scholarly journals АНАЛІЗ РИНКУ АДРЕНО-БЛОКАТОРІВ ТА ДИНАМІКИ ЗМІН ЇХ СОЦІАЛЬНО-ЕКОНОМІЧНОЇ ДОСТУПНОСТІ ЗА УМОВ РЕАЛІЗАЦІЇ ПРОГРАМИ «ДОСТУПНІ ЛІКИ» В УКРАЇНІ

World Science ◽  
2019 ◽  
Vol 2 (9(49)) ◽  
pp. 46-52
Author(s):  
Ю. В. Байгуш ◽  
Д. В. Семенів ◽  
М. М. Слободянюк
Keyword(s):  
Beta Blocker ◽  
Antihypertensive Drugs ◽  
Beta Blockers ◽  
Government Program ◽  
The Government ◽  
Trade Names

The article presents the results of an analysis of the market for drugs from the group of S07-Beta-blockers, as well as a study of the dynamics of changes in indicators of their socio-economic availability. It was established that during 2015-2019 the number of trade names of drugs increased. In this segment of the market, imported drugs dominate (64.94% -65.91%), as well as single drugs. In addition, there is a significant prevalence of drugs under international names such as C07AB07-Bisoprolol (33.3% of the total assortment of beta-blockers), C07AG02-Carvedilol (19.48%) and C07AB02-Metoprolol (10.83%). Despite all the efforts of the government to implement the «Affordable Drugs» program in 2018, drugs from the C07-Beta blocker group were not available to the country's population. (D≤1.0). This indicates the need to implement a larger government program aimed at improving the socio- economic availability of antihypertensive drugs in Ukraine.

scholarly journals Analysis of dynamics of the medcine list in the government program «available medicines» for treatment of bronchial asthma

2019 ◽  
pp. 12-20
Author(s):  
I. A. Kostiuk
Keyword(s):  
Bronchial Asthma ◽  
Age Groups ◽  
Important Place ◽  
Government Program ◽  
Regulatory Processes ◽  
The Government ◽  
Analysis Of Dynamics ◽  
Trade Names ◽  
Additional Payment ◽  
The Cost

The problem of accessibility for socially significant goods for the population, among which the most important place occupy medicines in Ukraine, is very acute today. In this regard, the need for specific state interference through regulatory processes becomes relevant. One of the priority directions for increasing the availability of medicines is the Government of Ukraine has recognized reimbursement. The mechanism of full or partial payment of the cost of medicines used to counteract most socially significant diseases. One of these diseases is bronchial asthma (BA), since it affects all age groups of the population, and with ineffective control of the disease, the quality of life of patients is significantly reduced. The aim of the work is to study the range of medicines for the treatment of BA, included in the Government program «Accessible medicines» for the period 2017–2019 years. From April 1, 2017 to July 1, 2019, the Ministry of Health of Ukraine issued five orders, which approved the Register of medicines, the cost of which is subject to reimbursement. In the study analyzed all editions of the Register and found that with each update, the number of trade names (TN) of the medicines increased: for the treatment of cardiovascular diseases – by 56%, diabetes – by 92%, and BA – by 133%. During the 2017–2019 years, the number of international non-proprietary names (INNs) for the treatment of BA also increased: 3 times Beclomethasone, Budesonide 3.5 times, and Salbutamol is almost 2 times. Also, found that 87% of TN are imported and only 13% – domestic. Total of medicines for the treatment of asthma, the value of which is refundable imports 6 countries, the main segment of which is formed by Spain (31%) and Sweden (23%). The analysis of the size and amount of rejection and the amount of the surcharge for packaging allows us to establish that the percentage of medicines without an additional payment is approximately up to 50%. At 75% of the medicines for the treatment of BA, the amount of packing surcharge with each edition of the Register of medicines subject to reimbursement was increased by 2 medicines (Beckhazon-eco 100 mcg/dose and 250 mcg/dose) and 1 medicine (Budesonide-inteli 200 mcg/dose) – decreased 1 medicine (Budesonide-inteli 200 mcg/dose) subject to partial compensation only once. The conducted studies allow us to conclude that there is a need to improve the assortment policy in order to provide the pharmaceutical market with the available and necessary domestic medicines, in accordance with the needs of the population and the standards for the treatment of BA.

scholarly journals Beta-blocker therapy in patients with COPD: a systematic literature review and meta-analysis with multiple treatment comparison

