法匹拉韦治疗新冠肺炎临床研究进展

新型冠状病毒肺炎(COVID-19)疫情在全球大流行,临床上迫切需要特异性抗病毒治疗药物。对已批准上市或正在临床开发的药物开展重定位研究是针对突发疫情快速寻找潜在治疗药物最为快速和高效的策略。法匹拉韦是一种广谱抗RNA病毒药物,在日本和中国已批准上市用于治疗流感,其作为抗新型冠状病毒感染的潜在药物,全球多个国家正在开展相关临床试验,初步的结果令人鼓舞。本文主要综述在中国、日本、俄罗斯和印度等国家开展的法匹拉韦单用或联合其他药物治疗COVID-19的临床试验,考察用药剂量、试验设计、药物有效性和安全性等。研究结果显示,法匹拉韦在针对COVID-19轻症和中症患者的治疗中,能够有效提高患者病毒RNA清除率或改善临床恢复率,且表现出良好的安全性。本文对法匹拉韦治疗COVID-19临床研究进展进行总结,为其在抗COVID-19治疗中的应用提供参考。     

几种常用的雾化吸入抗菌药物治疗肺部感染的临床效果评价

本文归纳了几种常用的雾化吸入抗菌药物用于治疗肺部感染的临床治疗记录和研究报告,包括雾化吸入抗菌药物的使用方法、剂量、疗效,致病菌的耐药性和毒理作用,通过比较几种常用的抗菌药物以常规给药方式和雾化吸入给药方式的临床疗效,发现雾化吸入抗菌药物对于肺部感染有较好的治疗效果,从而改善患者的健康状况,并没有明确的证据表明雾化吸入给药方式会产生较高的致病菌耐药性和提高药物的不良反应。雾化治疗肺部感染中有较好疗效,有待进一步临床研究。     

浅谈我院药品超说明书用药

目的探讨临床用药超说明书使用情况,促进临床药学的发展,做到规范用药,避免药物滥用。方法通过在各临床专科的药品监管与沟通学习,结合临床用药实践及专业药学知识对临床各专科常见药品超说明书用药进行归纳整理。结果庆大霉素注射液+注射用糜蛋白酶+地塞米松注射液雾化吸入,病毒唑雾化吸入,沐舒坦注射液雾化吸入,盐酸利多卡因注射液+利福平注射液进行灌肠及尿道灌注,维生素B1片+维生素B12片、消旋山莨菪碱片(654-2片)封包消碱片,红霉素眼膏治疗鼻炎等均超说明书使用并达到满意效果。结论在临床使用药品中,个别超说明书使用的药物安全效果应被临床医疗专家关注。     

雾化吸入治疗儿童呼吸道疾病596例分析

目的 观察分析我院雾化吸入治疗儿童呼吸道疾病的临床疗效.方法 对我院2016年6月至12月雾化吸入治疗儿童呼吸道感染病例596例进行统计分析.结果 平均住院天数为7天,使用雾化吸入的药物有4大类,共7个品种.它们分别是吸入用布地奈德混悬液,吸入用异丙托溴铵溶液,硫酸特布他林雾化液,盐酸氨溴索,地塞米松磷酸钠注射液,糜蛋白酶,重组人干扰素α1b注射液.雾化药物的联合使用率较高,其中吸入用布地奈德混悬液与吸入用异丙托溴铵溶液的联合使用率为58.6％.结论 雾化吸入治疗儿童呼吸道疾病操作简单,不良反应小,疗效确切.雾化吸入药物联合使用后有使单药疗效增强的作用.     

泛耐药铜绿假单胞菌感染的抗感染思路分析

目的 探讨泛耐药铜绿假单胞菌肺炎的药物治疗方案。方法 以临床药师参与一例大面积烧伤患者的泛耐药铜绿假单胞菌肺炎的抗感染方案为例，结合最新临床研究进展，探讨抗菌药物雾化吸入在治疗泛耐药细菌导致的肺部感染中的应用。 结果 泛耐药铜绿假单胞菌导致的肺部感染通常选择联合治疗，抗菌药物雾化吸入作为一种联合或补充治疗，可以提高肺部药物浓度，减少全身不良反应，但使用时仍需慎重选择临床适应症。 结论 临床药师应积极参与抗感染方案的制定，针对患者制定个体化的给药方案。     

