我院住院患儿口服片剂分剂量使用调查分析

目的:分析我院住院病区口服片剂分剂量使用情况。方法:调取我院2018年9月至2019年8月全院单剂量分包医嘱,获得分剂量医嘱数前20位的口服片剂,根据分剂量医嘱百分率、常用剂量及其医嘱百分率获得建议规格。依据建议规格重新核算理论分剂量医嘱百分率,以评价建议规格是否符合临床实际需求。结果:我院现有的20种常用分剂量口服片剂中,14种药品现有规格不符合临床实际需求,其中3种药品有批准的儿童适宜剂型,3种药品有批准的建议规格,4种药品无批准的儿童适宜剂型或更小剂量规格。结论:儿童适宜剂型及规格缺乏,为减少分剂量使用现象,需要政府、医药企业及医院各方共同努力。     

某院住院患儿口服药品分剂量使用情况分析

目的：分析医院住院患儿口服药品分剂量使用的现状,为保障儿童安全合理用药提供参考。方法：选取2022年1月—12月福建省福州儿童医院收治的9 245例使用分剂量口服药品的0～14岁住院患儿及其相关医嘱26 575条,采集患者的年龄、性别,以及分剂量药品的品种、剂型、规格等信息,分析但当前医院住院患儿口服药品分剂量使用的现状和特点。结果：26 575条医嘱涉及9 245例患儿,其中抗感染药物分剂量医嘱7 094条（占26.69%）,其次为影响变态反应和免疫功能药品分剂量医嘱6 279条（占23.63%）和消化系统药物医嘱5 425条（占20.41%）;片剂分剂量医嘱10 248条（占38.56%）,其次为颗粒剂5 350条（占20.13%）、干混悬剂5 191条（占19.53%）和散剂4 527条（占17.03%）。结论：我国市场上儿童适宜药品比较匮乏,药品分剂量用药现象普遍存在,为确保儿童用药安全,降低药害发生风险,药品监管部门、医药企业和医疗机构应共同努力做好儿童用药的安全性。     

我院住院患儿口服药品分剂量调查分析

目的:探讨我院儿童住院患者口服药品分剂量使用现状,为保障儿童合理安全用药提供参考.方法:抽取我院2018年6月至2019年5月儿童口服药品分剂量用药医嘱,统计分析分剂量药品信息,包括患儿年龄、性别、药品名称、规格、拆分剂量等.结果:共纳入1080例患儿,15724条医嘱,其中泌尿系统药物分剂量医嘱数占比最多(4282条...     

儿童多剂量包装口服药品启用后使用期限标注情况调查及分析

目的:调查我院儿童多剂量包装口服药品分剂量使用情况及启用后使用期限标注情况,了解儿童多剂量包装口服药品启用后使用期限标注现状,为药品的质量与安全管理提供参考。方法:通过我院PASS临床药学管理系统抽取门诊处方,分析药品分剂量使用情况;根据我院药品供应目录,除外自制制剂,筛选出多剂量口服药品,查阅药品说明书中药品启用后使用期限的标注情况。结果:我院口服药品346种,多剂量包装口服药品218种。明确提到多剂量口服药品启用后使用期限的共8种(3.67%);在标注使用期限后详细说明贮存条件的共3种(1.38%);提及贮藏条件但未提及使用期限的1种(0.46%)。提及遮光或避光保存的共23种,提及遮光或避光保存且采用棕色或褐色包装的仅3种。结论:多剂量包装口服药品分剂量使用在儿童医院较为常见,多剂量包装口服药品说明书启用后使用期限标注率低,不同生产厂家的口服药品启用后的使用期限标注不统一,多剂量包装口服液体药品贮藏条件与贮藏容器不统一。儿童使用多剂量包装口服药启用药品后药品安全性不可保障,影响药物疗效及儿童用药安全。     

中国儿童常用药品剂型使用现状分析

目的 分析目前中国儿科常用药品剂型使用现状。方法 收集中国8家不同省份三级甲等儿童医院的用药目录，筛选出儿童常见系统疾病用药品种目录，对收集到的药品剂型信息进行统计分析。结果 共收集到2 495种儿科常用药品品规，其中口服剂型1 162种（46.6%）、注射剂型1 072种（42.9%）、外用剂型225种（9.0%）及吸入剂型36种（1.4%）。口服剂型中最常用的为普通片剂和颗粒剂。注射剂型中中药注射液有9种品规，其中有5种说明书中未标明儿童用法用量。儿科专用药品剂型共有190个品规，最常见的剂型为颗粒剂、口服溶液剂和糖浆剂。结论 尽管中国儿科常用药品剂型对儿童的适宜性有一定的改善，但目前儿科专用药品较少，适宜学龄前及以下儿童的药品剂型仍然比较缺乏，还远远不能满足不同年龄儿童多样化的药品剂型需求。     