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Claudia Gulea ◽  
Rosita Zakeri ◽  
Vanessa Alderman ◽  
Alexander Morgan ◽  
Jack Ross ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Beta Blocker ◽  
Observational Studies ◽  
Beta Blockers ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Life Outcomes ◽  
Blocker Therapy ◽  
Beta Blocker Therapy

Abstract Background Beta-blockers are associated with reduced mortality in patients with cardiovascular disease but are often under prescribed in those with concomitant COPD, due to concerns regarding respiratory side-effects. We investigated the effects of beta-blockers on outcomes in patients with COPD and explored within-class differences between different agents. Methods We searched the Cochrane Central Register of Controlled Trials, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Medline for observational studies and randomized controlled trials (RCTs) investigating the effects of beta-blocker exposure versus no exposure or placebo, in patients with COPD, with and without cardiovascular indications. A meta-analysis was performed to assess the association of beta-blocker therapy with acute exacerbations of COPD (AECOPD), and a network meta-analysis was conducted to investigate the effects of individual beta-blockers on FEV1. Mortality, all-cause hospitalization, and quality of life outcomes were narratively synthesized. Results We included 23 observational studies and 14 RCTs. In pooled observational data, beta-blocker therapy was associated with an overall reduced risk of AECOPD versus no therapy (HR 0.77, 95%CI 0.70 to 0.85). Among individual beta-blockers, only propranolol was associated with a relative reduction in FEV1 versus placebo, among 199 patients evaluated in RCTs. Narrative syntheses on mortality, all-cause hospitalization and quality of life outcomes indicated a high degree of heterogeneity in study design and patient characteristics but suggested no detrimental effects of beta-blocker therapy on these outcomes. Conclusion The class effect of beta-blockers remains generally positive in patients with COPD. Reduced rates of AECOPD, mortality, and improved quality of life were identified in observational studies, while propranolol was the only agent associated with a deterioration of lung function in RCTs.

scholarly journals Supraventricular tachycardias in the first year of life: what is the best pharmacological treatment? 24 years of experience in a single centre

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guglielmo Capponi ◽  
Gilda Belli ◽  
Mattia Giovannini ◽  
Giulia Remaschi ◽  
Alice Brambilla ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Beta Blocker ◽  
Pharmacological Treatment ◽  
Beta Blockers ◽  
Combined Treatment ◽  
First Year ◽  
Single Centre ◽  
International Consensus ◽  
First Year Of Life ◽  
Supraventricular Tachycardias

Abstract Background Supraventricular tachycardias (SVTs) are common in the first year of life and may be life-threatening. Acute cardioversion is usually effective, with both pharmacological and non-pharmacological procedures. However, as yet no international consensus exists concerning the best drug required for a stable conversion to sinus rhythm (maintenance treatment). Our study intends to describe the experience of a single centre with maintenance drug treatment of both re-entry and automatic SVTs in the first year of life. Methods From March 1995 to April 2019, 55 patients under one year of age with SVT were observed in our Centre. The SVTs were divided into two groups: 45 re-entry and 10 automatic tachycardias. As regards maintenance therapy, in re-entry tachycardias, we chose to start with oral flecainide and in case of relapses switched to combined treatment with beta-blockers or digoxin. In automatic tachycardias we first administered a beta-blocker, later combined with flecainide or amiodarone when ineffective. Results The patients’ median follow-up time was 35 months. In re-entry tachycardias, flecainide was effective as monotherapy in 23/45 patients (51.1%) and in 20/45 patients (44.4%) in combination with nadolol, sotalol or digoxin (overall 95.5%). In automatic tachycardias, a beta-blocker alone was effective in 3/10 patients (30.0%), however, the best results were obtained when combined with flecainide: overall 9/10 (90%). Conclusions In this retrospective study on pharmacological treatment of SVTs under 1 year of age the combination of flecainide and beta-blockers was highly effective in long-term maintenance of sinus rhythm in both re-entry and automatic tachycardias.

scholarly journals Beta-blocker use is associated with prevention of left ventricular remodeling in recovered dilated cardiomyopathy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Enzan ◽  
S Matsushima ◽  
T Ide ◽  
H Kaku ◽  
T Higo ◽  
...  
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Beta Blocker ◽  
Primary Outcome ◽  
Protocol Analysis ◽  
Beta Blockers ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Funding Source ◽  
Ventricular Ejection Fraction

