{"id":1383883,"date":"2026-02-18T08:12:00","date_gmt":"2026-02-18T07:12:00","guid":{"rendered":"https:\/\/dnaera.com\/cs\/?p=1383883"},"modified":"2026-03-23T10:45:53","modified_gmt":"2026-03-23T09:45:53","slug":"vorikonazol","status":"publish","type":"post","link":"https:\/\/dnaera.com\/cs\/blog\/vorikonazol\/","title":{"rendered":"Individu\u00e1ln\u00ed l\u00e9\u010dba pl\u00eds\u0148ov\u00fdch infekc\u00ed: Jakou roli hraje genetika u vorikonazolu?"},"content":{"rendered":"\n<p><em>L\u00e9\u010dba z\u00e1va\u017en\u00fdch pl\u00eds\u0148ov\u00fdch infekc\u00ed vy\u017eaduje \u00fa\u010dinn\u00e1 a rychl\u00e1 \u0159e\u0161en\u00ed. Jedn\u00edm z nej\u010dast\u011bji pou\u017e\u00edvan\u00fdch l\u00e9k\u016f je \u0161irokospektr\u00e1ln\u00ed antimykotikum &#8211; <strong>vorikonazol<\/strong>. \u00da\u010dinnost a bezpe\u010dnost tohoto l\u00e9ku se m\u016f\u017ee u jednotliv\u00fdch osob li\u0161it. Ka\u017ed\u00fd organismus zpracov\u00e1v\u00e1 l\u00e9ky m\u00edrn\u011b odli\u0161n\u011b a v p\u0159\u00edpad\u011b vorikonazolu mohou hr\u00e1t roli tak\u00e9 <strong>genetick\u00e9 rozd\u00edly v enzymu CYP2C19<\/strong>.<\/em><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Co je vorikonazol a jak p\u016fsob\u00ed?<\/h2>\n\n\n\n<p>Vorikonazol se pou\u017e\u00edv\u00e1 hlavn\u011b k l\u00e9\u010db\u011b invazivn\u00ed aspergil\u00f3zy, z\u00e1va\u017en\u00e9 pl\u00eds\u0148ov\u00e9 infekce zp\u016fsoben\u00e9 rodem Aspergillus, kter\u00e1 nej\u010dast\u011bji postihuje pl\u00edce a p\u0159edstavuje zvl\u00e1\u0161tn\u00ed hrozbu pro pacienty s oslaben\u00fdm imunitn\u00edm syst\u00e9mem.<\/p>\n\n\n\n<p>Je tak\u00e9 \u00fa\u010dinn\u00fd p\u0159i t\u011b\u017ek\u00fdch form\u00e1ch kandid\u00f3zy zp\u016fsoben\u00e9 kvasinkami rodu Candida, kter\u00e9 se \u010dasto vyskytuj\u00ed u pacient\u016f na jednotk\u00e1ch intenzivn\u00ed p\u00e9\u010de (JIP) nebo u lid\u00ed s oslaben\u00fdm imunitn\u00edm syst\u00e9mem.<\/p>\n\n\n\n<p>L\u00e9k p\u016fsob\u00ed tak, \u017ee naru\u0161uje produkci ergosterolu, kl\u00ed\u010dov\u00e9 slo\u017eky bun\u011b\u010dn\u00e9 membr\u00e1ny pl\u00edsn\u00ed. T\u00edm zpomaluje jejich r\u016fst nebo vede k bun\u011b\u010dn\u00e9 smrti, \u010d\u00edm\u017e \u00fa\u010dinn\u011b bojuje proti infekci.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong>Kdy\u017e se l\u00e9\u010dba setk\u00e1v\u00e1 s genetikou<\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/h2>\n\n\n\n<p>Vorikonazol se vst\u0159eb\u00e1v\u00e1 a metabolizuje v j\u00e1trech, kde hraje kl\u00ed\u010dovou roli enzym CYP2C19. Aktivita tohoto enzymu je geneticky podm\u00edn\u011bna a ur\u010duje, jak rychle se l\u00e9k vylu\u010duje z t\u011bla.<\/p>\n\n\n\n<p>V souvislosti s metabolismem vorikonazolu, stejn\u011b jako jin\u00fdch l\u00e9k\u016f, se b\u011b\u017en\u011b pou\u017e\u00edvaj\u00ed n\u00e1sleduj\u00edc\u00ed pojmy:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><em>ultra-rychl\u00fd metaboliz\u00e9r<\/em> \u2013 l\u00e9k se rozkl\u00e1d\u00e1 velmi rychle, \u00fa\u010dinek m\u016f\u017ee b\u00fdt slab\u00fd a existuje riziko selh\u00e1n\u00ed l\u00e9\u010dby.