Review of the book “Practical issues of rational antibacterial therapy”

In 2023, the book “Practical Issues of Rational Antibacterial Therapy” under general ed. Yarovoy SK, Khokhlov AL, was published. This monograph is devoted to practical issues of empirical therapy for the most common nonspecific infectious and inflammatory diseases. The monograph presents the main provisions of antimicrobial therapy from the perspective of clinical pharmacology. The general patterns of prescription and distribution of antibacterial agents, the concepts of basic and reserve drugs, selection of hospital strains, natural and acquired resistance are explained. Antibacterial drugs are compared in pairs with each other based on an analysis of their spectra of antimicrobial activity. Combination (multicomponent) antibacterial therapy is being considered. Undesirable regimens of antimicrobial therapy are described, options with insufficient effectiveness and an unsatisfactory safety profile are analyzed

Use of etiotropic and pathogenetic medicines for COVID-19 in patients with renal failure and/or on dialysis

Impaired kidney function may influence pharmacokinetics of most of the drugs, including the ones used in COVID-19. In this publication, the most important pharmacokinetic parameters and dose adjustment approaches are provided, based on The Renal Drug Handbook и Sanford Guide. In the majority of cases, mild kidney function reduction does not necessitate dose adjustment. Each case should be considered individually, measuring benefits against risks

Thermal phase transitions in rotating QCD with dynamical quarks

Relativistic rotation causes a change of QCD critical temperatures. Various phenomenological and effective models predict a decrease of the critical temperatures in rotating QCD. Nevertheless, lattice simulations showed that the critical temperature in gluodynamics increases due to rotation. We extend the lattice study to the theory with dynamical fermions. We present the first lattice results for rotating QCD with $N_f=2$ dynamical clover-improved Wilson quarks. We also study separately the effect of rotation on gluonic and fermionic degrees of freedom. It is shown that separate rotations of gluons and fermions have opposite effects on the critical temperatures. In aggregate, the pseudo-critical temperatures in QCD increase with angular velocity. Dependence of the results on the pion mass is also discussed.Comment: 10 pages, 5 figures, Proceedings of the 39th International Symposium on Lattice Field Theory, 8th-13th August, 2022, Bonn, German

Change of opinion on the use of hydroxychloroquine for COVID-19 treatment and prevention

The use of hydroxychloroquine for COVID-19 treatment and prevention should be restricted in both out- and inpatient settings due to the lack of evidence for effectiveness and unfavorable safety profile

Current and future use of angiotensin II receptor blockers in patients with COVID-19

No scientific evidence for the negative influence of angiotensin II receptor blockers onto COVID-19 clinical course has been identified so far. Prescribing angiotensin II receptor blockers as COVID-19 pathogenetic therapy could only be considered within clinical trials. Patients who have been taking angiotensin II receptor blockers for approved indications should continue to do so

Genetic Risk Factors for Adverse Drug Reactions

The use of medicines may in some cases be associated with the development of drug-induced diseases (DIDs) аnd other adverse drug reactions (ADRs), which leads to an increase in morbidity/mortality rates, and/or symptoms forcing a patient to seek medical attention or resulting in hospitalisation. ADRs may develop due to changes in a patient’s genotype, which entail an inadequate pharmacological response. The aim of the study was to analyse and summarise literature data on genetic risk factors that cause DIDs аnd other ADRs. It was shown that the polymorphism of genes encoding enzymes of drug metabolism (CYP, UGT, NAT, TPMT, EPHX, GST, etc.) or carriers (transporters) of drugs (P-gp, BCRP, MRP, OATP, OCT, etc.) can change the pharmacokinetics of drugs, affecting their activity. Polymorphism of RYR1, CACNA1S, MT-RNR1, VKORC1, and other genes encoding receptors targeted by drugs, and human leukocyte antigen (HLA) gene, may affect drug pharmacodynamics by modifying drug targets or changing the sensitivity of biological pathways to pharmacological effects of medicines. Changes in drug pharmacokinetics and pharmacodynamics may cause DIDs аnd other ADRs. The use of pharmacogenetic tests will allow a personalised approach to patients’ treatment and prevention or timely detection of potential ADRs during therapy. Before prescribing some medicines, clinicians should use recommendations on their dosing based on pharmacogenetic tests, which are posted on the official websites of Pharmacogenomics Research Network (PGRN), Pharmacogenomics Knowledgebase (PharmGKB), and Clinical Pharmacogenetics Implementation Consortium (CPIC). The results of ongoing clinical studies on the effect of gene polymorphism on drug safety will soon allow for higher personalisation of the choice of pharmacotherapy and prevention of many ADRs, including DIDs

Possibilities for the use of anakinra in COVID-19

The use of anakinra cannot be currently recommended outside of clinical trials as pathogenetic treatment of “cytokine storm” in severe COVID-19

Anticoagulant deprescribing algorithm in patients with COVID-19 after hospital discharge

We present anticoagulant outpatient deprescribing algorithm in patients with COVID-19 discharged from the hospital. It is reasonable to continue the treatment should the patient have indications for therapeutic anticoagulation. Enhanced prophylaxis of venous thromboembolic complications should be considered in patients with high thromboembolic risk and low risk of bleeding

Possibility to use direct oral anticoagulants to prevent thromboembolic events in patients with COVID-19

Hospitalized patients with COVID-19 who have not previously received DOAK by it is not advisable to prescribe POAC for the prevention of thrombosis in patients with COVID-19 due to the lack of clinical trial results, significant potential interactions

Current and future use of colchicine in patients with COVID-19

There exist some theoretical premises for the use of colchicine in patients with COVID-19, and clinical trials are underway. There is currently no published evidence confirming effectiveness and safety of colchicine in COVID-19 and allowing to recommend it for general practice. If prescribing colchicine, the one should perform clinical and hematological monitoring and avoid drug interactions