Abstract Background Withdrawal of optimal medical therapy has been reported to relapse cardiac dysfunction in patients with dilated cardiomyopathy (DCM) whose cardiac function had improved. However, it is unknown whether beta-blockers can prevent deterioration of cardiac function in those patients. Purpose We examined the effect of beta-blockers on left ventricular ejection fraction (LVEF) in recovered DCM. Methods We analyzed the clinical personal records of DCM, a national database of Japanese Ministry of Health, Labor and Welfare, between 2003 and 2014. Recovered DCM was defined as a previously documented LVEF <40% and a current LVEF ≥40%. Patients with recovered DCM were divided into two groups according to the use of beta-blockers. The primary outcome was defined as a decrease in LVEF >10% at two years of follow-up. A one to one propensity case-matched analysis was used. A per-protocol analysis was also performed. Considering intra- and inter-observer variability of echocardiographic evaluations, we also examined outcomes by multivariable logistic regression model after changing the inclusion criteria as follows; (1) previous LVEF <40% and current LVEF ≥40%; (2) previous LVEF <35% and current LVEF ≥40%; (3) previous LVEF <30% and current LVEF ≥40%; (4) previous LVEF <40% and current LVEF ≥50%. Outcomes were also changed as (1) decrease in LVEF ≥5% (2) decrease in LVEF ≥10% (3) decrease in LVEF ≥15%. The analysis of outcomes by using combination of multiple imputation and inverse probability of treatment weighting was also conducted to assess the effects of missing data and selection bias attributable to propensity score matching on outcomes. Results From 2003 to 2014, 40,794 consecutive patients with DCM were screened. Out of 5,338 eligible patients, 4,078 received beta-blockers. Propensity score matching yielded 998 pairs. Mean age was 61.7 years and 1,497 (75.0%) was male. Mean LVEF was 49.1±8.1%. The primary outcome was observed less frequently in beta-blocker group than in no beta-blocker group (18.0% vs. 23.5%; odds ratio [OR] 0.72; 95% confidence interval [CI] 0.58–0.89; P=0.003). The prevalence of increases in LVDd (11.5% vs. 15.8%; OR 0.70; 95% CI 0.54–0.91; P=0.007) and LVDs (23.1% vs. 27.2%; OR 0.80; 95% CI 0.65–0.99; P=0.041) was also lower in the beta-blocker group. Similar results were obtained in per-protocol analysis. These results were robust to several sensitivity analyses. As a result of preventing a decrease in LVEF, the deterioration to HFrEF was also prevented by the use of beta-blocker (23.6% vs. 30.6%). Subgroup analysis demonstrated that beta-blocker prevented decrease in LVEF regardless of atrial fibrillation. Conclusion Use of beta-blocker was associated with prevention of decrease in left ventricular ejection fraction in patients with recovered DCM. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Health Sciences Research Grants from the Japanese Ministry of Health, Labour and Welfare (Comprehensive Research on Cardiovascular Diseases)

P3517Failure to achieve adequate heart rate control in women during therapy optimization

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
V Kutyifa ◽  
J W Erath ◽  
A Burch ◽  
B Assmus ◽  
D Bondermann ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Beta Blocker ◽  
Rate Control ◽  
Beta Blockers ◽  
Heart Rate Control ◽  
Blocker Therapy ◽  
Cardioverter Defibrillator ◽  
Beta Blocker Therapy ◽  
The Mean