郑州市儿童医院药品说明书中有关儿童用药信息的调查分析

目的:了解郑州市儿童医院(以下简称"我院")药品说明书中儿童用药信息的标注情况。方法:收集我院目前正在使用的732种药品的说明书,对药品说明书中"儿童用法用量""新生儿用法用量""儿童用药"项信息及儿童药动学参数的标注情况进行统计分析。结果:732种药品的说明书中,仅384种(占52.5%)标有明确的"儿童用法用量";其中,剂型上以口服制剂为最多(216种,占56.3%),药品类别上以抗感染药为最多,有94种(占24.5%)。732种药品中,81个品种(占11.1%)为儿童专用;651种非儿童专用的药品中,309种药品的说明书中有明确的儿童应用年龄范围、用法与用量等资料,剂型上也以口服制剂为最多(147种,占47.6%)。结论:药品说明书中"儿童用法用量"项标注率太低,"儿童用药"项缺失严重,专门针对儿童的药品太少,应当引起相关部门的重视。     

儿科常用散剂药品说明书中儿童用药信息的调查分析

目的:了解儿科常用散剂药品说明书中儿童用药相关提示信息,为临床用药提供参考,保障散剂药品在儿科的用药安全。方法:查阅某三甲儿童专科医院门诊药房的所有散剂剂型药品的说明书,对儿童用药信息进行统计,并查阅相关的资料和论文,进行信息的分析。结果:158种口服药品中散剂剂型药品13种,占总口服药品品种8.23%,西药散剂6种,中药散剂7种;其中有详细儿童用法用量的10份,注明"三岁以下酌减"的2份,注明"儿童用药尚不明确"的1份;不良反应、禁忌、注意事项、药理作用及药物相互作用,西药品种说明书中注明的比较详细,中药品种多为"尚不明确"或缺失。结论:散剂剂型药品在儿科中应用较为常见,其西药散剂药品说明书中儿童用药信息比较全面,中药散剂药品说明书中用药信息不够全面,应加强中药散剂药品说明书的完善和管理。     

我国儿童专用药品说明书调查与分析

目的：了解我国儿童专用药品（化学药品与生物制品）中药品说明书的标注情况及存在问题,为促进儿童用药信息的完善提供参考。方法：对儿童专用药品进行汇总,并依据药品说明书进行信息表的填写与统计,分析儿童专用药品说明书存在的问题。结果：共收集到儿童专用药品说明书1214份,其中国产药品1180个（占97.20%）,进口药品34个（占2.80%）;儿童专用药品数量最多的为呼吸系统用药（占42.01%）;儿童专用药品口服剂型1094个（占90.11%）,注射剂型57个（占4.70%）,外用剂型59个（占4.86%）,吸入剂型4个（占0.33%）;说明书中标注的剂量调整依据主要为年龄和体重（占45.80%）,只依据年龄进行剂量调整的占41.02%,而7.91%的药品未标注剂量调整依据;说明书中标有儿童用药最大剂量的占17.46%,标有儿童用药疗程的占28.01%,而标有儿童药代动力学的仅有16.72%。结论：我国儿童专用药品说明书存在标签撰写不规范、内容不完善、同一品规药品说明书差异大等问题,建议相关部门加强药品说明书的规范和管理,加大上市后的监管和数据监查,督促药品生产企业对儿童专用药品说明书中的内...     

第7版《WHO儿童基本药物示范目录》在儿童医院的使用情况分析

目的：基于样本儿童医院药品使用情况,为制定中国儿童基本药物目录提供参考。方法：利用18家三级儿童专科医院的药品采购数据,比较分析第7版《WHO儿童基本药物示范目录》（EMLc）与样本儿童医院用药在品种和剂型上的异同,根据欧洲药品管理局推荐的儿童用药剂型,分析不同年龄儿童适宜用药剂型的分布情况。结果：儿童医院用药与《WHO儿童基本药物示范目录》重合的活性成分191个,重合率64.3%,重合的品种247个,重合率75.3%。儿童医院使用较广泛的剂型分别为静脉注射剂（41.3%）、口服片剂（24.9%）,用药金额占比最高药品类别为抗感染药物（34.0%）,用药金额占比最高的药品为人免疫球蛋白（16.8%）;适宜新生儿和婴幼儿使用的泡腾剂、栓剂和灌肠剂较少。结论：儿童专科医院的用药情况与EMLc存在差异,部分类别药品剂型缺乏,在制定中国儿童基本药物目录时,可借鉴EMLc相对成熟的遴选原则,结合我国儿童临床用药实际情况,并充分考虑儿童在药物剂型和规格上的特殊需求,提高我国儿童用药的安全性、合理性。     

儿科用药药品分剂量的策略及实例分析

目的:为儿科临床合理用药提供参考。方法:通过检索儿科用药药品分剂量的相关文献,结合临床用药的经验,从剂型、品种、包装、规格、可替代药品等方面,对分剂量的不同策略进行实例分析。结果:药品分剂量的策略包括液体制剂替代固体制剂,片剂中尽量选择有刻痕、胶囊型、直径较大的品种,选用容易分剂量的包装,选用规格小的包装,选用可替代且容易分剂量的药物等。结论:药品分剂量的策略灵活多样,需要全面考虑药品的剂型、生产工艺、包装、规格等多种因素,必要时可选用可替代的其他药物或制备临用制剂以弥补儿童专用剂型的匮乏。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

---

Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.