Clinical Pharmacology and Pharmacy - Latest articles
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Společná konference farmakologických a toxikologických společností v BrněInformation
Jan Juřica, Rostislav Večeřa
Klin Farmakol Farm. 2026;40(3):191-192 
Úvodní slovo editora k hlavnímu tématuEditorial
David Karásek
Klin Farmakol Farm. 2026;40(3):144
Cefiderocol in the treatment of infectious complications caused by a multidrug-resistant strain of Acinetobacter baumannii in a patient with severe burnsCase reports
David Janák, Bohumil Bakalář, Mousa Awies, Cecílie Stonová, Marta Fridrichová, Břetislav Lipový, Robert Zajíček
Klin Farmakol Farm. 2026;40(3):186-190 | DOI: 10.36290/far.2026.028
Infections caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) pose a serious problem, particularly in critically ill burn patients with immunological dysfunction who require long-term intensive care. The high rate of MDR-AB resistance limits treatment options and is associated with a poor prognosis. The isolated MDR-AB strain in our case showed multidrug resistance with limited options for effective antimicrobial treatment. Based on microbiological testing, targeted treatment with cefiderocol was indicated. This case report supports the successful use of cefiderocol as an effective and safe therapeutic alternative for severe infections...
Pharmacovigilance: a pillar of safe pharmacotherapy and its importance in clinical practiceReview articles
Monika Laššánová, Jana Tisoňová, Daniel Lutz
Klin Farmakol Farm. 2026;40(3):181-185 | DOI: 10.36290/far.2026.014
Pharmacovigilance (PhV) represents a key process in modern medicine for monitoring drug safety following market authorization. As defined by the World Health Organization (WHO), it encompasses the science and activities related to the detection, assessment, understanding, and prevention of adverse drug reactions (ADRs). The primary mission of the system is to maximize therapeutic benefits while minimizing risks to patients. This article analyses risk identification methods in clinical practice, focusing on passive pharmacovigilance based on spontaneous reporting, as well as active and stimulated monitoring. This study is based on the Slovak regulatory...
Genotype-phenotype correlation of CYP2C19: phenoconversion, population-specific characteristics, and modern sequencing approaches in personalised pharmacotherapyReview articles
Jan Soukop, Marek Pecha, Pavel Anzenbacher
Klin Farmakol Farm. 2026;40(3):176-180 | DOI: 10.36290/far.2026.027
Cytochrome P450 2C19 (CYP2C19) plays a key role in the metabolism of many commonly used medicines, including clopidogrel, antidepressants and proton pump inhibitors. Although CYP2C19 genotyping is a useful tool in personalised medicine, its clinical application is often complicated by the phenomenon of phenoconversion, in which the patient's actual phenotype (enzymatic activity) does not correspond to the genetically predicted phenotype. This phenomenon is most commonly caused by drug-drug interactions involving CYP inducers and inhibitors or by patient comorbidities. In Central European populations, the distribution of alleles is characterised...
Magnesium and sexual health: biological mechanisms, clinical evidence and practical implicationsReview articles
Marek Broul, Aneta Hujová, Kateřina Langmaierová
Klin Farmakol Farm. 2026;40(3):170-175 | DOI: 10.36290/far.2026.016
Magnesium is an essential intracellular cation involved in more than 300 enzymatic reactions. In the context of sexual health, its relevance mainly derives from its role in neuromuscular function, endothelial homeostasis, vasodilation, energy metabolism, glucose and blood pressure regulation, stress response and sleep quality. Direct clinical evidence that magnesium supplementation improves sexual function remains limited. The strongest signal concerns male sexual health, particularly the association between lower magnesium stores and erectile dysfunction, but available data are mainly observational. In women, direct evidence is scarce and the literature...