Abstract Background Previous studies highlighted the importance of adequate heart rate control in heart failure patients, and suggested under-treatment with beta-blockers especially in women. However, data on women achieving effective heart rate control during beta-blocker therapy optimization are lacking. Methods The wearable cardioverter defibrillator (WCD) allows continuous monitoring of heart rate (HR) trends during WCD use. In the current study, we assessed resting HR trends (nighttime: midnight-7am) in women, both at the beginning of WCD use and at the end of WCD use to assess the adequacy of beta-blockade following a typical 3 months of therapy optimization with beta-blockers. An adequate heart rate control was defined as having a nighttime HR <70 bpm at the end of the 3 months. Results There were a total of 21,453 women with at least 30 days of WCD use (>140 hours WCD use on the first and last week). The mean age was 67 years (IQR 58–75). The mean nighttime heart rate was 72 bpm (IQR 65–81) at the beginning of WCD use, that decreased to 68 bpm (IQR 61–76) at the end of WCD use with therapy optimization. Women had an insufficient heart rate control with resting heart rate ≥70 bpm in 59% at the beginning of WCD use that decreased to 44% at the end of WCD use, but still remained surprisingly high. Interestingly, there were 21% of the women starting with HR ≥70 bpm at the beginning of use (BOU) who achieved adequate heart rate control by the end of use (EOU). Interestingly, 6% of women with adequate heart rate control at the start of therapy optimization ended up having higher heart rates >70 bpm at the end of the therapy optimization time period (Figure). Figure 1 Conclusions A significant proportion of women with heart failure and low ejection fraction do not reach an adequate heart rate control during the time of beta blocker initiation/titration. The wearble cardioverter defibrillator is a monitoring device that has been demonstrated in this study to appropriately identify patients with inadequate heart rate control at the end of the therapy optimization period. The WCD could be utilized to improve management of beta-blocker therapy in women and improve the achievement of adequate heart rate control in women.

scholarly journals Antihypertensive Drugs and the Risk of Cancer: A Nationwide Cohort Study

2021 ◽  
Vol 10 (4) ◽  
pp. 771
Author(s):  
In-Jeong Cho ◽  
Jeong-Hun Shin ◽  
Mi-Hyang Jung ◽  
Chae Young Kang ◽  
Jinseub Hwang ◽  
...  
Keyword(s):  
Antihypertensive Drugs ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Channel Blockers ◽  
Antihypertensive Medications ◽  
Converting Enzyme Inhibitors ◽  
Incident Cancer ◽  
Increased Risk ◽  
Risk Of Cancer

We sought to assess the association between common antihypertensive drugs and the risk of incident cancer in treated hypertensive patients. Using the Korean National Health Insurance Service database, the risk of cancer incidence was analyzed in patients with hypertension who were initially free of cancer and used the following antihypertensive drug classes: Angiotensin-converting enzyme inhibitors (ACEIs); angiotensin receptor blockers (ARBs); beta blockers (BBs); calcium channel blockers (CCBs); and diuretics. During a median follow-up of 8.6 years, there were 4513 (6.4%) overall cancer incidences from an initial 70,549 individuals taking antihypertensive drugs. ARB use was associated with a decreased risk for overall cancer in a crude model (hazard ratio (HR): 0.744, 95% confidence interval (CI): 0.696–0.794) and a fully adjusted model (HR: 0.833, 95% CI: 0.775–0.896) compared with individuals not taking ARBs. Other antihypertensive drugs, including ACEIs, CCBs, BBs, and diuretics, did not show significant associations with incident cancer overall. The long-term use of ARBs was significantly associated with a reduced risk of incident cancer over time. The users of common antihypertensive medications were not associated with an increased risk of cancer overall compared to users of other classes of antihypertensive drugs. ARB use was independently associated with a decreased risk of cancer overall compared to other antihypertensive drugs.

scholarly journals The association between beta-blocker therapy and daytime sleepiness in obstructive sleep apnoea

2021 ◽  
Author(s):  
Martina Meszaros ◽  
Alexander G. Mathioudakis ◽  
Maria Xanthoudaki ◽  
Victoria Sircu ◽  
Evangelia Nena ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Beta Blocker ◽  
Daytime Sleepiness ◽  
Beta Blockers ◽  
Multivariate Logistic Regression Analysis ◽  
Sleep Time ◽  
Sleep Apnoea ◽  
Sensitivity Analyses ◽  
Obstructive Sleep ◽  
Cardinal Symptom

