The effect of rs776746 polymorphism in the <i>CYP3A5</i> gene on heart rate when using bisoprolol in patients with acute coronary syndrome

Aim. The aim of this work was to study the occurrence of the rs776746 allelic variant of the CYP3A5 gene and its effect on heart rate (HR) when using bisoprolol in patients hospitalized with acute coronary syndrome (ACS).Materials and methods. The study included patients with ACS who were prescribed bisoprolol for clinical indications. All patients underwent molecular genetic testing. In order to evaluate the effectiveness of the therapy with bisoprolol, all patients underwent Holter electrocardiogram (ECG) monitoting on days 10, the following parameters were assessed: minimum, average, maximum heart rate and heart rate during an exercise test. The stress test was performed as a ladder test.Results. The study involved 97 patients (63,5±10,5 years), including 60 men and 37 women. The frequency of occurrence of the desired alleles of the CYP3A5 gene was: CYP3A5*3 - 93%, and CYP3A5*1 - 7%, which corresponds to its prevalence in the European population. 84 carriers of the CYP3A5*3*3 genotype (87%), 12 heterozygous carriers of the *1 allele (12%) and one patient with the *1*1 genotype (1%) were identified. In order to search for differences in the effects of bisoprolol depending on the genetically predetermined activity of CYP3A5, we divided the general group of patients into two subgroups: subgroup 1 (CYP3A5*3*3), represented by carriers of the genotype associated with the synthesis of the inactive form of CYP3A5, and subgroup 2 (CYP3A5*1*3 and CYP3A5*1*1), represented by carriers of at least one allele encoding the synthesis of a fully functional protein CYP3A5, coupled with an increased metabolic rate. Patients did not differ in clinical and demographic characteristics. By the time of daily ECG monitoring, both groups reached comparable heart rate values. In carriers of at least one CYP3A5*1 allele (n = 13), associated with an increased metabolic rate, the daily dose of bisoprolol on the 10th day of hospitalization was significantly higher (p &lt;0.05). The only carrier of the homozygous CYP3A5 *1*1 variant receives bisoprolol at a daily dose of 10 mg. Taking into account the close to significant differences in glomerular filtration rate (GFR) in patients in the groups with the studied genetic variants, and the known eliminating role of the kidneys for bisoprolol, a linear regression model was built with the inclusion of factors that could affect the dose of bisoprolol: GFR, functional class of chronic heart failure, gender, age, number of simultaneously assigned CYP3A5 substrates. Of the parameters listed, only the CYP3A5 genotype significantly predicted the dose of bisoprolol (F=8.5; p&lt;0.005; R2=0.096).Conclusion. In this study, it was demonstrated for the first time that patients with different genetic variants of CYP3A5, in particular with respect to the rs776746 polymorphism, may differ in individual requirements for the dose of bisoprolol

Каталитический тест-метод определения микроколичеств рутения на основе реакции окисления метилового оранжевого периодатом калия

A catalytic test-method for the determination of ruthenium based on methyl orange oxidation by potassium periodate at pH =1 on a paper carrier was proposed. The conditions for the indicator reaction performance were optimized. It is possible to determine ruthenium in the range of its concentrations 0.010 ÷ 0.55 µg/ml .The detection limit equals to 0.0035 µg/ml, the relative standard deviation (RSD) is not higher than 0.058. The accuracy of the analysis results was confirmed by the traditional added - found method.Предложен тест-метод определения рутения, основанный на проведении каталитической индикаторной реакции окисления метилового оранжевого периодатом калия при pH 1 на бумажном носителе. Выбран оптимальный вариант проведения реакции. Определение возможно в широком диапазоне концентраций рутения: 0.010 до 0.55 мкг/мл. Предел обнаружения составляет 0.0035 мкг/мл, относительное стандартное отклонение не превышает 0.058. Правильность результатов анализа по предложенной методике подтверждена методом «введено-найдено»

Сравнительный клиникоэкономический анализ затрат на лекарственные препараты в многопрофильном стационаре за 2014-2018 гг.

Objectives. To study the structure of drug purchases by a general hospital considering the names and costs of the purchased drugs as well as their current consumption by various clinical departments.Materials and Methods. The drug consumption was analyzed using the ABC/VEN and ATC/DDD methods with a simultaneous analysis of case histories.Results. The analysis of drug purchases in 2014-2018 and the obtained results prompted a reassessment of the drug procurement policy and readjustment of the financial resources between various groups of drugs.Conclusion. The simultaneous use of the ABC/VEN and ATС/DDD analyzes and the reevaluation of the list of prescribed medications allowed us to propose the ways to optimize the structure of drug consumption in a typical hospital.Цель – провести оценку структуры расходования финансовых средств медицинского учреждения на закупку лекарственных препаратов по номенклатуре и стоимости закупаемых лекарственных препаратов, потреблению различными подразделениями в течение года и в разные годы.Материалы и методы. Анализ расхода лекарственных препаратов выполнен с помощью АВС/VEN- и АТС/DDD-анализов с одновременным анализом медицинских карт пациентов.Результаты. Произведен анализ расходования лекарственных препаратов в медицинской организации за 2014-2018 гг. По результатам оценки структуры потребления лекарственных препаратов была изменена политика закупки препаратов, произведено перераспределение финансовых средств на различные группы лекарственных препаратов.Заключение. Одновременное проведение АВС/VEN- и АТС/DDD-анализов и оценки назначений лекарственных препаратов по медицинским картам позволило оптимизировать закупку и расход лекарственных препаратов в медицинской организации

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

At the time of print, the evidence for using umifenovir in COVID-19 is mainly theoretical. The published clinical trials have contradicting results. The decision to use umifenovir in COVID-19 should be individualized, considering the “experimental” nature of this treatment

Catalytic test-method for determination of ruthenium microquantities based on methyl orange oxidation with potassium periodate

A catalytic test-method for the determination of ruthenium based on methyl orange oxidation by potassium periodate at pH =1 on a paper carrier was proposed. The conditions for the indicator reaction performance were optimized. It is possible to determine ruthenium in the range of its concentrations 0.010 ÷ 0.55 µg/ml .The detection limit equals to 0.0035 µg/ml, the relative standard deviation (RSD) is not higher than 0.058. The accuracy of the analysis results was confirmed by the traditional added - found method

Clinical and economic analysis of drug costs in a general hospital in 2014-2018

Objectives. To study the structure of drug purchases by a general hospital considering the names and costs of the purchased drugs as well as their current consumption by various clinical departments.Materials and Methods. The drug consumption was analyzed using the ABC/VEN and ATC/DDD methods with a simultaneous analysis of case histories.Results. The analysis of drug purchases in 2014-2018 and the obtained results prompted a reassessment of the drug procurement policy and readjustment of the financial resources between various groups of drugs.Conclusion. The simultaneous use of the ABC/VEN and ATС/DDD analyzes and the reevaluation of the list of prescribed medications allowed us to propose the ways to optimize the structure of drug consumption in a typical hospital