Sadržaj
P1. DIZAJN JEDINJENJA SA VIŠESTRUKIM FARMAKOLOŠKIM
DEJSTVOM –KOLIKO TO TEŠKO MOŽE BITI...!? ...................................................................... 2
P1. DESIGNING POLYPHARMACOLOGY - HOW HARD COULD IT BE….? ................................................ 3
P2. LEKOVI U ŽIVOTNOJ SREDINI: SADAŠNJI STATUS ...................................................... 4
P2. PHARMACEUTICALS IN THE ENVIRONMENT: CURRENT STATUS .................................................... 5
P3. ULOGA FARMACEUTA U SPROVOĐENJU EFIKASNE I BEZBEDNE
SAMOMEDIKACIJE ...................................................................................................................... 6
P3. ROLE OF A PHARMACIST IN PROVIDING AN EFFECTIVE AND SAFE SELF-MEDICATION .................. 7
1
P1. DIZAJN JEDINJENJA SA VIŠESTRUKIM FARMAKOLOŠKIM
DEJSTVOM –KOLIKO TO TEŠKO MOŽE BITI...!?
Ranković Zoran
Eli Lilly, UK
Poslednjih godina je opštepoznato da efektivnost terapije za bolesti sa kompleksnom
etiologijom kao što su rak i psihijatrijski poremećaji zahteva istovremenu modulaciju multiplih
bioloških ciljeva. Uz to, postoji povećan interes za razvoj terapijskih sredstava sa specifičnom
ciljnom polifarmakologijom.
Međutim, otkriće lekova sa višestrukim ciljnim dejstvima je često izazovni poduhvat, pri čemu je
neophodna odgovarajuća ravnoteža afiniteta za dva ili više ciljeva i istovremeno sa fizičko –
hemijskim i farmakokinetskim svojstvima, koja omogućavaju peroralnu primenu.
U ovom predavanju, biće prikazana opravdanost, izazovi, savremena strategija i mogući budući
pravci za proizvodnju i optimizaciju liganda sa specifičnim, višeciljnim profilom (dizajniranje
višeciljnihj liganda ili DMLs)
Ključne reči: multipli lek, polifarmakologija, savremena strategija
2
P1. DESIGNING POLYPHARMACOLOGY
- HOW HARD COULD IT BE….?
Rankovic Zoran
Eli Lilly, UK
It has been widely recognised over the recent years that effective therapies for diseases with
complex aetiologies such as cancer and psychiatric disorders require simultaneous modulation
of multiple biological targets. Consequently, there is an increasing interest in developing
therapeutic agents with specifically targeted polypharmacology. However, multi-target drug
discovery is frequently a challenging endeavour, with the need to appropriately balance affinity
for two or more targets whilst obtaining physicochemical and pharmacokinetic properties that
are consistent with oral administration. In this talk we will discuss the rational, challenges,
current strategies and potential future directions for the generation and optimisation of ligands
with a specific multi-target profile (designed multi-targeted ligands, or DMLs).
Key words: multi-target drug, polypharmacology, current strategy
3
P2.
LEKOVI U ŽIVOTNOJ SREDINI: SADAŠNJI STATUS
Iscan Mumtaz
Farmaceutski fakultet, Zavod za Toksikologiju, Univerzitet Ankara, Tandogan – Ankara, Turska
Tokom zadnje dve decenije, detektovan je veliki broj lekova u životnoj sredini, što je izazvalo
zabrinutost u Evropi i drugim delovima sveta zbog mogućeg uticaja ovih bioaktivnih jedinjenja
na životnu sredinu.
Zabrinutost se povećala nakon otkrića da je nesteroidni, antiinflamatorni lek diklofenak izazvao
neuobičajeno visoku smrtnost kod tri vrste ptica u Indiji i Pakistanu 2004. godine.
Lekovi mogu da kontaminiraju životnu sredinu različitim putevima kao što su: fabrike za
proizvodnju lekova, pogoni za preradu kanalizacionog otpada, kućnog otpada i prisustvom na
deponijama.
Danas, da bi novi lek dobio dozvolu za promet, neophodna je procena mogućeg rizika za
životnu sredinu uz evaluaciju terapijskog i bezbednosnog aspekta, kao i procena efikasnosti i
kvaliteta proizvoda.
