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....

Injectable and non-injectable adrenaline applicators - their use in practiceMain topic

Irena Krčmová, Jakub Novosad

Klin Farmakol Farm. 2026;40(1):34-40 | DOI: 10.36290/far.2026.012  

Anaphylaxis is an acute, potentially life-threatening systemic reaction, that affects the skin, respiratory tract, circulation and/or digestive tract simultaneously or sequentially, but occurring within a short period of time (within 1 hour of the onset of the first symptoms). The most severe form of anaphylaxis is anaphylactic shock. From a pathophysiological point of view, it can be an immunological reaction, mediated by IgE antibodies or other immunological mechanisms and the subsequent massive release of biologically active mediators from mast cells and basophils. Mast cells/basophils can also be degranulated non-immunologically by direct receptor...

Biological treatment of asthma at the end of the first quarter of the 21^st centuryMain topic

Jakub Novosad, Irena Krčmová

Klin Farmakol Farm. 2026;40(1):25-33 | DOI: 10.36290/far.2026.010  

Bronchial asthma affects more than 339 million people worldwide, with traditional treatment achieving ultimate success in only about 50-60 % of patients. Since the turn of the 21^st century, we have been facing a revolution in asthmatology, consisting in the introduction of precision medicine focused on identifying pathogenetically causal molecular endotypes of the disease (type 2-high and type 2-low) using biomarkers (eosinophils, FeNO, IgE) and the introduction of targeted biological treatment with monoclonal antibodies: omalizumab (anti-IgE), mepolizumab, depemokimab (anti-IL-5), benralizumab (anti-IL-5R), dupilumab (anti-IL-4R) and tezepelumab...

Allergen immunotherapy for respiratory allergiesMain topic

Jiří Nevrlka

Klin Farmakol Farm. 2026;40(1):19-24 | DOI: 10.36290/far.2026.011  

Specific allergen immunotherapy is the only causal and disease‑modifying treatment modality for respiratory allergies. It represents a personalized approach that may induce long‑term immunotolerance to causal allergens. It can thus reduce or even completely eliminate symptoms of allergic rhinitis and, in some patients, allergic asthma, decrease the need for pharmacotherapy, improve patients' quality of life and, last but not least, protect them against progression of the allergic disease. This review summarizes the mechanisms of action and clinical efficacy of allergen immunothe­rapy in diseases related to inhalant allergens and discusses...

Allergic rhinitis - allergist's point of viewMain topic

Ester Seberová

Klin Farmakol Farm. 2026;40(1):13-18 | DOI: 10.36290/far.2026.013  

Allergic rhinitis is a chronic immunoglobulin E-mediated nasal illness that affects quality of life and productivity of patients and can lead to serious complications such as asthma. The complex therapy includes conventional pharmacotherapy (intranasal corticosteroids, oral and intranasal antihistamines, leukotriene antagonists, intranasal and oral vasoconstrictors, and nasal rinses), and in some cases also allergen immunotherapy. Good cooperation of patients, physitians of different specialities and pharmacists is necessary for improving standards of care. Modern informatic technologies can be helpful in this field.

The significant role of gliflozins in the treatment of type 2 diabetes mellitusOriginal articles

Mária Kolesárová, Michaela Bučková, Dana Marcinčáková, Zuzana Mačeková, Peter Takáč

Klin Farmakol Farm. 2026;40(1):5-12 | DOI: 10.36290/far.2025.072  

Type 2 diabetes mellitus (DM2) is a chronic progressive syndrome leading to damage to most tissues in the body. The aim of this retrospective study was to analyze the resulting effect of combined pharmacotherapy of DM2 after adding gliflozins to pharmacotherapy. The study included 30 patients with combined pharmacotherapy for DM2, with an average age of 65 ± 8.71 years. The parameters monitored were blood glucose, glycated hemoglobin (HbA1c), body mass index (BMI), blood pressure (BP), LDL-cholesterol, HDL-cholesterol, and triacylglycerides (TAG). Patients enrolled in the study were indicated for sodium-glucose cotransporter 2 inhibitors (SGLT2i),...

