Vnitřní lékařství, 1995 (vol. 41), issue 3
[Captopril in the treatment of heart failure].
M Herold
Vnitr Lek 1995, 41(3):161
The inhibitor of angiotensin converting enzyme played in recent years a significant role in the treatment of cardiac failure. Captopril administration to patients after myocardial infarction prevents enlargement of the left ventricle and its dysfunction. This leads to a reduced mortality and fewer relapses of infarction even in patients with asymptomatic left ventricular dysfunction.
[Use of captopril in diabetics].
J Jensovský
Vnitr Lek 1995, 41(3):162-163
The author describes in his brief review the pathophysiological effects of the inhibitor of the angiotensin converting enzyme (ACEI) and its favourable properties in the treatment of hypertension in diabetics, in the treatment of diabetic nephropathy and its metabolic effects on insulin resistance, improvement of cognitive functions and thus a better quality of life of the patients.
[Pharmacokinetics and pharmacodynamics of calcium channel blockers].
O Mayer
Vnitr Lek 1995, 41(3):164-166
The author presents a review of the chemically heterogeneous group of calcium antagonists, focused on their pharmacodynamic properties. He includes in the older generation of calcium antagonists drugs like verapamil, dihydropyridines (nifedipine) and dilthiazem (Diacordin, Blocalcin). The newer generation of dihydropyridines comprises substances with a higher vascular selectivity at a concentration of lower order. The latter include felodipine (Plendil), isradipine (Lomir) and nitrendipine (Baypress). The third generation includes drugs like amlodipine (Norvasc) and lacidipine. The slow onset of action of amlodipine is associated with a decline of...
[Calcium channel blockers in the treatment of ischemic heart disease].
J Bultas
Vnitr Lek 1995, 41(3):167-168
After a brief review of the pathophysiological properties of calcium channel blockers on the ischaemic heart muscle the author deals with the therapeutic effect of blockers on coronary spasms and at the same time on vasodilatation of arteries in the systemic circulation. Their effect is manifested also by the favourable action on the arteriosclerotic process proper, the clinically significant retardation of atherogenesis, stabilization of atherosclerotic plaques. The author pays special attention to the new calcium channel blocker-amlodipine which as to its pharmacokinetic properties is superior to all hitherto used types of blockers.
[Sulodexide in the treatment of venous thrombosis].
M Penka
Vnitr Lek 1995, 41(3):169-171
Contemporary views on the treatment of thromboembolic disease comprise the possibility to use preparations with an antithrombotic effect in indications, where it is not necessary to administer anticoagulants or thrombolytic drugs or combined treatment. Sulodexide can due to its effects, easy administration (in particular the oral form) and unpretentious monitoring be used where so far only more pretentious therapeutic procedures could be applied. Our initial experience in fourteen patients with deep venous thrombosis seems to be very encouraging.
[Pharmacotherapy of hyperlipoproteinemia in view of the newest European and American recommendations].
R Ceska
Vnitr Lek 1995, 41(3):172-175
UNLABELLED: Hyperlipoproteinaemias, in particular types associated with elevated levels of total and LDL-cholesterol and partly triacylglycerols (in particular in combination with reduced HDL-cholesterol), are one of the most serious risk factors of early manifestation of IHD and atherosclerosis at other sites. Their effective treatment is considered a rational procedure in preventive cardiology. Who should be treated, when and how? When deciding we have to combine two basic approaches. Every patient must be considered individually, on the other hand, it is necessary to respect some general recommendations. The most comprehensive view of the given...
[Helicobacter pylori eradication in patients with diseases of the stomach].
B Fixa, O Komárková, Z Nozicka
Vnitr Lek 1995, 41(3):176-178
The authors present a review of contemporary findings concerning treatment of gastroduodenal ulcers with a positive finding of Helicobacter pylori. Only combined anti-Helicobacter treatment leads to the eradication of Helicobacter pylori in 80-96% of the patients. Moreover it leads to gradual recovery from gastritis and bulbitis and thus prevents ulcer recurrence.
[Drugs affecting gastric acidity in the therapy of ulcer disease].
V Jirásek
Vnitr Lek 1995, 41(3):179-181
The most substantial factor in the pathogenesis of peptic ulcers of the gastroduodenum is a preserved HCl secretion (frequently hypersecretion) and the presence of Helicobacter pylori. In some of the ulcers a part is played by non-steroid antirheumatic drugs. In the treatment inhibition of acid secretion by antagonists of H2 receptors proved useful as they heal approximately 80% ulcers in the course of four weeks. Drugs of this group however, do not resolve the main problem of anti-ulcerous treatment, i.e. the liability of ulcers to relapse. 70-80% of the patients develop a relapse within one to two years. Moreover, in 5-10% of the patients the ulcers...
[Treatment of chronic viral hepatitis].
J Sperl
Vnitr Lek 1995, 41(3):182-184
The activity of the inflammatory process in chronic viral hepatitis is conditioned by active replication of the virus in hepatocytes. The objective of treatment of chronic viral hepatitis is to arrest the virus replication, or preferably complete elimination. In recent years the first place in the treatment of chronic hepatitis was occupied by interferons, in particular interferon alpha. The course of the disease can be favourably influenced by treatment with interferon alpha in the half of patients with chronic active hepatitis B and in approximately one quarter of patients with chronic active hepatitis C. Treatment of chronic viral hepatitis in the...