Važeći vodič, koji je izdala EMA (Evropska Agencija za lekove), opisuje procenu rizika za lekove
kao dvostepeni proces, koji uključuje predviđanja zasnovana na različitim uslovima izloženosti u
životnoj sredini i sudbinu u životnoj sredini kao i ispitivanje efekta.
Tokom poslednjih godina, sve je više dokaza koji potkrepljuju naše poznavanje sudbine i
dejstva lekova na životnu sredinu ali još uvek postoje brojne nejasnoće u vezi sa procenom
moguće ekspozicije i dejstva na organizme u životnoj sredini a što mora da se uzme u obzir pre
evaluacije celokupnog rizika.
Novije studije, koje su obuhvatile brojne multicentrične, kolaborativne studije, izvedene u
razvijenim zemljama su obezbedile detaljne podatke o njihovom potencijalu rizika za životnu
sredinu.
Sa druge strane, nedostatak podataka o uticaju lekova na životnu sredinu u zemljama u razvoju
je još uvek nepoznanica i izaziva posebnu zabrinutost.
Zbog toga svest o o prisustvu lekova u životnoj sredini uz dokaze o njihovom dejstvu na životnu
sredinu, ukazuje na neophodnost hitnog preuzimanja preventivnog plana dejstva da bi se
smanjilo njihovo oslaobađanje u životnu sredinu. U ovom predavanju će biti prikazani najnoviji
dostupni podaci o lekovima u životnoj sredini a u okviru napred pomenutih aspekata.
Ključne reči: lekovi, životna sredina, procena rizika, plan dejstva
4
P2. PHARMACEUTICALS IN THE ENVIRONMENT:
CURRENT STATUS
Iscan Mumtaz
Department of Toxicology, Faculty of Pharmacy, Ankara University, Tandogan-Ankara, Turkey
During the last two decades the widespread detection of a large variety of pharmaceuticals
in the environment has raised concern in Europe and in other parts of the world about the
potential impact of these bioactive substances on the environment. Concerns have further
strengthened after residues of the analgesic and anti-inflammatory drug substance diclofenac
were held responsible for the unusually high death rate among three species of vulture in India
and Pakistan in 2004. The pharmaceuticals may enter the environment by various routes such
as manufacturing plants, effluents of sewage treatment plants (STP)s, household waste and
landfill effluents. At present, the approvals for new pharmaceuticals require an assessment of
potential environmental risks related to their use, in addition to the evaluation of health and
safety aspects, efficacy, and quality of products. The current guidance by the regulatory bodies
such European Medicines Agency (EMEA) describes the risk assessment for pharmaceuticals
as a step-wise 2 phased assessment involving predictions based on various environmental
exposure scenarios and subsequent environmental fate and effects testing. Although during the
past few years, increasing body of evidence provided our understanding of the fate and effects
of pharmaceuticals in the environment has progressed significantly there are still a number of
uncertainties concerning the assessment of potential exposure and the effects of them on
organisms in the environment that have to be addressed before risks can be fully evaluated.
Nevertheless, the recent in-depth studies including the number of multi-centered collaborative
ones performed particularly in developed countries provided detailed information about their
potential in posing risk to environment. On the other hand, the lack of the environmental data of
the pharmaceuticals in less developed countries is still a matter of utmost concern. Hence, the
awareness of the presence of pharmaceuticals in the environment, coupled with some evidence
of effects, suggests the immediate requirement of the precautionary management action to
reduce their release to the environment. Herein, the current available information on the
pharmaceuticals in the environment will be presented within the aferomentioned perspectives.
Key words: Pharmaceuticals, environment, risk assessment, management action
5
P3. ULOGA FARMACEUTA U SPROVOĐENJU EFIKASNE I
BEZBEDNE SAMOMEDIKACIJE
Dobrić Silva
Vojnomedicinska akademija, Institut za naučne informacije, Beograd, Srbija
Samomedikacija podrazumeva upotrebu medicinskih proizvoda koje pojedinci primenjuju u
svrhu lečenja ili prevencije bolesti čije simptome mogu sami prepoznati bez konsultacije sa
lekarom. Uspešna (optimalna) samomedikacija treba korisnicima da omogući efikasno i
bezbedno lečenje, veću dostupnost lekovima i širi izbor terapijskih modaliteta.