某胸科医院住院患者雾化吸入用药合理性分析

目的 分析某胸科医院住院患者干预前后采用雾化吸入给药途径的药品使用情况和合理性。方法 比较2020年第一季度（干预前）和2021年第一季度（干预后）雾化吸入途径给药的使用情况，分别随机抽取每季度300例患者对其雾化吸入医嘱进行点评分析。结果 2组病例中采用雾化吸入的多为围术期用药。经过干预，非雾化吸入剂型药品中的特布他林注射液、注射用糜蛋白酶、盐酸氨溴索注射液及注射用盐酸溴己新使用雾化吸入给药途径的病例数较干预前有显著下降。该院主要常用的雾化吸入联合用药方案为吸入性糖皮质激素（ICS）+短效β2受体激动剂（SABA）和ICS+乙酰半胱氨酸，由于该院目前配备的雾化吸入药品不够完善，现有的雾化吸入剂型的药物无法使用三联方案给药。干预前的300例患者，雾化吸入用药不合理率为50.33%，经过干预后，2021年第一季度的不合理率下降至29.33%，说明干预有效。结论 雾化吸入疗法在该院的临床应用比较广泛，但不合理用药情况比较严重。经过干预后，不合理用药情况明显改善，但是还需长期、持续地干预。     

雾化吸入药物间配伍相容性的研究进展

雾化给药是指将药物直接递送到肺组织而发挥治疗作用,是治疗呼吸系统疾病的常用给药方式。2种或多种药物混合后同时雾化可缩短给药时间,但混合物的潜在不相容性会导致药物安全性降低并影响治疗疗效,明确雾化吸入药物间的配伍相容性,是保证临床安全用药的前提。该文对目前国内上市雾化吸入药物间配伍相容性的研究进展进行综述,以期为雾化吸入药物的临床安全使用和未来研究提供参考。     

新型冠状病毒肺炎合并肿瘤患者使用抗病毒药物的药学监护策略

摘要：为探讨治疗新型冠状病毒肺炎(COVID-19)的抗病毒药物在肿瘤患者中应用的药学监护策略,临床药师查阅相关文献资料,深度分析《新型冠状病毒感染的肺炎诊疗方案(试行第七版)》中推荐的抗病毒药物与抗肿瘤药物之间的药品不良反应(ADR)和药动学相互作用,提出了在COVID-19合并肿瘤患者中合理使用抗病毒药物的建议,旨在确保特殊人群的用药安全。     

456例新型冠状病毒肺炎患者抗病毒药物应用分析

目的 对新型冠状病毒肺炎(COVID-19)患者的临床特点及抗病毒药物应用现状进行分析,为临床合理用药提供参考.方法 收集2020年2月1日至29日仙桃市第一人民医院456例COVID-19患者的病例资料,对患者特征、抗病毒药物用法用量、联合使用情况及药品不良反应(ADR)进行回顾性分析.结果 456例COVID-19...     

α干扰素雾化治疗在新型冠状病毒肺炎中的合理使用及药学监护

由新型冠状病毒（SARS-CoV-2）引发的传染性肺炎，其传染性强，目前尚无特效抗病毒药物。对于新型冠状病毒肺炎（COVID-19）的治疗，现多个诊疗指南中均推荐包括α干扰素在内的抗病毒方案。本文对α干扰素可能的抗COVID-19机制、静脉制剂雾化给药的空气动力学特点、特殊人群的给药方案、常见不良反应以及雾化产生的气溶胶潜在传播风险进行简要综述，旨在为新冠肺炎患者α干扰素雾化的合理使用提供参考。     

Significance of neutralizing antibodies in COVID-19 therapy: progress and prospect

SARS-CoV-2 infection is a serious threat to human life and health all over the world, and COVID-19 is a global epidemic caused by SARS-CoV-2 infection. SARS-CoV-2 is highly infectious, strange and variable. Therefore, the treatment of COVID-19 must be urgent and targeted. However, vaccines and currently used drugs generally do not have the above-mentioned characteristics. Although convalescent plasma of COVID-19 has shown a clinical application value in the emergency treatment of critical patients, it shows great limitations. All human recombinant multivalent neutralizing nano-antibodies may meet the deficiency of COVID-19 therapy. Gene engineering technologies have been used to develop specific neutralizing antibody (nAB) drugs for the treatment of COVID-19 worldwide. Some of the candidate nAB drugs have been entered the clinical trials and can be used for the therapy of COVID-19 shortly. In the present review, we studied and analyzed nABs for the treatment of COVID-19 and the progress and prospect from the following five aspects: 1) The biological and clinical characteristics of SARS-CoV-2 infection; 2) The feasibility of plasma therapy for convalescents with COVID-19; 3) The technical routes of developing nAb drugs; 4) The current status of developing global COVID-19 antibodies; 5) The difficulties and clinical use.     