Current options in insulin pump therapy for diabetesMain topic
Lucie Radovnická
Klin Farmakol Farm. 2026;40(3):164-169 | DOI: 10.36290/far.2026.020
Insulin therapy has undergone substantial development over recent decades, evolving from insulin pen therapy and conventional insulin pump therapy to automated insulin delivery (AID) systems. A key milestone was the integration of insulin pumps with continuous glucose monitoring, which enabled the transition from sensor-augmented pump therapy to hybrid closed-loop systems. Based on CGM data, current AID systems continuously adjust insulin delivery, thereby improving glycaemic control, increasing time in range, and reducing the risk of hypoglycaemia. In type 1 and 2 diabetes, their benefit has been demonstrated in randomized trials as well as in real-world...
Current options in insulin therapyMain topic
Ondřej Krystyník
Klin Farmakol Farm. 2026;40(3):158-163 | DOI: 10.36290/far.2026.026
Insulin therapy remains a cornerstone of diabetes management despite major advances in non-insulin pharmacotherapy. Its current form is shaped by three interrelated pillars: pharmacological innovation, technological advancement, and individualized care. The development of insulin analogues has improved pharmacokinetic and pharmacodynamic profiles, reducing variability and the risk of hypoglycemia. At the same time, continuous glucose monitoring and automated insulin delivery systems have enabled more precise and safer glycemic control. Individualization of therapy reflects patient heterogeneity and allows treatment to be tailored to clinical characteristics,...
Gliflozins in the treatment of diabetes and its complicationsMain topic
Petr Žák, Karolína Kvíčalová, Eliška Ambrožová
Klin Farmakol Farm. 2026;40(3):153-157 | DOI: 10.36290/far.2026.023
The drug group gliflozins (SGLT-2 inh.) was introduced at the beginning of its clinical use as antidiabetic drugs with a low risk of hypoglycemia. Only later did the results of randomized clinical trials show us that the scope of their effect is much broader, with a confirmed benefit for reducing cardiovascular morbidity, mortality and their nephroprotective potential. Heart failure with preserved ejection fraction (HFpEF) is the most frequently reported failure phenotype in type 2 DM. However, this disease is often underdiagnosed and inadequately treated, despite the proven effectiveness of SGLT-2 inh. in the treatment of HFpEF. Currently, SGLT-2...
Obesity treatment with incretin-based therapiesMain topic
Ľubica Cibičková
Klin Farmakol Farm. 2026;40(3):148-152 | DOI: 10.36290/far.2026.015
Incretins, hormones of intestinal origin, stimulate insulin secretion in a glucose-dependent manner. Incretin-based therapy has a number of other beneficial metabolic effects in addition to weight reduction. In practice, we currently use two GLP-1 agonists (liraglutide, semaglutide) and a dual agonist of GIP and GLP-1 receptors (tirzepatide). This article provides information on the current indications for incretin-based therapy, clinical trials, adverse effects, and clinical use.
Deset principů personalizované léčby hypertrofické obstrukční kardiomyopatie: od algoritmů k individuálnímu rozhodováníEditorial
Josef Veselka
Klin Farmakol Farm. 2026;40(3):145-147
Rethinking Clinical Research – towards more inclusive, innovative, and sustainable patient-centered clinical trials developed in partnership with patientsEditorial
Christine Kubiak, PharmD, PhD, EMBA
Klin Farmakol Farm. 2026;40(2):76
Over-the-counter products, SARMs and dietary supplements as hidden causes of male hypogonadism and subfertility: a clinical overview and practical managementReview articles
Marek Broul, Aneta Hujová, Kateřina Langmaierová
Klin Farmakol Farm. 2026;40(2):134-138 | DOI: 10.36290/far.2026.004
Objective: To summarize clinically relevant exposures to over-the-counter (OTC) products and dietary supplements that may cause secondary hypogonadism and impaired male fertility, and to propose a pragmatic diagnostic and management pathway relevant to Czech clinical practice. Methods: Narrative review with targeted searches of MEDLINE/PubMed, Embase and the Cochrane Library (2000-2025), complemented by regulatory sources (FDA, WADA) and Czech resources on dietary supplement oversight and nutrivigilance. Results: Selective androgen receptor modulators (SARMs) carry the highest risk of suppressing the hypothalamic-pituitary-gonadal axis and remain prohibited...