Selection of an appropriate urinary spasmolytic in a geriatric patientCase reports

Lada Feřtová, Barbora Brezinová, Jaroslava Červeňová

Klin Farmakol Farm. 2025;39(4):245-248 | DOI: 10.36290/far.2025.064  

The selection of an appropriate medication for a geriatric patient is a complex process that requires careful consideration of several factors, such as the presence of all medications in the patient's pharmacological history, age-related changes in pharmacokinetics and pharmacodynamics, the patient's functional status, and comorbidities. Special attention should also be given to the medication regimen itself (including dosage forms), ensuring maximum support for patient adherence to pharmacotherapy. This case study discusses an individualized approach to urinary spasmolytic selection in a multimorbid geriatric patient. This article provides comparison...

Dapagliflozin in the treatment of IgA nephropathy in a paediatric patientCase reports

Markéta Ručková, Petra Matalová

Klin Farmakol Farm. 2025;39(4):241-244 | DOI: 10.36290/far.2025.043  

IgA nephropathy is the most common primary chronic glomerulonephritis in children and adults. It manifests itself as haematuria and proteinuria. Given that approximately half of patients develop kidney failure after 20 years, the prognosis is serious. In recent years, new treatment options have emerged for adults, including SGLT2 inhibitors, endothelin receptor antagonists, and targeted-release budesonide. These drugs are not yet approved for use in children with IgA nephropathy, but SGLT2 inhibitors are approved for children with diabetes mellitus type 2 (T2DM) over the age of 10. We describe the case of a boy with IgA nephropathy and an inadequate...

Vasoactive drugs in the treatment of erectile dysfunction: current conceptsReview articles

Markéta Rafajová

Klin Farmakol Farm. 2025;39(4):236-240 | DOI: 10.36290/far.2025.051  

Erectile dysfunction is a widespread health problem that significantly affects the quality of life of men. Pharmacotherapy is a key pillar of erectile dysfunction treatment, with vasoactive drugs, particularly phosphodiesterase type 5 inhibitors and prostaglandin E1, playing a crucial role in therapeutic approaches. This review article focuses on current concepts in the use of vasoactive drugs in the treatment of erectile dysfunction, including indications, mechanism of action, dosage, adverse effects and pharmacological interactions.

A brief overview of pharmacotherapy in palliative medicine - part twoReview articles

Miroslav Žiaran

Klin Farmakol Farm. 2025;39(4):229-235 | DOI: 10.36290/far.2025.070  

The second part of the overview of pharmacotherapy in palliative medicine focuses on the treatment of additional symptoms that significantly impair patients' quality of life - dyspnea, nausea and vomiting, constipation, diarrhea, hiccup, and cachexia. The article provides an overview of the etiopathogenesis of these conditions, non-pharmacological interventions, and in particular pharmacological approaches, highlighting their efficacy, safety, and practical application in clinical practice. Emphasis is placed on the need for an individualized approach, appropriate titration of medications, and multidisciplinary collaboration. The text is again intended...

Pharmacotherapie of neuropathic painReview articles

Dana Vondráčková

Klin Farmakol Farm. 2025;39(4):223-228 | DOI: 10.36290/far.2025.066  

Neuropathic pain is one of the most severe and difficult pain to treat with significant impact on health-related quality of life. The international associations IASP and EFIC have issued recommendations for the pharmacotherapy of this pain, which are based on recommendations in most countries. The three basic lines of choice as defined by the Clinical Standard for Pharmacotherapy of Neuropathic Pain include antidepressants, gabapentinoids, anticonvulsants, and weak or strong opioids. In addition, local treatment (capsaicin, lidocaine, botox) is recommended. For individual neuropathic pain syndromes, the recommendations slightly differ. The main differences...

Linezolid and therapeutic drug monitoring: Is it time for routine TDM?Main topic

Irena Murínová

Klin Farmakol Farm. 2025;39(4):218-222 | DOI: 10.36290/far.2025.075  

Therapeutic drug monitoring (TDM) has traditionally been used primarily for antibiotics with a narrow therapeutic index, such as aminoglycosides and vancomycin, or for drugs with complex pharmacokinetics, such as voriconazole. For most other antibiotics, its use has been limited to specific cases. However, in the context of the growing prevalence of multidrug-resistant pathogens and the limited development of new antibiotics, there is an increasing need to reconsider this approach. TDM is now seen not only as a tool for improving safety but also as a key strategy for optimizing efficacy, limiting the development of resistance, and thereby extending...

