临床药师参与抗感染治疗的药例分析

目的:分析临床药师参与临床抗感染会诊的方式与药学监护方法。方法:总结与归纳临床药师参与抗感染药物的治疗实例,对抗感染药物治疗实践的经验和有效的药学监护方法进行分析。结果:临床药师参与抗感染治疗的会诊使许多感染性疾病患者得到有效救治,使许多非感染性疾病患者避免了不合理使用抗菌药物的危害。结论:临床药师通过提供特殊人群抗感染治疗方案,耐药菌感染的治疗方法,及合理的联合使用抗感染药物,加强了抗感染药物使用过程的药学监护,从而得到临床医师的尊重和积极配合。     

临床药师参与1例感染性心内膜炎患者的抗感染治疗分析

目的 :探讨临床药师参与抗感染治疗的实践方式。方法:通过对1例感染性心内膜炎患者抗感染治疗的药物选择、剂量的调整、不良反应的关注等,提供药学服务。结果:在临床药师的积极参与下,患者的感染症状明显好转,为快速控制病情及后期手术治疗提供有利条件。结论:临床药师参与临床实践,可以为抗感染治疗提供安全、有效的治疗方案。     

一例泌尿系感染性结石患者感染性休克的药学监护

目的探讨临床药师在感染性休克患者治疗中全程化药学监护的作用。方法根据感染性休克的疾病特点和患者的自身因素,总结针对该类患者实施药学监护的要点。结果临床药师参与制订抗感染治疗方案、药物剂量、药物疗效、药物的遴选、不良反应等,并将其作为药学监护的要点。结论临床药师对患者提供药学监护,发现、解决问题,成为药物治疗团队的一员。     

临床药师参与1例感染性心内膜炎患者临床会诊治疗的药学监护

目的:分析临床药师参与感染性心内膜炎(IE)患者临床会诊治疗的药学监护,探究其药学监护过程。方法:通过参与1例IE患者会诊治疗的药学监护,分析患者抗感染治疗方案的合理性。结果与结论:临床药师提供个体化药学服务,得到临床医师的肯定,成功控制了感染;临床药师协助临床医师选择药物,有利于促进患者用药的安全性和有效性。     

临床药师参与脓毒症休克患者继发泛耐药鲍曼不动杆菌感染的病例分析

摘要：本文旨在探讨临床药师参与耐药菌感染药学监护模式及在抗感染治疗中的作用。临床药师参与1例脓毒症休克患者继发泛耐药鲍曼不动杆菌（XDR-AB）感染的治疗,结合相关指南和文献报道,综合抗菌药物的药动学/药效学（PK/PD）特点,从抗菌药物品种选择、剂量、疗程、给药方式及不良反应等方面开展临床药学服务,协助临床医师制订抗感染方案,最终患者感染得到有效控制。临床药师利用药学知识,协助临床制订抗感染治疗方案,对XDR-AB感染患者实施精准药学监护,提高脓毒症休克及XDR-AB感染药物治疗的有效性和安全性,提高患者生存率,体现临床药师自身价值。     

1例肺癌及其骨转移伴感染患者临床治疗的药学监护

目的:探讨药师对肺癌及其骨转移伴感染患者临床治疗的药学监护过程及其解决对策。方法:药师参与1例肺癌及其骨转移伴感染患者的用药情况并提出用药建议,分析其抗感染治疗及药学监护。结果:通过药师的合理化用药方案与治疗监护过程,提高了药物治疗效果。结论:药师利用与医师、护士互补的专业知识,为患者提供了个体化用药治疗方案是有效的、合理的。     

临床药师参与1例血液透析患者金黄色葡萄球菌所致导管相关性感染治疗的药学监护

目的:分析临床药师参与血液透析患者导管相关性感染临床治疗的药学监护过程。方法:通过医院收治的1名血液透析患者股静脉置管透析后发生导管相关性感染,经血培养结果证实为金黄色葡萄球菌所致,临床药师参与用药及其剂量调整,并参与了全程治疗过程。结果:临床药师对其感染患者的抗感染治疗进行了过程药学监护,在治疗药物用药剂量的合理性、安全性和药物不良反应为切入点,为患者提供了个体化药学服务。结论:临床药师利用自身的专业优势,对导管相关性感染的患者提供更精准的药学监护服务,以确保患者用药的有效性。     

临床药师参与膝关节置换术后感染性休克治疗的体会

目的：探讨临床药师在二级医院中进行药学监护途径和方法。方法对右膝关节置换术后因处理不当引起的感染性休克患者提供治疗方案，剂量调整等药学监护。结果患者感染得到有效控制和治疗。结论二级医院的临床药师需从多学科进行发展。     

1例神经外科ICU患者抗生素导致重症药疹的药学监护

目的 :探讨临床药师对抗生素导致重症药疹患者的药学监护及患者治疗过程的经验教训。方法:临床药师参与1例神经外科重症患者的抗感染治疗,对抗生素治疗方案提出建议,并对因抗生素使用导致重症药疹后的治疗进行了全程药学监护。结果:经过停药、抗炎及对症治疗后,患者药疹消退、感染并未再发。结论:临床药师在抗感染治疗和药物不良反应的治疗过程中,可以为患者提供全程药学监护,改善患者预后和临床疗效。     