The role of glucocorticoids in endocrinologyReview articles
Pavel Cee, Jan Drugda, Filip Gabalec
Klin Farmakol Farm. 2026;40(2):129-133 | DOI: 10.36290/far.2026.007
Glucocorticoids represent a fundamental group of hormones that play a key role in the regulation of metabolism, immune response, and adaptation to stress. Their widespread use in medicine is based on potent anti-inflammatory and immunosuppressive effects; however, long-term therapy is associated with the risk of serious adverse effects. This article focuses on hypercortisolism, both in the form of endogenous Cushing's syndrome and the more frequent exogenous form related to long-term glucocorticoid administration. Clinical manifestations, diagnostic procedures, and current therapeutic options including surgical, pharmacological, and radiotherapeutic...
Specifics of corticosteroid administration in patients with central nervous system diseases with a focus on neurointensive careReview articles
Lucie Sauerová
Klin Farmakol Farm. 2026;40(2):124-128 | DOI: 10.36290/far.2026.008
Corticosteroids (CST) play a key role in the treatment of oncological, infectious, and autoimmune diseases of the central nervous system (CNS). CST reduces inflammatory processes and is used mainly to reduce brain edema and intracranial pressure, thereby significantly improving the quality of life of patients. They are also administered as substitution therapy in the context of a functional deficit of the pituitary gland or hypothalamus. Administration is not indicated universally in all patients. Before use, we should evaluate the risk/benefit, i. e., the severity of the clinical manifestations of the disease and the risk of adverse effects, and...
Proton pump inhibitors: rational prescribing and long-term safety in childrenReview articles
Jana Tomanová, Petra Rozsívalová, Rita Halašová, Josef Malý, Jan Melek
Klin Farmakol Farm. 2026;40(2):116-123 | DOI: 10.36290/far.2026.009
Proton pump inhibitors (PPIs) are among the most commonly prescribed drugs in paediatrics, with their prescription rates having significantly increased in recent years. Although effective for indications such as gastroesophageal reflux disease, peptic ulcers, or eosinophilic esophagitis, concerns remain regarding their safety, dosing, and frequent off-label use, especially in infants and newborns. This article provides a comprehensive overview of the pharmacological properties of PPIs in the pediatric population, focusing on the specifics of pharmacokinetics and pharmacodynamics in different age groups. It considers the influence of CYP2C19 genetic...
Patient and Public Involvement in clinical research: from regulatory requirements to partnerships with patientsMain topic
Hana Blahynková, Lenka Součková, Adriána Papiež
Klin Farmakol Farm. 2026;40(2):112-115 | DOI: 10.36290/far.2026.025
In recent years, clinical research has increasingly focused on the systematic involvement of patients and the public (Patient and Public Involvement, PPI), with patients no longer viewed merely as study participants but also as active partners contributing to research planning. This approach enhances the relevance of research questions, improves the feasibility of studies, and increases the applicability of their results in clinical practice. The principles of patient involvement are reflected in modern methodological and regulatory frameworks, including the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human...
Environmentální udržitelnost v klinickém výzkumuMain topic
Michaela Beníšková, Jitka Rychlíčková
Klin Farmakol Farm. 2026;40(2):108-111 | DOI: 10.36290/far.2026.021
Skleníkové plyny zásadně ovlivňují globální klima. Sektor zdravotní péče představuje jeden z významných zdrojů emisí CO₂, v celosvětovém měřítku se řadí na páté místo. Klinický výzkum je jeho nedílnou součástí; přináší inovace, ale i další environmentální zátěž. Snaha minimalizovat uhlíkovou stopu proto prostupuje i do metodologie a designu klinických studií a klinického výzkumu jako celku. Prvky jako digitalizace a decentralizace klinických studií mohou přispět ke snižování environmentální zátěže. Stále jde ale spíše o předpoklad podložený omezenými daty. K dosažení udržitelnějších metodik je třeba cílenější kvantifikace a identifikace klíčových...