新型冠状病毒肺炎临床治疗药物最新研究进展

新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)正在世界范围内流行。作为冠状病毒,新型冠状病毒(SARS-Co V-2)和严重急性呼吸综合征冠状病毒(SARS-Co V)都通过人血管紧张素转化酶2(ACE2)受体侵入宿主细胞。面对疫情异常严峻的现状,目前尚缺乏疫苗和尚无特异性针对该病毒的抗病毒药物,临床上仍以支持治疗和对症治疗为主。本文简单介绍了新型冠状病毒和ACE2的关系及作用机制,总结了潜在抗新型冠状病毒治疗药物的最新临床疗效,及其相关药物可能的作用机制,以便充分了解COVID-19的发展过程和药物研究方向,为后续探讨COVID-19药物治疗和疫苗研发提供思路。     

雾化吸入疗法在传染病医院的应用与合理性分析

目的分析住院患者采用雾化吸入途径给药的药品使用情况和合理性。方法回顾性分析我院2019年1-6月雾化吸入途径用药的使用情况,随机抽取600份病历对其雾化吸入医嘱进行点评分析。结果我院雾化吸入途径用药消耗金额最大为吸入用布地奈德混悬液,为32.60万元,采用雾化吸入途径给药的药品DDDs最大的为异烟肼注射液,为38 667。9种非雾化剂型药品中,硫酸沙丁胺醇注射液、盐酸氨溴索注射液、注射用盐酸氨溴索、金银花免煎颗粒、注射用糜蛋白酶、注射用盐酸溴己新的雾化比例均>50%,金额占比均>60%。采用雾化吸入疗法最多的3个临床诊断为支气管结核(182例)、喉结核(105例)、肺结核(87例),占抽取病历的62.33%,不合理医嘱数最多的2个类型为给药途径不适宜(269个)、用法用量不适宜(327个),占比为75.83%。雾化液量<6 ml的医嘱数为700,占比为68.43%。结论雾化吸入疗法在我院应用广泛,不合理用药现象比较严重,应充分发挥药师的作用,增强临床医师合理用药意识,促进临床合理用药的持续改进。     

Antivirals and the Potential Benefits of Orally Inhaled Drug Administration in COVID-19 Treatment

Coronavirus Disease 2019 (COVID-19) pandemic has been on the agenda of humanity for more than 2 years. In the meantime, the pandemic has caused economic shutdowns, halt of daily lives and global mobility, overcrowding of the healthcare systems, panic, and worse, more than 6 million deaths. Today, there is still no specific therapy for COVID-19. Research focuses on repurposing of antiviral drugs that are licensed or currently in the research phase, with a known systemic safety profile. However, local safety profile should also be evaluated depending on the new indication, administration route and dosage form. Additionally, various vaccines have been developed. But the causative virus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), has undergone multiple variations, too. The premise that vaccines may suffice to eradicate new and all variants is unreliable, as they are based on earlier versions of the virus. Therefore, a specific medication therapy for COVID-19 is crucial and needed in order to prevent severe complications of the disease. Even though there is no specific drug that inhibits the replication of the disease-causing virus, among the current treatment options, systemic antivirals are the most medically appropriate. As SARS-CoV-2 directly targets the lungs and initiates lung damage, treating COVID-19 with inhalants can offer many advantages over the enteral/parenteral administration. Inhaled drug delivery provides higher drug concentration, specifically in the pulmonary system. This enables the reduction of systemic side effects and produces a rapid clinical response. In this article, the most frequently (systemically) used antiviral compounds are reviewed including Remdesivir, Favipiravir, Molnupiravir, Lopinavir-Ritonavir, Umifenovir, Chloroquine, Hydroxychloroquine and Heparin. A comprehensive literature search was conducted to provide insight into the potential inhaled use of these antiviral drugs and the current studies on inhalation therapy for COVID-19 was presented. A brief evaluation was also made on the use of inhaler devices in the treatment of COVID-19. Inhaled antivirals paired with suitable inhaler devices should be considered for COVID-19 treatment options.     

