/ili kvantitativno drugačiji način da utiče na FK karakteristike lekova, jasno se javlja potreba za poznavanjem deskriptora veličine organizma koji na najbolji način opisuje promene u sastavu organizma u gojaznih pacijenata. Takođe je neophodno poznavati koji bi skalarni deskriptor dao najbolje predviđanje vrednosti ključnih FK parametara režima doziranja. U ovom radu dat je osvrt na različite načine procene stepena gojaznosti koje su sa FK aspekta opravdane, potom patofiziološke promene kao rezultat gojaznosti koje se odražavaju na FK procese i na kraju rada su dati primeri individualizacije režima doziranja pojedinih lekova u gojaznih pacijenata

Farmaceutska zdravstvena zaštita kod starijih

Stariji pacijenti (≥65 godina starosti) primenjuju oko polovinu ukupno propisanih lekova. U ovoj populaciji je česta polipragmazija koja se definiše istovremenom primenom više od četiri leka ili primenom više lekova nego što je klinički opravdano. Kao posledica polipragmazije, neretko se javljaju problemi u farmakoterapiji poput niskog stepena adherence, povećane učestalosti neželjenih reakcija na lek i interakcija među lekovima. Pružanjem usluga zdravstvene zaštite, farmaceuti u značajnoj meri mogu pomoći gerijatrijskoj populaciji. Kvalitetna farmaceutska zdravstvena zaštita podrazumeva proveru indikacija za svaki lek koji pacijent primenjuje (odnosi se na propisane lekove i one koji se izdaju bez recepta), proveru potencijalnih interakcija, otkrivanje neželjenih reakcija i drugih problema koje pacijent može iskusiti. Otklanjanje navedenih problema i edukacija pacijenta o koristi, načinu primene, potencijalnim neželjenim reakcijama na lekove i prevenciji njihovih posledica značajno doprinosi poboljšanju ishoda terapije i kvaliteta života pacijenata

Pollen viability in Quercus robur L.

The variability of viability (germination rate and the length of pollen tubes) of fresh pedunculate oak (Quercus robur L.) pollen grains was studied in vitro on a medium containing 15% sucrose. Spatial variability was studied by sampling fresh pollen grains from a total of thirteen trees at four different sites in the area of Belgrade (Košutnjak, Banovo Brdo, Ada Ciganlija and Bojcin Forest) in a single year (2011). In order to assess temporal variability and determine the effects of climate change on a small time scale, we studied the viability of the pollen grains collected from one tree at the Banovo Brdo site in six different years (2004, 2005, 2006, 2007, 2011 and 2012). Interindividual variability was tested on the pollen grains sampled from eight trees at Ada Ciganlija in 2004. The percentage values of the pollen grain germination rate and the pollen tube length showed no statistically significant differences between the sites. However, the studied characteristics of the pollen grain viability (germination rate and pollen tube length) showed statistically significant differences in both temporal (between the pollen collection years) and interindividual variability. This type of research makes a valuable contribution to pedunculate oak breeding programs through the identification of trees with stable production and a good quality of pollen. Furthermore, it can be important in defining the patterns of spatial, temporal and individual variability of pollen grain viability under the influence of climate factors, which are showing compelling changing trends from year to year.Archives of Biological Sciences (2017), 69(1): 111-11