<\/li>\n\n\n\n<li><em>rychl\u00fd metaboliz\u00e9r<\/em> \u2013 l\u00e9k se rozkl\u00e1d\u00e1 rychleji ne\u017e u standardn\u00edho metaboliz\u00e1toru, co\u017e m\u016f\u017ee v\u00e9st ke sn\u00ed\u017een\u00ed hladiny.<\/li>\n\n\n\n<li><em>standardn\u00ed metaboliz\u00e9r<\/em> \u2013 ide\u00e1ln\u00ed rovnov\u00e1ha mezi \u00fa\u010dinnost\u00ed a bezpe\u010dnost\u00ed.<\/li>\n\n\n\n<li><em>slab\u00fd metaboliz\u00e9r<\/em> \u2013 pomalej\u0161\u00ed vylu\u010dov\u00e1n\u00ed l\u00e9ku, zv\u00fd\u0161en\u00e9 riziko ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f.<\/li>\n\n\n\n<li><em>velmi slab\u00fd metaboliz\u00e9r<\/em> \u2013 velmi pomal\u00e9 vylu\u010dov\u00e1n\u00ed l\u00e9ku, co\u017e vede k vysok\u00e9mu riziku toxicity a ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Ne\u017e\u00e1douc\u00ed \u00fa\u010dinky<\/h2>\n\n\n\n<p>Mezi \u010dast\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky pat\u0159\u00ed poruchy zraku (rozmazan\u00e9 vid\u011bn\u00ed, zm\u011bny vn\u00edm\u00e1n\u00ed barev), nevolnost, zvracen\u00ed, pr\u016fjem a ko\u017en\u00ed reakce (v\u010detn\u011b fotosenzitivity). Mezi z\u00e1va\u017en\u011bj\u0161\u00ed ne\u017e\u00e1douc\u00ed \u00fa\u010dinky pat\u0159\u00ed po\u0161kozen\u00ed jater (hepatotoxicita) a poruchy srde\u010dn\u00edho rytmu.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong>Jak\u00e1 je v\u00fdhoda znalosti va\u0161\u00ed genetick\u00e9 predispozice<\/strong>?<\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/h2>\n\n\n\n<p>Znalost va\u0161\u00ed genetick\u00e9 predispozice k metabolismu vorikonazolu je d\u016fle\u017eit\u00e1 informace, kter\u00e1 umo\u017e\u0148uje va\u0161emu l\u00e9ka\u0159i l\u00e9pe a rychleji optimalizovat u\u017e\u00edv\u00e1n\u00ed tohoto l\u00e9ku a v p\u0159\u00edpad\u011b pot\u0159eby doporu\u010dit jin\u00e9 mo\u017enosti l\u00e9\u010dby. D\u00edky tomuto individu\u00e1ln\u00edmu p\u0159\u00edstupu je mo\u017en\u00e9 minimalizovat vedlej\u0161\u00ed \u00fa\u010dinky, zv\u00fd\u0161it \u0161ance na \u00fasp\u011b\u0161nou l\u00e9\u010dbu a vyhnout se ne\u00fa\u010dinn\u00fdm metod\u00e1m pokus\u016f a omyl\u016f.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong><strong><strong><strong><strong>Nov\u00fd v\u00fdsledek anal\u00fdzy<\/strong><\/strong><\/strong><\/strong><\/strong><\/h2>\n\n\n\n<p><a href=\"https:\/\/app.dnaera.com\/sign-in?&amp;lng=cz\">P\u0159ihlaste se<\/a> do sv\u00fdch v\u00fdsledk\u016f. Nov\u00e1 predispozice je nyn\u00ed zdarma k dispozici v\u0161em na\u0161im st\u00e1vaj\u00edc\u00edm z\u00e1kazn\u00edk\u016fm. Z\u00e1rove\u0148 ji bude m\u00edt ve sv\u00e9 anal\u00fdze ka\u017ed\u00fd budouc\u00ed z\u00e1kazn\u00edk, kter\u00fd vstoup\u00ed do sv\u011bta DNA s <a href=\"https:\/\/dnaera.com\/cs\/produkt\/dna-complex-test\/\" target=\"_blank\" rel=\"noreferrer noopener\">DNA Complex testem<\/a>. Znalost sv\u00fdch gen\u016f m\u00e1 smysl v ka\u017ed\u00e9m v\u011bku. \u010c\u00edm d\u0159\u00edve, t\u00edm l\u00e9pe. Za\u010dn\u011bte objevovat svou DNA tak\u00e9.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-medium-font-size\"><strong><strong>Zdroje<\/strong><\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list has-small-font-size\">\n<li class=\"has-small-font-size\">Clary, R. T., Deja, E., Rittmann, B., &amp; Bearman, G. (2025). Impact of voriconazole therapeutic drug monitoring on adverse effects and clinical outcomes: a literature review. <em>Current Infectious Disease Reports<\/em>, <em>27<\/em>(1), 6.