Saratov JOURNAL of Medical and Scientific Research

Reshetko O.V.

Saratov State Medical University n.a. V.I. Razumovsky, Department of Pharmacology, Professor, Doctor of Medical Science

Analysis of a real practice in hospital pharmacotherapy psoriatic arthritis

Year: 2016, volume 12 Issue: №3 Pages: 498-500
Heading: Dermatovenerology Article type:
Authors: Levitan A.l., Reshet'ko O.V.
Organization: Saratov State Medical University
Summary:

The Aim of the study: to define the characteristics of the current treatment of psoriatic arthritis in the settings of specialized medical care in a hospital, based on pharmacoepidemiological study, to optimize the treatment of such patients. Material and Methods. A retrospective pharmacoepidemiological study is based on an analysis of medical records of hospitalized patients rheumatology department requesting assistance in the period from January 2016 to April 2016. Result. As a part of basic anti-inflammatory therapy of psoriatic arthritis, methotrexate was used in 67% patients, sulfasalazine in 25% patients, and cyclosporine and D-penicillamine in 4% patients. Genetically engineered biologic drugs (GEBD) were not used. The anti-inflammatory therapy in hospital was carried out with glucocorticosteroids in 33% patients, with non-steroidal anti-inflammatory drugs (NSAIDs) in 20% cases and in 47% cases a combination of both was used. Gastroprotective therapy was given to all patients receiving corticosteroids and NSAIDs. Conclusion. The study shows that, the treatment of psoriatic arthritis meets the current recommendations, although there are problems associated with excessive use of corticosteroids and the lack of GEBD.

AttachmentSize
2016_03-1_498-500.pdf234.54 KB

Clinical pharmacology for doctors of different specialties: the results of annual Interregional conference "From theory to practice: opportunities and difficulties of modern pharmacotherapy"

Year: 2016, volume 12 Issue: №2 Pages: 216-219
Heading: Scientific life Article type: Short message
Authors: Chernenkov Yu.V., Reshetko O.V., Novikov D.E.
Organization: Saratov State Medical University
Summary:

The article presents the information on the annual Interregional conference held in Saratov State Medical University" From Theory to Practice: Opportunities and challenges of modern pharmacotherapy". The next conference will be held on 20-21 April 2017.

AttachmentSize
2016_02_216-219.pdf269.18 KB

Pharmacoeconomics as an instrument of clinical pharmacology for optimization of pharmacotherapy

Year: 2015, volume 11 Issue: №3 Pages: 428-431
Heading: Dermatovenerology Article type: Review
Authors: Reshetko O.V., Lutsevich К.А., Nelyubova 0.I.
Organization: Saratov State Medical University
Summary:

The article presents pharmacoeconomics is an essential component of health technology assessment and the appraisal of medicines for use by patients. As a comparatively young discipline, its methods continue to evolve. Pharma-coeconomic analyses encompass cost — minimization, cost — utility, cost — benefit, and cost — effectiveness studies, providing essential information critical for optimization of pharmacotherapy, optimal health-care resource allocation and drug development success.

AttachmentSize
2015_03-01_428-431.pdf249.78 KB

Innovative medicines for treatment of psoriatic arthritis

Year: 2015, volume 11 Issue: №3 Pages: 423-425
Heading: Dermatovenerology Article type: Review
Authors: Levitan A.l., Reshetko O.V.
Organization: Saratov State Medical University
Summary:

The problem of effective treatment of psoriatic arthritis has not been solved yet. The search for new therapeutic options is very active in many directions. At the stage of clinical trials are drugs that block interleukin-17-a (secukinumab, ixekizumab, brodalumab), drugs that suppress interleukin-12 and interleukin-23 (ustekinumab). To modern means to ensure psoriatic arthritis include drugs that are inhibitors of small molecules orkinase pathways (apremilast, tofacitinib).

