Clinical Pharmacology,within the Internal Clinic and the Department of Laboratory Medicine
The Department of Clinical Pharmacology was established in January 1990. Currently, clinical pharmacologists (MUDr. Karin Máčalová, MUDr. Marek Rác) work within the Internal Clinic and a clinical pharmacist (PharmDr. Mária Göböová, PhD.) works within the Internal Clinic and the pharmacokinetic laboratory (Department of Laboratory Medicine).
Currently, we provide expert consultations in the field of antibiotic treatment, drug risks (interactions, adverse effects, and drug intolerance), optimization of dosage regimens for individual patients, pharmacotherapy in pregnancy and lactation, and drug risks in elderly and specific patient groups. Expert consultations include both hospitalized and outpatient patients.
Since 1992, we have been providing a complete pharmacokinetic service, which includes therapeutic drug monitoring (TDM) using the immunoassay method and toxicological drug screening.
Currently, we monitor levels of: amikacin, benzodiazepines, cyclosporine, digoxin, phenobarbital, gentamicin, carbamazepine, valproic acid, opiates, theophylline, vancomycin. Toxicological examination of drugs and medications is determined in urine. We currently measure concentrations of addictive drugs and medications: amphetamine, benzodiazepines, buprenorphine, cannabinoids, opiates. We interpret every TDM result and propose optimal dosage regimens for the individual patient, evaluating interactions of the current therapy. For high-risk patients, we determine the dosage regimen using a pharmacokinetic computer program based on the determined drug levels.
We perform examinations mainly for our patients at the Nitra University Hospital, as well as for ŠN Zobor, the Psychiatric Hospital in Veľké Zálužie, the Hospital in Topoľčany, and specialized clinics in Nitra, Topoľčany, Zlaté Moravce, Šahy, Šaľa, and Galanta. Since 1992, we have determined over 110,000 drug levels.
Current staff composition, qualifications, contacts
MUDr. Karin Máčalová – clinical pharmacologist, diabetologist, internist – ext. 867
Organizationally assigned under the Internal Clinic of FN Nitra
Qualifications:
- attestation in internal medicine, clinical pharmacology, diabetology, metabolic disorders and nutrition
(more information on the page of the diabetology clinic and the Internal Clinic of FN Nitra)
MUDr. Marek Rác – clinical pharmacologist, hepatologist, internist – ext. 492
Qualifications:
Organizationally assigned under the Internal Clinic of FN Nitra
- attestation in internal medicine, clinical pharmacology, hepatology
(more information on the page of the hepatology clinic and the Internal Clinic of FN Nitra)
PharmDr. Mária Göböová, PhD. – clinical pharmacist – ext. 370
Qualifications:
- attestation in clinical pharmacy level I and II, attestation in pharmacy,
- certificate in clinical trials of drugs and products from the Slovak Medical University in Bratislava,
- rigorous examination in the field of pharmacy at the Faculty of Pharmacy of Comenius University in Bratislava,
- doctoral studies in the field of pharmacology at the Faculty of Pharmacy of Comenius University in Bratislava
Other activities:
- Chief Expert for Clinical Pharmacy of the Ministry of Health of the Slovak Republic
- professional guarantor for the field of clinical pharmacy at SZU in Bratislava
- scientific secretary of the Clinical Pharmacy Section, SFS, o.z. SLS
- member of the state examination board and the departmental examination board for the accredited doctoral study program in clinical pharmacy at the Faculty of Pharmacy of Comenius University Bratislava.
- chairwoman of the Ethics Committee, member of the Commission for Rational Pharmacotherapy and Drug Policy, member of the Commission for Anti-infective Treatment of FN Nitra
PhDr. Monika Fábriková – laboratory technician – ext. 243
organizationally assigned under the Department of Laboratory Medicine of FN Nitra
Possibilities for professional internships (based on the approval of the FN Nitra management)
Undergraduate education:
- students of the Faculty of Pharmacy of Comenius University in Bratislava, students of other faculties (medical faculties, faculty of nursing, public health, and other faculties for the education of healthcare professionals), diploma theses, student scientific works
Postgraduate education:
- in the field of clinical pharmacy within rigorous, doctoral studies, and attestation preparation
Professional internships:
- therapeutic drug monitoring, clinical pharmacy
| Group |
Drug |
Collection time |
Steady state
(first collection from patient) |
| ANTIBIOTICS |
amikacin
gentamicin |
0-30 min. before dose administration
30 min. after completion of i.v. administration |
3rd – 4th dose |
|
vancomycin |
0-30 min. before dose administration
60 min. after completion of i.v. administration |
|
| CARDIOVASCULAR DRUGS |
digoxin
quinidine |
before dose administration |
5-7 days
2 days |
| ANTIASTHMATICS |
theophylline |
before dose administration |
2 – 6 days |
| ANTIEPILEPTICS |
carbamazepine
phenobarbital
phenytoin
valproate |
before dose administration |
2 – 6 days
10 – 25 days adults: 8 – 20 children
4 – 24 days
2 – 4 days |
| TRICYCLIC ANTIDEPRESSANTS |
amitriptyline
imipramine
clomipramine |
before dose administration |
3 – 8 days
2 – 5 days
7 – 14 days |
| IMMUNOSUPPRESSANTS |
cyclosporine A tacrolimus |
before dose administration;
in case of organ transplantation 2 hours (+/- 10 min.) after cyclosporine dose administration |
3 – 5 days
(collection into EDTA tube!!) |
| OPIATES |
morphine
codeine
heroin |
before dose administration
heroin – toxicol. determination |
after 14 – 24 hours of treatment |
| BENZODIAZEPINES |
all with BZD structure |
mainly toxicological determinations |
|
| AMPHETAMINE/METAMPH |
|
mainly toxicological determinations |
|
| CANNABINOIDS |
|
mainly toxicological determinations |
|