某院门诊患儿雾化吸入用药合理性分析

目的:调查郑州大学第三附属医院门诊患儿雾化吸入用药现状,分析评价其合理性,为临床合理用药提供参考。方法: 采用回顾性分析法,从医院信息系统提取2022 年1-3 月门诊患儿应用雾化药物处方1 017 张,对患儿性别、年龄、临床诊断、雾 化剂品种、使用量及联合用药情况等进行统计分析,评价该院儿科雾化吸入用药的合理性。结果:1 017 张雾化用药处方中,单 独用药20. 16%,二联用药56. 05%,三联用药23. 78%。在所有种类雾化药物中,糖皮质激素应用最广泛,使用率87. 61%。雾化 药与口服药联用处方占28. 52%。雾化药物主要应用于呼吸道感染、支气管炎、肺炎、哮喘、喉炎等22 类临床诊断。不合理处方 占3. 15%,主要为适应证不适宜和遴选药品不适宜。结论:我院门诊患儿雾化吸入联合用药普遍存在,用药符合治疗指南。药 品拓展性应用有循证医学证据支持,使用合理,但亦存在部分不合理用药情况,需进一步规范。     

Integrating heterogeneous data to facilitate COVID-19 drug repurposing

In the COVID-19 pandemic, drug repositioning has presented itself as an alternative to the time-consuming process of generating new drugs. This review describes a drug repurposing process that is based on a new data-driven approach: we put forward five information paths that associate COVID-19-related genes and COVID-19 symptoms with drugs that directly target these gene products, that target the symptoms or that treat diseases that are symptomatically or genetically similar to COVID-19. The intersection of the five information paths results in a list of 13 drugs that we suggest as potential candidates against COVID-19. In addition, we have found information in published studies and in clinical trials that support the therapeutic potential of the drugs in our final list.     

抗新型冠状病毒肺炎（COVID-19）药物潜在相互作用研究进展

自2019年12月以来,国内外暴发了新型冠状病毒肺炎(COVID-19)。在COVID-19的患者中,除了抗病毒治疗外,还要治疗并发症,临床需要采取联合用药的方式进行治疗。虽然在近期发布的指南中多次强调注意抗COVID-19药物间的相互作用,但却无相应的详述。主要对治疗COVID-19药物的潜在相互作用进行综述,以期为COVID-19的临床安全、合理用药提供参考。     

Novel β-Coronavirus (SARS-CoV-2): Current and future aspects of pharmacological treatments

The novel coronavirus outbreak has reported to be rapidly spreading across the countries and becomes a foremost community health alarm. At present, no vaccine or specific drug is on hand for the treatment of this infectious disease. This review investigates the drugs, which are being evaluated and found to be effective against nCOVID-19 infection. A thorough literature search was performedon the recently published research papers in between January 2020 to May 2020, through various databases like “Science Direct”, “Google Scholar”, “PubMed”,“Medline”, “Web of Science”, and “World Health Organization (WHO)”. We reviewed and documented the information related with the current and future aspects for the management and cure of COVID-19. As of 21st July 2020 a total of 14,562,550 confirmed cases of coronavirus and 607,781 deaths have been reported world-wide. The main clinical feature of COVID-19 ranges from asymptomatic disease to mild lower respiratory tract illness to severe pneumonia, acute lung injury, acute respiratory distress syndrome (ARDS), multiple organ dysfunction, and death. The drugs at present used in COVID-19 patients and ongoing clinical trials focusing on drug repurposing of various therapeutic classes of drug e.g. antiviral, anti-inflammatory and/or immunomodulatory drugs along with adjuvant/supportive care. Many drugs on clinical trials shows effective results on preliminary scale and now used currently in patients. Adjuvant/supportive care therapy are used in patients to get the best results in order to minimize the short and long-term complications. However, further studies and clinical trials are needed on large scale of population to reach any firm conclusion in terms of its efficacy and safety.     

新型冠状病毒肺炎治疗药物研发现状

目的 探讨新型冠状病毒肺炎(简称新冠肺炎)治疗药物研发现状、成效和存在的问题,并提出改进建议。方法 以国家卫生健康委员会《新型冠状病毒肺炎诊疗方案》中药物治疗的演变为切入点,结合临床治疗现状,总结各种治疗新型冠状病毒感染药物的特点,分析新冠肺炎疫情暴发以来登记注册拟开展的药物临床试验研究情况及存在的问题。结果 对于新冠肺炎,目前尚无特效抗病毒治疗方法,国家卫生健康委员会《新型冠状病毒肺炎诊疗方案》中所推荐的药物治疗也是基于突发疫情条件下的试用建议,且需严格监控。针对新冠肺炎疫情下登记注册拟开展的药物临床试验项目整体上普遍存在立题依据、研究基础和研究条件不充分,缺乏必要的临床前试验数据和质量保证体系等问题。结论 针对新冠肺炎,药物选择都是基于既往的严重急性呼吸综合征(SARS)、中东呼吸综合征(MERS)或其他新型流感病毒的治疗经验,积极的对症支持治疗仍是治疗的关键。针对新型冠状病毒的新药研发应回归到认真做好基于药物作用靶点、作用机制的活性筛选的基础工作。