Inclusivity in clinical trials: barriers and their potentional solutionsMain topic
Hana Kocourková, Jitka Rychlíčková
Klin Farmakol Farm. 2026;40(2):102-107 | DOI: 10.36290/far.2026.022
Inclusivity in clinical research is an important prerequisite for obtaining relevant results applicable to routine clinical practice. Clinical research should therefore include participants who accurately represent the target population across a range of characteristics. However, certain patient groups remain under-represented in clinical trials. The so called under-served populations often include older adults, ethnic minorities, patients with multiple comorbidities, and socioeconomically disadvantaged individuals. Their limited participation may be due to methodological and organizational barriers inherent in the study design. This review article...
Innovative clinical trial designsMain topic
Adriána Papiež, Lenka Součková, Jitka Rychlíčková
Klin Farmakol Farm. 2026;40(2):97-101 | DOI: 10.36290/far.2026.024
Innovative clinical trial designs represent an important shift in the methodology of clinical research, reflecting the growing complexity of diseases, the development of personalized medicine, and the emergence of advanced therapy medicinal products. In addition to traditional randomized controlled trials, approaches such as adaptive designs, master protocols or single-arm studies are increasingly being used, enabling more flexible and targeted evaluation of new therapeutic interventions. They may accelerate the identification of effective therapies and improve the efficiency of resource utilization; however, they also introduce methodological and...
Clinical trials: The evolution of the traditional phase-based approach in contemporary clinical researchMain topic
Lenka Součková, Veronika Kunešová, Adriána Papiež, Hana Blahynková
Klin Farmakol Farm. 2026;40(2):92-96 | DOI: 10.36290/far.2026.017
Clinical trials represent a key component of the development of medicinal products and a fundamental source of evidence for evidence-based medicine. Traditionally, the clinical development of medicines has been described through four sequential phases of clinical trials (I-IV), reflecting the stepwise evaluation of safety, dosing, efficacy, and post-marketing surveillance after a medicinal product is introduced to the market. This model has long served as both a regulatory and educational framework for clinical research. However, in recent decades the clinical development of medicines has undergone significant changes. In practice, sub-phases of clinical...
Luna - a software tool for data transfer from admission note to medication chartOriginal articles
Marek Pecha
Klin Farmakol Farm. 2026;40(2):87-91 | DOI: 10.36290/far.2026.019
The admission report is a fundamental document that a physician creates when admitting each patient for hospitalization. Manually transcribing data from the admission report into the medication chart (so-called "temperature chart") is time-consuming and represents a potential source of errors. Medication errors are among the most common adverse events in hospital care, and a significant proportion of them occur during the prescribing and refilling of medications, including incomplete or illegible prescriptions. The author presents a software tool called Luna, which automatically transfers key information from the admission report into a medication...
Potentially inappropriate drugs in patients with chronic ischemic heart diseaseOriginal articles
Mária Kolesárová, Martina Dobrovičová, Dalibor Kolesár
Klin Farmakol Farm. 2026;40(2):77-86 | DOI: 10.36290/far.2026.003
As a result of population aging, the rate of polymorbidity and the associated polypharmacy and polypragmasia are increasing. There is an increased risk of drug interactions, adverse effects, and the likelihood of inappropriate drug use in the elderly population. The aim of this retrospective study was to analyze the medication history of older adult patients with chronic ischemic heart disease (IHD) and to identify potentially inappropriate medications (PIMs). Data were collected over a one-month period from the prescription records of patients who were institutionalized in a social services home. PIMs were identified according to the current Beers...
Slovo editoraEditorial
MUDr. Irena Krčmová, CSc.
