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Drug dosing remains one of the topical issues of modern pediatrics. Insufficient number of clinical studies, vulnerable patient populations (preterm newborns, patients with renal and/or hepatic insufficiency, obesity), and high risk of polypragmasy create additional difficulties for practicing physicians. This review provides description of currently used approaches to drugs dosing in children. It has been shown that prognostic models should be used for solving drugs dosing issues regarding characteristics of young patients. Such models include: physiologically based pharmacokinetic modelling; population pharmacokinetic analysis; model-based precision dosing; modeling and simulation approach; use of real world data; and pharmacogenetic testing-based dosing. These models use information from preclinical and clinical stu

Systemic lupus erythematosus (SLE) is a disease of women of reproductive age. Up to a certain time, pregnancy was contraindicated in patients with SLE, improving the management of the disease itself (monitoring), as well as understanding the safety of drugs make pregnancy possible for most patients with SLE. Careful pregnancy planning is crucial when the disease is well controlled with pregnancy-compatible medications. This is also facilitated by the management of patients jointly by doctors of different specialties (rheumatologist, neurologist, endocrinologist, etc.) with obstetricians. The article discusses the achievements of managing women with SLE during pregnancy planning, during pregnancy and after delivery.

Background. Polypharmacy and drug interactions are of particular concern in people living with HIV/AIDS, especially those who receive antiretroviral therapy (ARVs). Polypharmacy and drug-drug interactions (DDIs) can impact the efficacy and toxicity of HIV treatment. ARVs used in HIV treatment are often prone to drug interactions if administered with other non-ARV drugs because many of them are metabolized through the cytochrome P450 system. The pharmacological management of HIV patients in the intensive care unit (ICU) is usually complex and typically involves the administration of several classes of drugs. This patient group may be at higher risk for potential DDIs due to polypharmacy in the ICU. The main objective of this study was to assess the iatrogenic effects of polypharmacy in HIV patients treated in the ICU and to describe the DDI profile between ARVs and other non-ARV medications prescribed in the ICU. Methods and materials. Between 2018 and 2020, we conducted a single-center, retrospective study evaluating the medical records of 59 HIV patients admitted to the ICU for more than 24 hours at the Infectious Disease Clinical Hospital No. 2, Moscow, Russia. We evaluated the impact of polypharmacy on renal, hepatic and haemopoietic function. The Liverpool HIV Drug Interaction database was used to identify DDIs in ART-treated HIV patients. Results. All patients received more than 5 different medications matching the definition of polypharmacy. The average number of concurrent medications prescribed was 156.713 (maximum 40, minimum 6). All drug interactions recorded were between ARVs and antibiotics: 30 cases of potential interactions in 65.5% patients who received ARV. Of such patients, 94% were exposed to at least two potential interactions. Tenofovir (TDF) and the antibiotic vancomycin underlaid the most common potential interaction (49.2%), followed by lopinavir ritonavir (LPV/RTV) and ciprofloxacin (30.3%). A significant difference in average creatinine levels was found in patients with TDF/vancomycin potential interactions (p 0.05). Conclusion. This study demonstrated that potential DDIs frequently occur in ICU patients in line with previous investigations. It is necessary to implement collaborations among clinical pharmacologists and infectious disease/HIV specialists, as well as frequent clinical and laboratory monitoring, aimed at developing effective and actionable strategies that could reduce potential DDIs in HIV patients in the ICU.

This article proceeds the topic of the article "The development of regulation of the circulation of medicines in the EU and the USA in 1992-2020." The history of development of European pharmaceutical legislation in 2001-2020 is considered. The acts of indirect action adopted by EU Parliament at first stage of development of legislation concerning medications failed to fully harmonize normative base of the EU Member States in pharmaceutical market. Since 2000, the EU Parliament and the EU Council adopt laws of direct action - the Regulations. Alongside with the pharmaceutical Code, the Regulations for single segments of pharmaceutical market constituted set of laws related to turn-over of medications. The legislators, at developing EU laws, took into account the US regulatory standards. Despite differences in history, legislative traditions and structure, regulatory systems of the USA and the EU concerning medications turn-over were basically harmonized.

Alcohol-induced psychotic disorder (AIPD) is a diagnosis in the ICD 10. Previous studies of AIPD do not appear to have reported the co-morbid presence of depressive disorder in either prevalence studies or treatment studies. Five cases are presented with a dual diagnosis of AIPD and depressive disorder. These cases were assessed using the Brief Psychiatric Rating Scale (BPRS), Hamilton Depression Rating Scale (HDRS), Clinical Global Impression Severity score (CGI-S), Clinical Global Impression Improvement score (CGI-I), Drug Attitude Inventory 10 (DAI 10), Short Assessment Personality-Abbreviated Scale (SAPAS) and Modified Sainsbury Tool. Antidepressants and antipsychotics were chosen based on drug attitude scores from DAI 10. Cases demonstrate inpatient and outpatient treatment with good treatment outcomes after six months. Three cases demonstrate suicide risk. The majority did not have a personality disorder. These cases highlight the importance of treating a depressive disorder in AIPD and of tailored medication treatments for poor medication compliance.