Induction of CYP3A4 by metamizole confirmed by TDM: a case study with quetiapineMain topic

Ivana Tašková

Klin Farmakol Farm. 2025;39(4):213-217 | DOI: 10.36290/far.2025.071  

Metamizole is an analgesic and antipyretic with a long history of clinical use, although some of its pharmacological properties, including its safety profile, remain incompletely understood. Recent studies indicate that metamizole is a moderate inducer of cytochrome P450 enzymes (CYP), particularly CYP3A4 and CYP2B6, which may result in altered plasma concentrations of concurrently administered drugs that are substrates of these enzymes. This article presents a case report of a patient whose regular administration of meta­mizole led to a marked decrease (approximately 75%) in quetiapine plasma concentration, consistent with the moderate induction of...

TDM as a tool for pharmacogenetic patient profiling: a case report of phenoconversionMain topic

Ivana Tašková, Nicole Šafářová

Klin Farmakol Farm. 2025;39(4):206-212 | DOI: 10.36290/far.2025.073  

Pharmacogenetics and therapeutic drug monitoring (TDM) are essential tools of personalised medicine in psychiatry. While pharmacogenetic testing enables the prediction of genetically determined enzyme activity, TDM provides a direct view of actual plasma drug concentrations and individual pharmacokinetics. These two methods are complementary; TDM can be utilised not only for dose optimisation but also to estimate the patient's metabolic phenotype or detect phenoconversion - a situation where the observed metabolic profile does not align with the genotype-predicted enzymatic activity. This case report details a patient with obsessive-compulsive disorder...

The importance of therapeutic monitoring of theophyllineMain topic

Kristina Pechandová

Klin Farmakol Farm. 2025;39(4):199-205 | DOI: 10.36290/far.2025.069  

Theophylline, a worldwide known and long-used bronchodilators in the treatment of lung diseases, has a narrow therapeutic range. The considerable interindividual variability in its pharmacokinetic parameters, the weak correlation between dose and plasma concentration, and the close relationship between plasma concentration and clinical effect make it a suitable candidate for therapeutic drug monitoring. Theophylline is mainly used in the treatment of pulmonary diseases, but its expected bronchodilator effect is only exerted when higher plasma levels are reached. During treatment, their regular determination is necessary to optimize therapy. High levels...

Retrospective evaluation of remdesivir effectiveness in the treatment of COVID-19 disease during the second wave of the pandemicOriginal articles

Lucia Žigová, Orsolya Hrubá, Andrea Gažová

Klin Farmakol Farm. 2025;39(4):194-198 | DOI: 10.36290/far.2025.049  

The COVID-19 pandemic has posed unforeseen challenges to healthcare systems and prompted intensive research into novel therapeutic strategies. Remdesivir, a nucleoside analogue with an approved indication for the treatment of COVID-19, has been included in numerous clinical trials aimed at evaluating its efficacy. While some of these studies suggested a potential clinical benefit, others failed to demonstrate a clear effect on mortality reduction or shortening of hospital stay. The aim of this retrospective study was to evaluate whether the administration of remdesivir during the second pandemic wave influenced clinical outcomes in hospitalized patients...

Úvodní slovo k tématu číslaEditorial

Ivana Tašková

Klin Farmakol Farm. 2025;39(4):192-193  

Pharmacokinetic interactions of clozapine and olanzapine: case studies of drug modifications due to CYP1A2 inhibitionCase reports

Kateřina Skopalová

Klin Farmakol Farm. 2025;39(3):181-184 | DOI: 10.36290/far.2025.063  

MARTA antipsychotics are essential drugs in the treatment of psychiatric disorders; however, their efficacy and safety can be affected by drug interactions. This article focuses on interactions between antipsychotics and antibiotics, particularly through the inhibition of cytochrome P450 1A2 (CYP 1A2), which may lead to drug level changes beyond the therapeutic range. Two selected case reports from clinical practice in an inpatient psychiatric hospital illustrate the consequences of these interactions and possible solutions. Special emphasis is placed on the drug interaction between clozapine and ciprofloxacin and the necessity of therapeutic drug...

