The questionnaire showed satisfactory internal consistency, with Cronbach's alpha of 0.898, good construction and homogeneity of questions. After splitting the questionnaire to two parts at random, Cronbach's alphas were 0.834 and 0.842 for the both parts, respectively. Exploratory factorial analysis revealed two domains. The patients rated their knowledge of the side effects of statins 52.7±19.9 on the visual analogue scale.Based on the results of this study, we believe that this questionnaire could be a useful tool for testing the knowledge of patients about adverse effects of statins and help physicians to identify patients with insufficient knowledge who should be additionally informed about it.
САЖЕТАКНормалне вредности концентрације калијума у серуму се крећу од 3,5 до 5 mМ/L, при чему у целом организму човека има око 50 mМ/kg калијума (98% се налази унутар ћелија). Вредност концентрације калијума у серуму испод 3,5 mМ/L се назива хипокалијемијом, која постаје тешка ако ниво калијума падне испод 2,5 mМ/L. Знаци и тешке хипокалијемије обухватају слабост скелетних мишића, парализе и парезе,депресију и/или психотична стања, асимптоми грчеве, парестезије,опстипацију, мучнину и понекад повраћање, полиурију и полидипсију,.Поред мерења концентрације калијума у серуму, треба обавезно измерити концентрацију магнезијума, калцијума, фосфата, бикарбоната и глукозе (као и рН крви), јер су поремећаји нивоа ових супстанција често повезани са хипокалијемијом.Пацијента са хипокалијемијом треба прикључити на ЕКГ мониторинг, обезбедити венску линију и проценити респираторни статус. Благу хипокалијемију обично лечимо корекцијом узрока који ју је изазвао, док је код умеренеобично довољна орална надокнада калијума. Тешку хипокалијемију лечимо парентералном надокнадом калијума. Уколико постоји хипомагнезијемија, надокнада калијума се тешко спроводи, па је потребно кориговати недостатак оба јона.Приликом интравенске надокнаде калијума користи се стандардни раствор калијум хлорида од 7,4%, који у једном милилитру садржи 1 мМ калијума.У току дана не треба дати више од 90 мМ калијума, нити се сме прећи брзина интравенске примене од 20 мМ на сат. Потребна доза стандардног раствора калијум хлорида се пре примене разблажује у 500 милилитара простог физиолошког раствора, који се пре почетка инфузије мора добро промућкати, како не би дошло до таложења калијума.Кључне речи: хипокалијемија, мишићна слабост, калијум хлорид ABSTRACT Normal serum levels of potassium range from 3.5 tо 5mМ/L, and whole body content of potassium amounts to 50 mМ/kg (98% is located within the cells). Serum levels of potassium below 3.5 mМ/L are classified as hypokalemia, which becomes severe if serum levels drop below 2.5 mМ/L.Signs and symptoms of hypokalemia could be: muscle weakness, paresis or paralysis, paresthesias, obstipation, nausea, sometimes vomiting, muscle cramps, polyuria, polydipsia, depression and/or psychotic states.Besides measuring serum levels of potassium, those of magnesium, calcium, phosphate, bicarbonate (as well as blood pH) and glucose
Introduction: After searching literature, Professor of Pharmacology at Cornell University Harry Gold was the first to use the name Clinical Pharmacology in the late 1930s and early 1940s. Topic: Clinical pharmacology is a medical discipline created in the middle of the 20th century, it implies the most effective application of medicine, and it could be said that it is the culmination of all therapeutic approaches in medicine, or simply in the preservation of human health. It is a field that spontaneously appeared in the medical field and from the first moment has the only perspective in the unity of practice and science. The second half of the last century is the time of the beginning of the recognition of specialization in clinical pharmacology as an independent medical discipline, in Europe - first in Sweden, England, Switzerland, Norway in the fifties of the last century, in America also in the same period. In Serbia and Montenegro, we noted the beginning in 1981. Clinical pharmacology is a hospital medical specialization; specialists in clinical pharmacology are doctors who know the most adequate use of drugs, which achieves an optimal therapeutic effect. The basis of clinical pharmacology is pharmacokinetics and pharmacodynamics. The development path of clinical pharmacology spans more than seven decades, and the key moments are the following: concept of bioavailability (Oser et all, 1945), pharmacokinetics (Friedrich Hartmut Dost, 1953), pharmacokinetics / pharmacodynamics (PK/PD) model (De Jongh and Wijnans and Van Gemert and Duyff, 1950), 1960 - 1980 explosion of pharmacokinetic studies and dramatic progress in the field. Pharmacokinetic interactions between drugs become evident and become the subject of many studies: in the 1970s, drug-level monitoring for digoxin, aminoglycosides, phenytoin, theophylline and other drugs began to be implemented in many hospitals. The 1980 - 2000 period is characterized by the advancement of technology, including liquid chromatography, liquid chromatography with a mass detector, and the development of computer technology. What makes clinical pharmacology attractive is the concept of the connection between drug concentration and pharmacodynamic effect, which unites science and practice in achieving a therapeutic effect and more successful medical treatment patients, appeared in the eighties of the last century. In the mid-1980s, Yusko and Boudinot began research linking biochemical mechanisms with pharmacokinetic/pharmacodynamic techniques and leading to their refinement. Conclusion: The development of pharmacology as a profession and science related to the use of drugs spontaneously moved from experimental pharmacology to clinical pharmacology to hospital pharmacology. In order for a clinical pharmacology specialist to really show and prove the useful value of this knowledge, the cooperation of all doctors in teamwork is necessary, as well as cooperation with scientists and cooperation with pharmaceutical magnates. If they find a way for a positive dialogue, the results will become a daily practice. Underline the letter to editors of journals, and alert letters via professional community, meaning be supported and informed. The main developmental goal of hospital pharmacology is to encompass a wide vaiety of specialists and subspecialists, together with strict demands in respecting pharmacoterapy choice, clinical trials law, monitoring side effects of drugs and medical devices. Ffrom authors's experience clinical pharmacologists' duties are clear, however, clinical pharmacology specialists and subspecialists are insufficient. Educating more colleagues is necessery for the future in order to increase presence of clinical pharmacology
Background: Rituximab is a B-cell-depleting monoclonal antibody whose off-label use is funded in Alberta by the Short-Term Exceptional Drug Therapy (STEDT) program. This study describes the use of rituximab for pediatric central nervous system (CNS) inflammatory disorders in Alberta. Methods: Rituximab applications for CNS inflammatory indications in patients < 18 years of age were identified from the STEDT database between January 1, 2012 – December 31, 2019. Patient information was linked to other provincial datasets, including the Discharge Abstract Database, Pharmaceutical Information Network, and provincial laboratory data. Analysis was descriptive. Results: 51 unique rituximab applications were identified, of which 50 were approved. New applications increased from one in 2012 to a high of 12 in 2018. The most common indication was autoimmune encephalitis (other than anti-NMDA receptor encephalitis; n=20, 39%). Most children were approved for a two-dose (n=33, 66%) or four-dose (n=16, 32%) induction regimen. Physician-reported outcomes were available for 24 patients, of whom 14 (58%) were felt to have fully met outcome targets. Conclusions: The use of rituximab for pediatric CNS inflammatory disorders has increased, particularly for the indication of autoimmune encephalitis. This study identified significant heterogeneity in dosing practices and laboratory monitoring, as well as regional disparities in use.
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