Objective: to analyze the availability and affordability of pharmaceuticals for children in need of palliative care.Materials and methods. The price, affordability and physical availability of pharmaceuticals for children in need of palliative care were analyzed in accordance with the Health Action International guidelines of the World Health Organization. Linear distribution index (LDI) was calculated to produce the best estimates of availability. Research data was sourced from AlphaRM (as of April 26, 2021) and International Medicine Reference Piece Data. The data array was based on the fiscal data provided by pharmacies. The research was carried out on the total population of pharmacies in the Russian Federation (69,050 pharmacies) and in St. Petersburg (1986 pharmacies).Results. Pharmaceutical price and affordability estimates show that low-priced generics, which cover over 75% of the whole range, have the most optimal median value of the median price ratio (MPR1). Midazolam (AR=2.494), morphine (AR=2.324), and celecoxib (AR=1.373) had low affordability. Notably, prescription-based pharmaceuticals such as diazepam, midazolam, tramadol, morphine, and fentanyl had the lowest physical availability scores (LDI60%).Conclusions. The results call for better organizational action in the pharmaceutical industry to provide due drug regimens to children in need of palliative care.

Some medication instructions have records about the need of caution in case of management in pregnant women or during lactation period. Moreover the instructions do not have direct prohibition against drug administration during gestation and lactation periods. In this regard the legitimacy of such medications prescription to pregnant women or women during lactation period is questionable (even when physician thinks that there are indications for such therapy). Another question is legal responsibility of the physician in case of any adverse effects development. The evidence favouring legitimacy of physician actions on prescribing such medication are considered as well as the probability of physician prosecution to civil and criminal liability are analyzed in this article. Special attention should be given to the issue of recognition of physician actions as reasonable risk. The guidelines based on performed analysis have been developed. The implementation of this guidelines can significantly reduce the risks of physician legal exposure.

Pulmonary hypertension (PH) in pediatrics is a polygenic multifactorial condition with extremely adverse prognosis. Selection of optimal management is a severe task. In absence of treatment the mean life duration in children is not higher one year. Last two decades, revolution in approaches to treatment improved the survival of this patients group. Recently, pediatricians and pediatric cardiologists have three drugs groups that act on the main pathogenetic chains of PH: endothelin pathway, nitric oxide pathway and prostacyclin pathway. At the moment, approaches to pediatric PH are based on the data obtained in the trials on adult patients. However, not long ago there were first randomized trials on children performed. The group of authors of current article presents a modern view on the problem of PH in children, and expert recommendations on children management. Class of recommendations and evidence level were set by the data obtained in pediatric population or on adult population with at least 10% of children included. To the strategy, developed by the Russian clinicians, laid the analysis of experience of the pathology treatment in Russian Federation, as the current practics and clinical guidelines on pediatric PH in Europe, and the recent trials published.

Prevention of adverse events caused by medication errors is an important challenge of modern healthcare as it offers the possibility to reduce mortality, improve patient safety and reduce costs arosed from correction of complications. Two modern methods (Global Trigger Tool and Failure Mode and Effect analysis) of detection and analysis of information about adverse events and medication errors are presented in the article, and according authors opinion can provide the opportunity to develop and suggest measures for reduction of potential risks.

In the review, recent data presented, on possible targets for medications of specific pathogenetic action in atherosclerosis. The results described, of application of some drugs in complex treatment of atherosclerotic vessels lesions. The data can be applied for target development of antiatherosclerotic drugs with the aim of prevented progression of atherosclerosis and thromboembolic complications.

Despite significant advances in the diagnosis and treatment of acute respiratory infections in children, the incidence of SARS, influenza and pneumonia in the last decade among children has not changed, indicating the urgency of the problem.

the study presents a characteristic of new normative act prepared by the Russian Federation Ministry of Defense stating a normative standard of supplying an operative dentistry of military schools students with medications and materials. A practical use of the normative standard will allow increasing of efficiency of medical supply of students and improving their health state.

Having studied the circulation of adulterrated medications in Russia, the author has stated that in prractice these actions are qualified by the Russian Criminal Code not uniformly, and grounded including into the Russian Crimianal Code of the Artice 238.1 "Production, storing, labelling, transportation and dealing in outdated or non-standard medications and (or) pharmaceuticals".

The Federal program of supplementary preferential pharmaceutical support of particular categories of citizen functions since 2005. During this period, it seriously impacted on quality of pharmaceutical support, accessibility of medications, development of pharmaceutical market in general. The article presents analysis of state of pharmaceutical support of particular categories of citizen during 2017-2018. The established problems requiring solution are discussed too. It is established that in majority of cases the problems with pharmaceutical support have organizational specificity. The health care authorities allow decreasing of volumes including shortcomings in purchase and logistic of deliver, untimely holding of auctions, inconsistent compiling of applications and insufficient control of trade stock management. The problems with accessibility of pharmaceuticals occur because of inefficient application of already bought items. The open access data of official web-site of Minzdrav of Russia and Roszdravnadzor were used for analysis and preparation of article.

«The thalidomide tragedy» served as a push for developing modern system of pharmacological control forcing many countries to revise actual practice of medications' licensing. The pharmacological control is a sector of science and business being engaged in detection, evaluation, interpretation and prevention of side-effects of medications and other problems related to pharmaceuticals. The predestination of specialists of pharmacological control is in increasing safety of patients and amelioration of caring, ensuring public health and safety in case of application of various medications. Their predestination also includes promoting understanding, awareness and effective communications related to health care specialists and community. The article considers regulations of pharmacological control at the territory of the Russian Federation and also main accounting of producer and its periodicity needed for implementation of evaluation of benefits/risks for pharmaceuticals. Nowadays, owing to continuous and strict implementation of all activities in the Russian Federation and the Eurasian Economic Union described in this review, a strictly regulated system of pharmacological control is functioning. This system enables all interested subjects of turnover of pharmaceuticals (manufacturers and holders of registration certification, medical organizations and medical professionals, patients and regulating agencies).