我院2006年药品不良反应报告分析

目的分析宿州市立医院药品不良反应(ADR)的相关因素为临床合理用药提供依据,提高本院的合理用药水平。方法对宿州市立医院2006年收集的168例临床不良反应报告进行统计分析。结果168例临床ADR涉及的药品种类及例次中以抗菌药占首位,应用的药物中为抗感染药(101例,占60%)占很大比例;最常见的临床表现为皮肤及其附件损害(76例);女性ADR发生率高于男性;老年人ADR发生率较高。结论药品不良反应的发生与多种因素有关,必须注视药物的不良反应,降低不良反应的发生率,确保合理用药。     

我院2004年药品不良反应分析

目的:分析安贞医院药品不良反应(ADR)的相关因素为临床合理用药提供依据。方法:对北京安贞医院2004年1-10月间收集的142例临床不良反应报告进行统计分析。结果:142例临床ADR病例报告中最易引起不良反应的药物为抗感染药(91例,占59.8%);最常见的临床表现为皮肤及其附件损害(67例);女性ADR发病率高于男性;老年人ADR发生率最高(83例,占58.5%)。结论:药品不良反应的发生与多种因素有关,合理用药是降低ADR发生的关键。     

我院627例不良反应报告分析

摘要：目的 统计分析我院药品不良反应发生规律、特点，为临床合理用药提供参考依据。方法 收集我院2015年下半年各科室上报的不良反应报告627例，利用Excel软件进行回顾性统计分析。 结果 627例ADR报告中一般不良反应450例，（占比71.77%），新的一般的不良反应177例（占比28.23%），无严重不良反应/事件发生；男性359例（占比57.26%），女性268例（占比42.74%），各年龄段的男性ADR发生率均高于女性ADR发生率; 60岁以上老人有260例，占41.47%，占比最大；ADR发生率最高的给药途径为静脉滴注（573例，占比91.39%），其次是静脉注射（17例，占比2.71%）和口服（15例，占比2.39%）；以消化系统损害（212例，33.81%）最为常见；抗感染药物引起179例ADR，占比28.55%；其次是维生素、电解质和营养药物类，引起106例ADR，占比16.91%；引起ADR例数排名第三的是神经系统用药，引起103例ADR，占比16.43%；中成药引起的ADR（77例，占比12.28%）亦不能忽视。结论 ADR大多是药品的固有属性的延伸, 无法避免。提高ADR系统监测性能，保证临床合理用药，降低不良反应发生率，需要医药护的共同努力。     

我院328份药品不良反应报告与分析

目的分析广西壮族自治区桂东人民医院2018年药品不良反应(ADR)发生的特点及规律,为临床安全合理用药提供参考依据。方法回顾性统计分析广西壮族自治区桂东人民医院2018年上报国家不良反应中心的328份ADR报告。结果328例ADR报告中,女性患者(53.05%)略高于男性患者(46.95%);41~80岁患者发生率最高,共219例(66.77%);引发ADR的主要给药途径为静脉用药(65.55%);涉及ADR的药品主要为抗肿瘤药物(35.06%),其次为抗感染药物(28.35%);ADR主要累及器官和(或)系统为消化系统(41.71%),其次为血液系统(27.27%);新的ADR共20份(6.10%),严重的ADR共78份(23.78%)。结论应加强对中老年患者的ADR监测,减少静脉给药途径,重点监测抗肿瘤药物及抗感染药物,降低ADR发生率,确保临床安全合理用药。     

我院495例药品不良反应报告分析

目的:了解我院药品不良反应(ADR)发生规律、特点和临床表现,为临床合理用药提供参考。方法:采用回顾性研究方法,对我院2014年1月–2015年12月收集的495例ADR报告进行汇总,从ADR发生的年龄、性别分布、给药途径、药物类别与品种数、累及系统/器官及临床表现、不良反应类型、严重ADR报告等进行统计分析。结果:495例ADR报告中,男性发生率(55.56%)明显高于女性发生率(44.44%);60岁以上患者发生ADR的比例最高(29.29%);抗感染药物引起ADR的比例最高(26.87%),其次为消化和循环系统药物(分别为15.76%);静脉用药引发的ADR最多(71.92%);消化系统损害133例(26.87%),其次为皮肤及附件损害130例(26.26%);严重ADR报告占比12.73%,消化系统损害23例,血液系统损害12例,全身性反应11例。结论:需进一步重视ADR监测工作,充分发挥临床药师作用,确保临床用药安全有效。     