Efficacy and safety of fezolinetant in the treatment of moderate to severe vasomotor symptoms in women for whom hormone therapy is considered inappropriateReview articles

Marek Lapka

Klin Farmakol Farm. 2025;39(3):174-180 | DOI: 10.36290/far.2025.062  

The phase 3b DAYLIGHT study evaluated fezolinetant, a neurokinin-3 receptor anta­gonist, in women with moderate-to-severe vasomotor symptoms (VMS) unsuitable for hormone replacement therapy (HRT). A total of 453 women aged 40-65 years were randomized to fezolinetant 45 mg once daily or placebo for 24 weeks. Fezolinetant significantly reduced the frequency and severity of VMS, improved sleep quality and menopause-related quality of life, with effects evident from week 1 and sustained throughout treatment. The safety profile was favorable and comparable to placebo, with slightly more fatigue and mild, transient liver enzyme elevations. Fezolinetant represents...

Nitazenes and other opioid receptor superagonistsReview articles

Jitka Rychlíčková, Ema Kunová

Klin Farmakol Farm. 2025;39(3):171-173 | DOI: 10.36290/far.2025.061  

Nitazenes and spirochlorphine are synthetic opioids that have been of interest in recent years in relation to unintentional overdoses with non-fatal and fatal consequences. These substances are potent agonists, predominantly of µ-opioid receptors, and exhibit a similar potency to fentanyl. The diagnosis of overdose is complicated by the inability to detect them with standard opioid screening tests. The available literature on the treatment of nitazene and spirochlorphine intoxication is limited. The objective of this article is to highlight the existence of these agents, summarise the known information on their pharmacology, and point out possible...

Treatment of multimorbid patients with multiple sclerosisReview articles

Martina Petrášová, Jan Kočica

Klin Farmakol Farm. 2025;39(3):165-170 | DOI: 10.36290/far.2025.060  

The review summarises practical principles for treating polymorbid patients with multi­ple sclerosis. Comorbidities are common and strongly influence diagnosis, prognosis, and the choice of chronic disease-modifying therapy (DMT); radiographic activity in the setting of vascular comorbidities should therefore be interpreted in the context of additional biomarkers. In highly active disease, early high-efficacy therapy (e. g., anti-CD20 antibodies, cladribine, or natalizumab) has a clear role, always coupled with rigorous pharmacovigilance. Overlapping conditions can be managed safely with parallel, comorbidity-targeted treatment (e. g., anti-CGRP for...

Beta-blockers in the treatment of heart failureMain topic

Monika Špinarová, Karel Lábr

Klin Farmakol Farm. 2025;39(3):160-164 | DOI: 10.36290/far.2025.059  

Heart failure is a common disease with a serious prognosis. Treatment is always complex and includes both pharmacological and non-pharmacological processes. Beta-blockers are one of the fundamental drugs in treatment of chronic heart failure with reduced ejection fraction (HFrEF). The recommended drugs include bisoprolol, carvedilol, metoprolol succinate and nebivolol. Beta-blockers should be initiated in clinically stable, euvolaemic, patients at a low dose and gradually uptitrated to the maximum tolerated dose. The only reason for not administering beta-blockers in these patients are contraindications. We do not have enough evidences for recommendation...

Betablockers in the treatment of heart rhythm disordersMain topic

Dominik Broniš, Irena Andršová, Tomáš Novotný

Klin Farmakol Farm. 2025;39(3):155-159 | DOI: 10.36290/far.2025.058  

Beta-blockers represent a fundamental component in the treatment of cardiac arrhythmias due to their ability to suppress the effects of the sympathetic nervous system and stabilize heart rhythm. They are primarily used for heart rate control in atrial fibrillation, and they also reduce the risk of ventricular arrhythmias and sudden cardiac death, particularly in patients with ischemic heart disease or heart failure. Thanks to their long-established efficacy, good tolerability, and favorable impact on survival, beta-blockers maintain a strong position in clinical practice. Advances in personalized medicine and genetic profiling of patients further open...

Beta-blockers in the treatment of arterial hypertensionMain topic

Karel Lábr, Monika Špinarová

Klin Farmakol Farm. 2025;39(3):150-154 | DOI: 10.36290/far.2025.057  

Beta-blockers represent a traditional class of antihypertensive drugs, whose role in the treatment of arterial hypertension has evolved significantly over recent decades. While they are no longer recommended as first-line therapy for uncomplicated hypertension, they remain a key treatment option in certain clinical scenarios - particularly in patients with concomitant ischemic heart disease, a history of myocardial infarction, heart failure, tachyarrhythmias, or increased sympathetic activity in younger individuals. This review aims to summarize the mechanism of action of beta-blockers, evaluate available clinical evidence of their efficacy, compare...