依法加强医院药品管理工作的几点思考

新修订的《中华人民共和国药品管理法》（简称《药品管理法》）已于２００１年１２月１日起正式施行，《中华人民共和国药品管理法实施条例》（简称《实施条例》）也于２００２年９月１５日起施行。新《药品管理法》及其《实施条例》的公布并施行，是我国新时期强化药品监督管理工作的重大举措，对保障人民身体健康、确保用药安全有效有着十分重要的意义。《药品管理法》及其《实施条例》对药品的科研、生产、流通、使用各方面都作了明确的详细的法律规定，药品生产企业、经营企业和医疗卫生机构都必须依照执行，医院的药品管理工作理应按照…     

北京市药品监督管理局2007年第四季度北京市药品质量公告

为进一步贯彻执行《中华人民共和国药品管理法》，严厉打击制售假劣药品的违法行为，保障首都人民用药的安全有效，根据《2007年北京市药品抽验计划》，我局组织在全市范围内对药品生产、经营、使用单位进行了抽查检验。现将2007年全年和第四季度药品抽验情况及对不合格药品的查处事宜通知如下：     

对新修订的<药品管理法>及其<实施条例>的几点质疑

新修订的《中华人民共和国药品管理法》（以下简称《药品管理法》）已于２００１年１２月１日起正式施行。《中华人民共和国药品管理法实施条例》（以下简称《实施条例》）已于２００２年９月１５日起正式施行。新修订的《药品管理法》和《实施条例》的公布施行，对加强新的历史时期的药品监督工作无疑将起到巨大的推动作用。新修订的《药品管理法》顺应社会主义市场经济新的时代背景的要求，针对改革开放中的新问题，对原法进行了大幅度的修改，重点体现在：改变了执法主体；简化了药品生产企业、经营企业和药品的审批程序；进一步规范了对…     

国家食品药品监督管理局发布2006年第二期违法药品广告公告汇总

近日，国家食品药品监督管理局发布《关于印发2006年第二期违法药品广告公告汇总的通知》。 为了加强药品广告的监督管理，积极配合有关部门开展违法药品广告专项治理活动，规范药品广告发布秩序，依据《药品管理法》和《药品管理法实施条例》，各省（区、市）食品药品监督管理部门加大了对药品广告的监测力度，在本期公告汇总期间，以发布《违法药品广告公告》等方式通报并移送同级工商行政管理部门的违法药品广告共计7730次。     

国家食品药品监督管理局发布2006年第二期违法药品广告公告汇总

近日，国家食品药品监督管理局发布《关于印发2006年第二期违法药品广告公告汇总的通知》。 为了加强药品广告的监督管理，积极配合有关部门开展违法药品广告专项治理活动，规范药品广告发布秩序，依据《药品管理法》和《药品管理法实施条例》，各省（区、市）食品药品监督管理部门加大了对药品广告的监测力度，在本期公告汇总期间，以发布《违法药品广告公告》等方式通报并移送同级工商行政管理部门的违法药品广告共计7730次。     

药品监督行政执法中存在的问题及对策

本文通过对实行《药品管理法》结合我国药品监督行政执法工作的实际,分析了当前药品监督行政执法中存在的问题,根据已重新修订并于2001年12月1日开始实施的《药品管理法》的有关原则,提出了解决这些问题的方法和对策。     

山东省药品质量公告

为认真贯彻《药品管理法》等法律法规，严厉打击制售假劣药品的违法行为，保障人体用药安全有效。根据2004年山东省药品抽验计划，组织山东省药品检验所及各市药品检验所在全省范围内对药品生产、经营企业和医疗机构的药品质量进行了抽样检验，现将2004年第三季度抽验结果予以公告。     

新<药品管理法>对医药企业的影响有多大

从２００１年１２月１日起，我国新的《药品管理法》已经开始执行。《药品管理法》作为国家管理药品生产、经营企业．保障人民安全用药，维护人民健康生活的纲领性法规，必将对我国医药企业包括医药类上市公司产生深远的影响。 与此前执行的国家１９８４年颁布的《药品管理法》相比，新的《药品管理法》对旧法的绝大部分条款都做了修订和补充。尤其在法律责任方面由原来的７条增加出２６条，在违法和处罚上的规定更加明确．更有可操作性，为各类医药企业在更加公平环境下的经营提供了法律保障，同时对与药品相关的各个利益部门的要求和监管…     

试析药品说明书与合理用药

药品说明书是指药品生产企业印刷并提供的包含药理学、毒理学、药效学、医学等药品安全性、有效性、重要科学数据和结论，用以指导临床正确使用药品的技术性资料。药品说明书对于医、药、护治疗团队以及患者的安全合理用药有着重要的意义。国家药品监督管理局于2000年10月15日发布的《药品包装、标签和说明书管理规定（暂行）》以及2001年6月22日发布的《药品说明书规范细则（暂行）》，对药品说明书内容、格式进行了较为详尽的规范要求。     

《药品管理法》的实施将药品管理工作推向新局面

实施《药品管理法》是加强药品监督管理的一项重要举措，对保证药品质量、保障人体用药安全、维护人民身体健康和用药的合法权益，促进医药事业健康发展具有重大意义。《药品管理法》进一步完善了法律责任制度，它涵盖了药品研制、生产、经营、使用和监督管理的全过程，而医疗机构作为药品使用的主要部门，不言而喻是实施《药品管理法》的重要主体。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Hyperkalaemia in patients in hospital

A survey of all laboratory blood specimens with a plasma potassium concentration greater than or equal to 5.5 mmol/L was conducted over a three month period. Of 331 specimens with hyperkalaemia, 71 were excluded because the specimens was haemolysed, old or contaminated. The laboratory served a population of 348,561 and during this time measured the plasma potassium on 25,016 occasions. Sixty-six outpatients and 20 neonates were not evaluated. The survey was undertaken on 86 of 102 inpatients (46 males), 48 of whom were over 66 years of age. Fifty-seven patients were admitted under a medical service and 29 under a surgical service. Fifty-nine had a single episode of hyperkalaemia. Thirty-two underwent a surgical procedure. The commonest contributing factor was impaired renal function which was present in 71 (83%) patients. Although a definitive causative role for drugs could be identified in only five patients, in 52 (60%) patients drugs were a contributing factor (potassium supplements 24, ACE inhibitors 16, nonsteroidal antiinflammatory drugs 12). Thirty-five of the 86 (41%) patients died during their hospital admission. Nineteen of the 35 deaths occurred within three days of the hyperkalaemia being recorded. A normal plasma potassium was eventually documented in 50 of the 86 patients. Of the remaining 36 patients, 25 (69%) subsequently died. In general the treatment of patients with hyperkalaemia focused on identifying and treating the underlying cause. Hyperkalaemia must always be considered seriously and regard given to the overall clinical status of the patient, with particular attention to drug therapy, renal and cardiac function, acid base status and the possibility of sepsis.