[Pharmacotherapy of portal hypertension].
E Drazná
Vnitr Lek 1995, 41(3):185-188
The task of pharmacotherapy in acute haemorrhage from oesophageal varices in patients with cirrhosis of the liver and portal hypertension is to arrest bleeding by reducing the blood pressure and blood flow in the oesophageal varices. The mechanism of action of the majority of drugs used is vasoconstriction of the arterioles in the splanchnic region. Somatostatin seems to be more effective and in particular safer than vasopressin, terlipressin or their combination with the vasodilatator nitroglycerin. Initial pharmacotherapy for rapid control of haemorrhage is simple and effective treatment, however, it cannot be considered an alternative of sclerotherapy,...
[Modern therapy of ascites in liver cirrhosis].
M Brodanová
Vnitr Lek 1995, 41(3):189-192
The most frequent cause of ascites in the Czech Republic is cirrhosis of the liver. Treatment of ascites in cirrhotic patients must be very careful as the use of strong diuretics is associated with some adverse complications. The latter are reviewed. The basic therapeutic provision is restriction of water and salt intake. Aldosterone antagonists are diuretics of first choice. A commonly used diuretic is also furosemide and thiazides. The author outlines the algorithm of treatment of ascites, in particular from the aspect of the general practitioner.
[Therapy of chronic cholestasis].
Z Marecek
Vnitr Lek 1995, 41(3):193-195
Therapy of chronic intrahepatic cholestasis is either symptomatic or causal. Symptomatic treatment is focused above all on treatment of pruritus - in the treatment an important place is held by the administration of cholestyramine and Rifadine; administration of opiate antagonists is very promising. In the causal treatment administration of ursodeoxycholic acid predominates. Its favourable effect was proved in several controlled studies. It is useful in primary biliary cirrhosis and primary sclerotizing cholangoitis, however, also in other types of cholestasis. In advanced cases it is a useful starting point for transplantation of the liver.
[Diagnosis and therapy of functional gastric and intestinal disorders].
Z Maratka
Vnitr Lek 1995, 41(3):196-198
The author summarizes his own views and experience as regards the classification, diagnosis and treatment of gastric and intestinal dyspepsias. In the diagnosis he emphasizes in particular a detailed case-history, in treatment and individual approach based on careful analysis and careful interviews with every patient.
[Functional disorders of the digestive tract and possibilities of therapy with Prepulside (cisapride)].
A Hep, J Prásek, P Dítě
Vnitr Lek 1995, 41(3):199-203
The authors give an account of functional disorders of the digestive tract. They deal briefly with possibilities of their medicamentous treatment with regard to the pharmacological action of prokinetics. Finally they review indications for Prepulside.
[Modern therapeutic trends in the conservative treatment of ischemic disease of the lower extremities].
V Puchmayer
Vnitr Lek 1995, 41(3):204-206
The author reviews contemporary knowledge of the pathogenesis of ischaemia of the lower extremities. As to therapeutic provision which influence in a favourable way pathological processes associated with the development of ischaemia an important place is held by pentoxiphylline (Trental) which reduces the pathologically raised adhesiveness and activity of leucocytes causing an excessive immune response; it reduces the viscosity of blood and procoagulation activity.
[Advances in the pharmacotherapy of osteoporosis].
J Kocián
Vnitr Lek 1995, 41(3):207-209
In the pharmacotherapy of osteoporosis administration of calcium, small amounts of vitamin D and fluorides still is the basic treatment. Thyrocalcitonin can be also administered, recently also in the form of a nasal spray. It does not only prevent reabsorption of bone but has also an analgetic effect. In the treatment of postmenopausal osteoporosis we use conjugated oestrogens in cyclic preparations with gestagens. Biphosphonates prevent bone resorption but also apposition of the mineral. As to new preparations, Ipriflavone and TGF-beta seem most promising, moreover, there is the perspective of the use of other preparations: small doses of PTH, tamoxifen...
[Therapeutic use of recombinant human erythropoietin in clinical practice].
V Scudla
Vnitr Lek 1995, 41(3):210-214
The author presents an account of contemporary and perspective indications of the therapeutic use of recombinant human erythropoietin (r-HuEPO). He discusses the role of endogenous erythropoietin in the pathogenesis of hypoproliferative anaemias (due to its shortage or inadequate effect) and classification of these conditions as a starting point of expedient therapeutic use of r-HuEPO in clinical practice. More detailed attention is paid in particular to the problem of treatment of anaemia in patients with chronic renal failure, anaemia in chronic inflammatory and malignant diseases, in myelodysplastic syndrome and aplastic anaemia. The author mentions...
[Modern methods of urinalysis].
I Bilyk
Vnitr Lek 1995, 41(3):215-218
The author describes work with two apparatuses, Urilux and Miditron, which evaluate by means of reflex photometry as many as ten parameters on diagnostic strips dipped in the examined urine sample. The first apparatus is suitable for doctors' surgeries or in-patient departments, the second larger one for diagnostic laboratories.