AttachmentSize
2015_03-01_423-425.pdf250.65 KB

Pharmacometrics as an instrument of clinical pharmacology for optimization of drugs dosing regimens during pregnancy

Year: 2014, volume 10 Issue: №1 Pages: 199-203
Heading: Parmacology Article type: Review
Authors: Reshetko O.V., Lutsevich К.А.
Organization: Saratov State Medical University
Summary:

Changes in maternal physiology and metabolic during pregnancy influence pharmacokinetics and illustrate that standard adult dosing is likely to be incorrect during pregnancy. Different pharmacometric approaches are available for design and analysis of clinical studies during pregnancy. Physiologically-based pharmacokinetic (PBPK) model could be used to evaluate different dosing regimens for pregnant women and serves in predicting drug exposure and response at the personal level.

AttachmentSize
2014_01-01_199-203.pdf350.96 KB

Pharmacoepidemiological analysis of the drugs used for secondary prevention of brain infarction on dispensary stage

Year: 2014, volume 10 Issue: №1 Pages: 189-195
Heading: Parmacology Article type: Original article
Authors: Miheyeva N.V., Reshetko O.V., Furman N.V.
Organization: Saratov Institute of Cardiology, Russia, Saratov State Medical University
Summary:

Aim. The secondary prevention of cerebral infarction on dispensary stage to current clinical guidelines was analyzed. Adherence of patients to prescribe medications was evaluated. Material and methods. 106 patients of hospital neurologic department with brain infarction were included in prospective pharmacoepidemiological study of the drugs used for secondary prevention of brain infarction on dispensary stage since 1 January 2009 to 31 December 2009. Duration of outpatient observation was 3 years. Results. All of the patients were of 64,9 ± 10,3 years old. Hypertension was diagnosed in 102 of them (96.2%), atrial fibrillation — in 33 (31.1%) patients. 39 (36.8%) patients died during 3 years after discharge from the hospital. ACE inhibitors/angiotensin II receptor antagonist were prescribed for 83 (78.3%) patients, antiplatelet- 76 (71,7%), statins — 16 (15,1%) patients in discharge from hospital. Warfarin was prescribed only for 1 (3.05%) patient with atrial fibrillation and ischemic stroke.consumption of drugs with evidence efficiency were diminished already after one year of observation in outpatient clinics. Conclusion.Therapy for secondary stroke prevention is not fully comply with current clinical guidelines

Keywords: -
AttachmentSize
2014_01-01_189-195.pdf484.69 KB

Features of pharmacotherapy and clinical course of atrial fibrillation in patients with type 2 diabetes in real clinical practice. Saratov Journal of Medical Scientific

Year: 2014, volume 10 Issue: №1 Pages: 178-185
Heading: Parmacology Article type: Original article
Authors: Graifer l.V., Reshetko O.V., Furman N.V., Dolotovskaya P.V.
Organization: Saratov Institute of Cardiology, Russia, Saratov State Medical University
Summary:

The aim of the study was to investigate the clinical status of patients with atrial fibrillation (AF) and diabetes mellitus (DM) type 2 and to identify differences in the treatment of AF, conducted in the cardiology departments of multidisci-plinary teaching hospitals of the Saratov city. Materials and methods. A comparative retrospective analysis of 1041 pharmacoepidemiological solid history of patients with AF who were hospitalized in emergency, and in the planning department of cardiology of 2 multidisciplinary teaching hospitals of the Saratov city consecutively in a calendar year on the AF, recorded on an electrocardiogram. Results. Among all patients with AF, patients with DM accounted for 20.2%. Among them were women, they were younger, they developed fibrillation at a younger age, they differed more severe structural heart disease, among which was significantly greater with myocardial infarction, nearly all had symptoms of heart failure. Patients with DM performed less frequently cardioversion, and to monitor heart rate often preferred a combination of beta-blockers and digoxin. 100% of patients with DM had a higher risk of thromboembolic complications (91.9% without diabetes) in both groups, oral anticoagulants (OAC) prescribed often enough. Conclusion. DM was diagnosed in every fifth patient with AF, especially among women and patients with persistent AF and is associated with the presence of more severe organic heart disease compared with patients without DM. All patients on the background DM was a high risk of thromboembolic complications, i.e. OAC must be assigned in 100% of cases, but in the surveyed hospitals OAC were appointed only in 23% of cases.