52例中药注射液不良反应报告分析

目的 统计分析中药注射液药品不良反应(ADR)发生规律、特点,为临床中药注射液合理用药提供参考依据.方法 应用Excel回顾性统计宿州市立医院2016年1～6月各科室上报的52例中药注射液ADR报告.结果 52例ADR报告共涉及8个科室,以神经内科上报的ADR报告(30例,57.69％)最多;其中一般不良反应40例,占比76.92％,新的一般的不良反应12例(23.08％),无严重不良反应/事件发生;男性24例(46.15％);女性28例(3.85％),女性占比略高于男性;65岁以上老人26例(50％),占比最大;涉及的9种中药注射液中排名前三位的分别是丹红注射液(25例,48.08％),注射用血栓通(13例,25％)及喜炎平注射液(4例,7.69％);以头痛、头晕、麻木等神经系统损害(15例,28.85％)最为常见;52例中药注射液引起的ADR预后均良好.结论 中药注射液成分复杂,ADR逐年增高,不断完善中药注射液ADR上报制度是科学合理应用中药注射液的动力.     

我院328例门诊患者药物不良反应报告分析

目的了解我院门诊患者药品不良反应(ADR)发生的特点和规律。方法对我院门诊药房2013年所收集的328例ADR进行统计分析。结果在328例报告中,女性发生率(70.73%)明显高于男性(29.27%);在给药方式中,口服途径引发的ADR占56.10%,静脉滴注引发的ADR占41.77%;ADR发生率最高的是心脑血管系统药物(27.74%),其次是抗菌药物(25.30%)和神经系统药物(20.43%),抗菌药物中头孢菌素类发生ADR居首位(28例),其次是大环内酯类(25例);ADR累及器官或系统ADR累及系统以消化系统损害最多,共117例(25.77%)。结论医院应加强ADR监测工作,规范临床合理用药,确保患者用药安全。     

我院624例药品不良反应报告分析

目的 通过统计分析对我院上报的624例药品不良反应(ADR)报告,旨在促进ADR监测工作的开展,保障用药安全.方法 回顾性地分类统计分析我院2014~2015年收集上报的624例ADR报告.结果 624例ADR中,女性发生率略高于男性,≥70岁的患者发生药品不良反应的比例最高(189例,占30.29%);静脉给药引发的药品不良反应最多(448例,占71.79%);最易引发不良反应的药物类别为抗感染药(138例,占22.12%),其次为心血管系统用药和中药类制剂;药品不良反应可发生于人体各个系统,但主要以皮肤及附件为主(251例,占39.72%);624例药品不良反应中新的、严重的不良反应占118例.结论 临床应该重视和强化药品不良反应监测工作,积极开展药学监护,保障患者用药安全.     

某院3181例药品不良反应报告分析

目的 了解药品不良反应(ADR)发生的一般规律及特点,为临床合理用药提供参考.方法 采用回顾性分析方法 ,对3 181例ADR报告从ADR发生的年龄与性别分布、给药途径、药品种类、累及的系统/器官及临床表现、ADR报告类型及ADR转归等方面进行统计分析.结果 3 181例ADR报告中,男性1 501例(47.19%),女性1 680例(52.81%);ADR在各年龄段均有分布,>50~60岁者ADR发生率最高,有829 例,占26.06%;引起ADR药品以抗感染药物居多,且主要为头孢菌素类,其次为心血管系统用药;引发ADR的给药途径以静脉滴注为主,占73.09%;ADR最常累及系统/器官为全身性损害,占23.07%;一般ADR占87.11%,大多好转或治愈,新的ADR占12.39%,严重ADR占0.69%,其中1 例留有后遗症,参麦注射液发生过敏性休克而死亡1例.结论 临床应高度重视ADR监测和报告工作,降低用药风险.     

134例药品不良反应报告回顾性分析

目的:了解我院药品不良反应(ADR)发生的特点及临床表现,为临床合理用药提供格对我院2009-2011年收集上报的134例ADR报告申患者的性别、年龄、过敏史、ADR严重程度、给药途径以及引起ADR药物的类别、ADR累及器官或系统、ADR的转归等进行统计分析.结果:134例ADR报告中,男性71例(52.99%),女性63例(47.01%);年龄最小16 d,最大96岁,年龄分布无差异性;以静脉滴注方式给药的ADR例次较高(119例);所涉及的药品中抗茼药物引起ADR例次较高(35例),其次是中药注射剂(33例);ADR临床表现以全身损害为主(38.01%),其次为皮肤及附件损害(21.27%);严重的ADR共5例(3.73%).结论:应重视抗茼药物及中药注射剂的规范用药,尽量避免静脉用药.     

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.

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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.