Lekovi za samomedikaciju (engl. over the counter – OTC) su lekovi koji se proizvode,
distribuiraju i izdaju bez recepta da bi ih koristili pacijenti na sopstvenu inicijativu i odgovornost,
u situaciji kada smatraju da je ta upotreba ispravna. Oni treba da budu kvalitetni, dokazano
efikasni i bezbedni, da se koriste za jasnu indikaciju, u odgovarajućoj dozi i farmaceutskom
obliku, da se ne primenjuju parenteralnim putem, da njihovi pojedinačni dozni oblici sadrže
minimalnu količinu aktivnih supstanci i da im je pakovanje predviđeno za najviše 10 dana. Ovi
uslovi su neophodni jer samomedikacija uvek nosi određene rizike, uglavnom vezane za
neadekvatno postavljenu dijagnozu od strane samog pacijenta s posledičnim izborom
neodgovarjućeg leka, doze, načina primene, opasnosti od napredovanja bolesti, itd.
Zahvaljujući svom obrazovanju i poziciji (svi lekovi, uključujući i OTC-proizvode, mogu se
nabaviti samo u apoteci), farmaceut predstavlja idealnog stručnjaka koji može da pomogne
pacijentu u izboru pravog, efikasnog i bezbednog OTC preparata i da ga, na taj način, zaštiti od
potencijalnih rizika koji prate samomedikaciju. Farmaceut, ujedno, ima i odgovornost da
preporuči samomedikaciju samo kada proceni da je to bezbedno i podesno za datog pacijenta.
Da bi ispunio svoju ulogu u sistemu samomedikacije, farmaceut, pored inoviranja znanja o
lekovima, mora da savlada i veštinu komunikacije sa pacijentom, veštinu edukacije, da sarađuje
sa drugim zdravstvenim radnicima, strukovnim organizacijama i regulatornim telima u cilju
razmene iskustava i podataka, da učestvuje u kampanjama za promociju zdravlja i da pruža
savete u cilju donošenja ispravnih odluka o spostvenom zdravlju. Na taj način farmaceut će
moći u potpunosti da obezbedi optimalnu samomedikaciju najširem krugu korisnika.
Ključne reči: samomedikacija, OTC lekovi, lečenje, prevencija bolesti, farmaceutska usluga.
6
P3. ROLE OF A PHARMACIST IN PROVIDING AN EFFECTIVE AND
SAFE SELF-MEDICATION
Dobric Silva
Military Medical Academy, Institute for Scientific Information, Belgrade, Serbia
Self-medication is the use of medicines in treatment or prevention of diseases whose symptoms
patients can recognize with no consultation with physicians. Successful (optimal) selfmedication should provide an effective and safe therapy, increased drug availability and wider
choice of therapeutic modality.
Self-medication drugs are nonprescription medicines, so called over the counter (OTC) drugs.
They are used by poeple on their own initiative and responsibilty in situation when they consider
this use as proper one. OTC drugs should have high quality, as well as be proved effective and
safe. They should be used for a distinct indication, in proper dose and dosage form, not by
parenteral route, and their single dosage forms must contain a minimal quantity of active
substances, in package sufficent for maximum 10 days. These conditions are needed because
self-medication always carries some risks mainly associated with wrong diagnosis made by a
patient, and as a consequnce with wrong choice of drug, wrong dose or route of drug
administration, as well as a danger of disease progression.
A pharmacist, due to one’s own education and position (all drugs, including OTC ones are
supplied in the pharmacy) has a key role in helping patient to choose a right, effective and safe
drug for self-medication, and, in this manner, protecting him/her from potential risks associated
with self-medication. Besides, a pharmacist has a responsibility to recommend self-medication
just when estimates it is safe and convenient for particular patient.
In order to perform one’s own role in the system of self-medication, a pharmacist, except
renovation of drug knowledge, has to learn communication skills with a patient, as well as
education skills, has to colaborate with other health care professionals, professional
organizations, and regulatory bodies due to mutual exchange of experiences and data, and has
to participate in campaign for health promotion offering advices for health improving. In this
manner a pharmacist will be able to completely provide an optimal self-medication to widest set
of users.
Key words: self-medication, OTC drugs, therapy, disease prevention, farmaceutical service.
7
Download

Sadržaj