<\/li>\n\n\n\n<li>Donnelly, J. P., &amp; De Pauw, B. E. (2004). Voriconazole\u2014a new therapeutic agent with an extended spectrum of antifungal activity. <em>Clinical Microbiology and Infection<\/em>, <em>10<\/em>, 107-117.<\/li>\n\n\n\n<li>Lou, Y., Wang, Y., Liu, J., Wang, Y. J., Wang, J., Ma, S., &#8230; &amp; Qiu, Y. Q. (2025). Voriconazole-induced liver injury: incidence patterns and risk factors in a retrospective cohort. <em>Antimicrobial Agents and Chemotherapy<\/em>, <em>69<\/em>(9), e00487-25.<\/li>\n\n\n\n<li class=\"has-small-font-size\">Moriyama, B., Obeng, A. O., Barbarino, J., Penzak, S. R., Henning, S. A., Scott, S. A., &#8230; &amp; Walsh, T. J. (2017). Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for CYP2C19 and voriconazole therapy. <em>Clinical Pharmacology &amp; Therapeutics<\/em>, <em>102<\/em>(1), 45-51.<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>L\u00e9\u010dba z\u00e1va\u017en\u00fdch pl\u00eds\u0148ov\u00fdch infekc\u00ed vy\u017eaduje \u00fa\u010dinn\u00e1 a rychl\u00e1 \u0159e\u0161en\u00ed. Jedn\u00edm z nej\u010dast\u011bji pou\u017e\u00edvan\u00fdch l\u00e9k\u016f je \u0161irokospektr\u00e1ln\u00ed antimykotikum &#8211; vorikonazol. \u00da\u010dinnost a bezpe\u010dnost tohoto l\u00e9ku se m\u016f\u017ee u jednotliv\u00fdch osob li\u0161it. Ka\u017ed\u00fd organismus zpracov\u00e1v\u00e1 l\u00e9ky m\u00edrn\u011b odli\u0161n\u011b a v p\u0159\u00edpad\u011b vorikonazolu mohou hr\u00e1t roli tak\u00e9 genetick\u00e9 rozd\u00edly v enzymu CYP2C19. Co je vorikonazol a jak p\u016fsob\u00ed? [&hellip;]<\/p>\n","protected":false},"author":876,"featured_media":1383884,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"content-type":"","inline_featured_image":false,"footnotes":"[]"},"categories":[33],"tags":[58,59,100],"place-taxonomy":[],"class_list":["post-1383883","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized-cs","tag-dna-analyza","tag-dna-test","tag-predispozice"],"acf":[],"views":2668,"_links":{"self":[{"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/posts\/1383883","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/users\/876"}],"replies":[{"embeddable":true,"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/comments?post=1383883"}],"version-history":[{"count":1,"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/posts\/1383883\/revisions"}],"predecessor-version":[{"id":1383886,"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/posts\/1383883\/revisions\/1383886"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/media\/1383884"}],"wp:attachment":[{"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/media?parent=1383883"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/categories?post=1383883"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/tags?post=1383883"},{"taxonomy":"place-taxonomy","embeddable":true,"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/place-taxonomy?post=1383883"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}