AbstractDaytime sleepiness is a cardinal symptom of obstructive sleep apnoea (OSA) and a well-recognised side effect of beta-blockers, therefore patients with OSA under this treatment may have worse sleepiness. However, the interaction between daytime sleepiness and beta-blockers use has not been thoroughly investigated in patients with OSA before. We analysed the data of 2183 individuals (1852 patients with OSA and 331 snorer controls) from 3 countries (Greece, Hungary and Moldova). Medical history, including medication usage and the Epworth Sleepiness Scale (ESS) were recorded. Patients and controls were divided into somnolent (ESS ≥ 11) and non-somnolent (ESS < 11) groups, and the association between-blocker use with the somnolent group was investigated with multivariate logistic regression analysis adjusted for confounders. Sensitivity analyses were performed in each cohort, in the severity subgroups, in patients who did not take statins and in those who had polysomnography as a diagnostic test. There was no relationship between beta-blocker usage and the somnolent OSA (p = 0.24) or control (p = 0.64) groups. These results were similar in sensitivity analyses (all p > 0.05). ESS was related to BMI (ρ = 0.25), total sleep time (ρ = 0.07), AHI (ρ = 0.32), oxygen desaturation index (ρ = 0.33) and minimum oxygen saturation (ρ =  – 0.32, all p < 0.05) in OSA, and was higher in patients with hypertension, diabetes and cerebro/cardiovascular disease and those who took statins (all p < 0.05). In general, beta-blockers are not associated with increased daytime sleepiness in OSA. Thus, the diagnosis of OSA should not discourage initiation of beta-blocker treatment, if it is clinically indicated.

MODERN PROGRESS OF EVENTFUL TOURISM TRENDS ІN ZAKARPATTIA

2021 ◽  
Vol 298 (5 Part 1) ◽  
pp. 125-135
Author(s):  
Natalia PANKIV ◽  
Keyword(s):  
Web Sites ◽  
Small Towns ◽  
Resource Potential ◽  
Government Program ◽  
History Of ◽  
Tourist Infrastructure ◽  
Regional Centers ◽  
The Government ◽  
International Status ◽  
History Of Study

Theoretical principles and history of study of eventful tourism, his classification, and also modern state of this sphere, are considered in the article. Progress of eventful tourism trends are analysed on Zakarpattia and it is set that during the last years there are positive tendencies in relation to their development, in particular: the specialized tour operators that offer corresponding tours and the new objects of eventful rest are opened appear. It is educed that Zakarpattia is extraordinarily rich in traditions and ethnic colour and has considerable advantages for development of eventful tourism, as here is considerable tourist-recreational potential. In villages and small towns Zakarpattia the most various and interesting festivals and holidays pass that, it is possible conditionally to divide into three groups-guilty, gastronomic and folklore. Lately large popularity was purchased by the tours of flowers on Zakarpattia. Eventful tourism is perspective on Zakarpattia, with inexhaustible resource potential, and the programs of festivals are saturated, original and interesting and profitable. They assist to socio-economic development of area, popularization of potential tourist resources among a population. Important pre-condition of organization of festival tourism is the timely informing and advertising of events, popularity to information about her and organization of her systematic realization. Most permanent festivals have own web-sites, on that there is information about realization and program of measures, tourist infrastructure, transport report. Forming of positive image of region and increase of amount of tourists is assisted by tourist-informative centers that accumulate information about tourist-recreational suggestions. Without regard to plenty of festivals international status is had only separate from them. Therefore, in order to attract the attention of tourists to Zakarpattia, it is expedient to create the government program of assistance and development of festival motion and distinguish the regional centers of festival tourism. Such regional centers can be cities that are selected on the principle of scale and the possibility of representation of an event. Such centers in the region can be Uzhgorod, Beregovo, Rakhiv, Mukachevo.

Cardiotoxicity with antihypertensive drugs (literature review) Part 1. Calcium channel blockers and beta-blockers

2021 ◽  
pp. 12-19
Author(s):  
A. N. Esaulenko ◽  
A. Yu. Moiseeva ◽  
A. A. Ivannikov ◽  
I. V. Bratischev ◽  
Kh. G. Alidzhanova
Keyword(s):  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Antihypertensive Drugs ◽  
Beta Blockers ◽  
Research Literature ◽  
Channel Blockers ◽  
Distinctive Features ◽  
Experimental Pharmacology ◽  
Myocardial Insufficiency ◽  
Β Blockers

The effect of hypotensive drugs overdose on cardiovascular system is poorly studied; it should undergo clinical, experimental pharmacology and toxicology together with cardiology. There is too little information about cardiotoxicity of beta-blockers (β-blockers) and calcium channel blockers (CCB) in existing research literature. Intoxication from these groups of drugs causes similar severe hemodynamic abnormalities and myocardial insufficiency, however pathophysiological mechanisms of these abnormalities are not thoroughly studied. The review highlights how difficult it is to identify toxic level and distinctive features of clinical evidence of intoxication. Methods of diagnosis as well as β-blockers and CCB overdose treatment are discussed.

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