Faculty of Medicine
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Item type:Publication, Drugs with a negative impact on cognitive functions (part 3): antibacterial agents in patients with chronic kidney disease(Oxford University Press (OUP), 2024-08); Bobot, MickaëlThe relationship between chronic kidney disease (CKD) and cognitive function has received increased attention in recent years. Antibacterial agents (ABs) represent a critical component of therapy regimens in patients with CKD due to increased susceptibility to infections. Following our reviewing work on the neurocognitive impact of long-term medications in patients with CKD, we propose to focus on AB-induced direct and indirect consequences on cognitive function. Patients with CKD are predisposed to adverse drug reactions (ADRs) due to altered drug pharmacokinetics, glomerular filtration decline, and the potential disruption of the blood-brain barrier. ABs have been identified as a major cause of ADRs in vulnerable patient populations. This review examines the direct neurotoxic effects of AB classes (e.g. beta-lactams, fluoroquinolones, aminoglycosides, and metronidazole) on the central nervous system (CNS) in patients with CKD. We will mainly focus on the acute effects on the CNS associated with AB since they are the most extensively studied effects in CKD patients. Moreover, the review describes the modulation of the gut microbiota by ABs, potentially influencing CNS symptoms. The intricate brain-gut-kidney axis emerges as a pivotal focus, revealing the interplay between microbiota alterations induced by ABs and CNS manifestations in patients with CKD. The prevalence of antibiotic-associated encephalopathy in patients with CKD undergoing intravenous AB therapy supports the use of therapeutic drug monitoring for ABs to reduce the number and seriousness of ADRs in this patient population. In conclusion, elucidating AB-induced cognitive effects in patients with CKD demands a comprehensive understanding and tailored therapeutic strategies that account for altered pharmacokinetics and the brain-gut-kidney axis. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Drug Interactions(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024)Drug interactions can be described as the pharmacological influence of one drug on another drug, when administered in combination. Drug interaction can cause an increased or decreased effect of the drug, but it can also lead to a toxic effect. In daily practice in operating rooms and intensive care units, anesthesiologists routinely combine drugs. Interactions are usually divided according to the mechanism of occurrence and the most frequent are pharmacokinetic and pharmacodynamic. In pharmacokinetic interactions, the interactions are at the level of absorption, distribution, metabolism, or elimination processes. Such interactions are predictable, but their extent cannot be predicted. Pharmacodynamic interactions refer to antagonistic or synergistic action between drugs. It remains a challenge to teach clinicians how to combine these drugs in order to achieve and maintain optimal anesthetic and vital conditions, while minimizing side effects. A good understanding and knowledge of drug interactions can improve the ability to titrate multiple drugs more effectively. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evaluation of performance characteristics of test devices for drugs of abuse in urine produced by different manufacturers(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2017); ; ; ;