AttachmentSize
2014_01-01_178-185.pdf275.12 KB

Association of polymorphism of CYP2D6 and CYP2C9 genes encoding P-450 proteins of cytochrome with arterial hypertension

Year: 2012, volume 8 Issue: №4 Pages: 933-937
Heading: Internal Diseases Article type: Original article
Authors: Borodulin V.B., Shevchenko O.V., Bychkov E.N., Kiselev A.R., Reshetko O.V., Posnenkova O.M., Saratsev A.V., Losev O.E.
Organization: Saratov State Medical University
Summary:

Gene polymorphisms of cytochrome P-450 CYP2 encoding proteins of cytochrome P-450 are essential forantihy-pertensive drugs metabolism. Purpose: We study the associations of functionally defective allele variants of CYP2D6 gene and CYP2C9 gene with the degree of arterial hypertension (AH). Materials and methods: Samples of DNA of leukocytes of blood of 150 patients with AH without the associated clinical conditions (56% of women) at the age of 20-59
years have been investigated. For the study of polymorphism of genes the pharmacogenetic biochip developed in the Institute of Molecular Biology n.a. V. A. Engelgardt has been used. Comparison of frequencies of occurrence of signs has been carried out on the basis of chi-square criterion. Results: It has been revealed that homozygotes by mutant A1075C, C430T alleles of CYP2C9gene and G1934A of CYP2D6 gene have been significantly more common among patients with hypertension III (p=0.01). Conclusion: The research works on genes of system of P-450 cytochrome have important clinical value for rationalization of pharmacotherapy of hypertension. The increased frequency of occurrence of mutant allele of CYP2D6 and CYP2C9 genes in patients with hypertension III requires special attention to the problem of efficiency and safety of application of hypotensive drugs for the patients.

AttachmentSize
201204-933-937.pdf913.73 KB

The role of genetic mutations in development of metabolic disturbances in patients with arterial hypertension

Year: 2012, volume 8 Issue: №3 Pages: 751-756
Heading: Internal Diseases Article type: Original article
Authors: Borodulin V.B., Shevchenko O.V., Bychkov E.N., Reshetko O.V., Kiselev A.R., Posnenkova O.M., Zhelezinskaja N.V., Sarattsev A.V., Losev O.E.
Organization: Saratov State Medical University, Saratov Institute of Cardiology, Russia, First Moscow State Medical University n.a. I.M. Sechenov, Clinical Hospital of Ministry of Internal Affairs of the Russian Federation
Summary:

The article stresses on the study of molecular markers of essential arterial hypertension providing insight into the pathological mechanisms underlying the disease and creation of «genetic passport» for every patient in the future. Objective: To study genetic markers of 5,10-methylenetetrahydrofolate reductase (MTHFR), involved in the metabolism of homocysteine, and N-acetyltransferase 2 (NAT2), ensuring the process of transformation of acetyl-CoAto acetoacetyl-coenzyme A. Methods: The study involved 160 patients with essential hypertension l-lll stages Caucasian (57.5% female.) aged 20-59 years. MTHFR gene polymorphisms and NAT2 in DNA of peripheral blood leukocytes were studied using a set of Wizard Genomic DNA Purification Kit (Promega, USA). Results: It was shown that «slow acetylators» (homozygous for a mutant version of the gene NAT2) were more frequently (p <0.05) determined among patients with hypertension stage 1. It was also revealed the dependence on the presence of hypertension stage mutant allele T (hetero-and homozygous variants) in 677 nucleotide gene MTHFR (r = 0,40, p <0.001). Conclusions: The regularities of the distribution of polymorphic variants of MTHFR and NAT2 gene were found out in hypertensive patients according to the stage of the disease.

AttachmentSize
201203-751-756.pdf612.78 KB