Klin Farmakol Farm. 2026;40(1):04
Komentář k článku: Linezolid a terapeutické monitorování: Nastal čas pro rutinní TDM?Comment
Martin Róbert Grác, Pavel Suk, Jitka Rychlíčková
Klin Farmakol Farm. 2026;40(1):70-71
Methadone poisoning in a childCase reports
Alice Nogolová, Markéta Ručková, Petra Matalová
Klin Farmakol Farm. 2026;40(1):67-69 | DOI: 10.36290/far.2026.005
Intoxication and accidental ingestion of toxic substances is a common cause of hospitalization in children, especially younger ones. Usually, the cause of ingestion is improper storage of toxic substances and their easy accessibility to children. The most common causes of poisoning are the ingestion of medicines, chemicals, drugs, including alcohol, and natural substances. We describe a case of intoxication in a four-year-old boy, who accidentally ingested methadone, used by his stepfather in substitution treatment of opiate addiction, he received treatment with opiate antidote naloxone. Though is this type of intoxication being rare in children,...
Targeted treatment of psoriatic arthritisReview articles
Leona Procházková
Klin Farmakol Farm. 2026;40(1):61-66 | DOI: 10.36290/far.2025.067
Psoriatic arthritis is a chronic, immune-mediated inflammatory disease from the group of spondyloarthritis. The disease is characterized by joint, enthesis, or axial skeleton involvement in patients with psoriasis. Joint manifestations usually occur after the development of skin psoriasis, although in a smaller subset of patients, this may be the reverse. The phenotype of psoriatic arthritis is highly variable, reflecting a combination of specific musculoskeletal manifestations and various forms and severity of skin psoriasis, as well as the presence of extra-articular manifestations of the disease. The different presentations of the disease, especially...
The microbiome and pharmacotherapy: from mechanisms to consequencesReview articles
Lenka Jourová, Eva Anzenbacherová, Pavel Anzenbacher
Klin Farmakol Farm. 2026;40(1):56-60 | DOI: 10.36290/far.2026.001
The gut microbiome plays a significant role in the regulation of physiological processes and, in certain cases, may also influence the outcome of pharmacotherapy - from variability in the efficacy of commonly used drugs to the results of modern immunotherapies. Interactions between microbial metabolites, host hepatic enzymes, and the immune system may determine whether a treatment succeeds or fails. Understanding these mechanisms opens the way to novel approaches that can enhance drug efficacy, reduce the risk of adverse effects, and bring personalized medicine closer to clinical practice. This article provides a concise overview of current knowledge...
QT interval, etiopathogenesis of "torsade de pointes", and risk pharmacotherapyReview articles
Přemysl Mladěnka, Josef Kautzner
Klin Farmakol Farm. 2026;40(1):47-55 | DOI: 10.36290/far.2026.002
The electrocardiographic QT interval reflects the duration of ventricular depolarization and repolarization. Prolongation of the QT interval occurs most commonly due to a slowdown in the late repolarization phase. There are inherited forms of long QT syndrome caused by mutations in genes that encode components of potassium or sodium channels, with a prevalence of about 1 in 2000 inhabitants. Additionally, there are acquired forms of long QT syndrome, which often result from the use of certain medications. These drugs either directly block the potassium channel Kv11.1 (hERG), or disrupt its trafficking. Prolonged QT interval is a key risk factor for...
Interactions between ARTA drugs and orally administered anticoagulantsReview articles
Kryštof Dobečka, Anna Králová
Klin Farmakol Farm. 2026;40(1):41-46 | DOI: 10.36290/far.2025.068
ARTA drugs, including enzalutamide, apalutamide, darolutamide, and abiraterone, are antiandrogenic agents used in the treatment of prostate cancer. These medications can induce or inhibit biotransformation enzymes and transporters, thereby affecting plasma concentrations and the efficacy of concomitantly administered drugs. This article examines the interactions between ARTA and orally administered anticoagulants such as apixaban, rivaroxaban, edoxaban, dabigatran, and warfarin. It outlines the mechanism of interactions between individual agents and summarizes the current state of knowledge on optimizing pharmacotherapy when combining ARTA with anticoagulants....