Kerec-Kos, Mojca

Mojca Kerec Kos 
University of Ljubljana, Slovenia

Biography:
Since 1999 she has been working at the Chair of Biopharmacy and pharmacokinetics. Her recent scientific work is focused on drugs pharmacokinetics in special population, such as elderly and children, with the aim to optimise the safety and efficacy of pharmacotherapy. She is also actively involved in research activities in the area of clinical pharmacy. Her other research focus is on  bioadhesive polymers, which increase the permeability of urinary bladder epithelia and enhance drug permeation into the bladder wall or by desquamation of superficial urothelial cells provide a promising treatment of bacterial cystitis and superficial bladder cancer. 

 

Lecture:
Changes in pharmacokinetics in patients with chronic heart failure

Chronic heart failure can lead to changed body composition and cachexia. Cachexia is a unique process of weight loss resulting from constant activation of inflammatory processes caused by underlying chronic disease like cancer, chronic heart failure, chronic obstructive pulmonary disease, etc. In patients with chronic heart failure, the disease itself and changes in body composition and cachexia may influence drug pharmacokinetics. Additionally, body composition may influence the estimation of renal function if it is based on serum creatinine concentration. Patients may lose their muscle mass despite unchanged total body weight and this may result in decreased serum creatinine concentration regardless of their renal function. On the other hand, renal function is one of the key clinical parameters to be monitored in heart failure patients. Besides predicting mortality, it can importantly change renal excretion of drugs. A significant proportion of patients with chronic heart failure develop a rapid decline in renal function, regardless of their baseline renal function. In pharmacotherapy of heart failure, inhibitors of angiotensin convertase enzyme and beta blockers are used to improve survival and reduce number of hospitalizations.

In patients with chronic heart failure we evaluated the pharmacokinetics of bisoprolol and ramipril, including longitudinal changes, and the influence of changed body composition and cachexia on drugs pharmacokinetics (1). Moreover, we assessed the performance of creatinine-based renal function estimating equations in monitoring changes of renal function in chronic heart failure patients, and the effect of body composition on the equations performance (2).

References:
Trobec K., Grabnar I., Kerec Kos M. et al. Eur J Clin Pharmacol 2016, 72 (7): 813-822.
Trobec K., Kerec Kos M., Haehling S., et al. Croat Med J 2015, 56 (6), 531-541.

Kerec Kos M.1, Cvan Trobec K.1, Grabnar I.1, Vovk T.1, Lainscak M. 2, 3
1 Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
2 Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
3 Department of Internal Medicine, General Hospital Murska Sobota