1例神经外科术后感染患者的分级药学监护

目的 探讨临床药师参与术后感染患者抗感染治疗过程中的药学监护内容.HT5"H方法 临床药师从药物选择、相关疗效指标监测、不良反应监测等方面对1例术后合并颅内感染、肺部感染患者的治疗过程实施药学监护.结果 通过在抗茵药物治疗方案中对万古霉素的疗程及对其他药物提出合理建议,患者感染得到有效控制,生命体征平稳转院继续治疗.结论 临床药师参与患者抗感染治疗过程中个体化治疗方案的制订,开展分级药学监护,对促进药物治疗的有效性、减少或避免药品不良反应的发生,协助医生更好为患者提供药学服务.     

Deamination of beta-phenylethylamine by monoamine oxidase--inhibition by imipramine

The oxidative deamination of tyramine (Tyr), 5-hydroxytryptamine (5-HT), and β-phenylethylamine (PEA) by mitochondrial preparations of rabbit lung and brain was inhibited by imipramine. This tricyclic iminodibenzyl antidepressant drug was most effective in decreasing the deamination of PEA: at 1 × 10^?4M imipramine, deamination of PEA, Tyr and 5-HT was inhibited by approximately 70, 45 and 45 per cent, respectively, when either lung or brain mitochondrial monoamine oxidase (MAO) preparations were used. Imipramine-induced inhibition of MAO was shown to be of a mixed type based on Lineweaver-Burk plots, but was found to be completely reversible. The desmcthyl and didesmethyl derivatives of imipramine were equally as effective as the parent drug in inhibiting the deamination of PEA, whereas the N-oxide analog of imipramine was less effective as an inhibitor of this reaction. These results support the premise that the action of imipramine as a clinically effective antidepressive agent may be related to its inhibitory effect on the specific form of MAO which deaminates PEA.     

Augmentation by serrapeptase of tissue permeation by cefotiam

Cefotiam (CTM) is a new cephalosporin with a broad spectrum of activity against both Gram-positive and Gram-negative microorganisms. Cephalosporins are widely used for prophylaxis of infections in patients undergoing thoracotomy. Augmentation by serrapeptase on tissue permeation of CTM was examined in 35 thoracotomy patients with lung cancer. The subjects were divided into two groups according to the method of the administration of CTM. Group I consisted of 17 subjects, each of whom received a single dose of 2 g of CTM alone by an instillation for 30 minutes. Group II consisted of 18 subjects, each of whom received a combination of CTM and serrapeptase; serrapeptase was given 2 tablets (10 mg) each time for three times/day until the day before surgery, and then CTM was administered by the same procedure. The following results were obtained: Individual difference was observed for the permeation of CTM into tissues. Pathologic differences also affected the permeation. Nevertheless, the CTM levels in pulmonary tissues reached about a half of those in the blood in both the single dose group and the combination group, hence sufficient concentrations exceeding MIC80 for main microorganisms that caused infections in the lung were obtained. The concentrations of CTM in inflammatory tissues have showed lower levels than those of normal tissues in both CTM single dose and the combination groups. Decrease of blood flow volume may have contributed to the reduction in levels of CTM in the inflammatory tissues. The ratio of the concentration of the drug in pulmonary tissues to that in the blood was 29.1 +/- 2.5% in the single dose group, and 44.2 +/- 6.0% in the combination group, the latter showing quite a significant increase (P less than 0.05). Combined administrations of CTM and serrapeptase deserves more trials in the case when surgical treatments of the lung are performed. An antiinflammatory effect of serrapeptase in the respiratory system is expected, and in addition, the combined use of CTM and serrapeptase should stimulate permeation of the antibiotic into tissues.     

Synergism by caffeine and by cocaine of the motor control deficit produced by midazolam

To evaluate the effects of caffeine and cocaine on the impairment of discriminative motor control produced by midazolam, rats were trained to hold a force transducer operated with a paw so that it remained between upper and lower limits of a force band for a continuous 1.5-s period to deliver each food pellet. Acute doses of 3 mg/kg midazolam SC impaired motor performance. Except for one animal, caffeine (10-40 mg/kg IP) had little or no effect on performance, while cocaine (3.75-22.5 mg/kg IP) produced dose-related impairment. When each dose of caffeine was combined with 3 mg/kg midazolam, a marked synergism in motor performance impairment occurred. Cocaine plus midazolam produced mainly an additive synergism. The conspicuous synergistic action of caffeine on the motor control deficit produced by midazolam contrasts with the typical antagonism found between the benzodiazepines and methylxanthines when performance is evaluated by psychomotor tests not requiring fine motor control.     

Antagonism of morphine by beta-melanocyte-stimulating hormone and by tetracosactin

Using the decerebrate—spinal Lloyd preparation morphine depressed evoked mono- and polysynaptic reflex activity, β-melanocyte-stimulating hormone enhanced monosynaptic reflex activity, and tetracosactin had no effect. When morphine injection was preceded either by β-melanocyte-stimulating hormone or by tetracosactin a statistically significant depression was not observed. The stimulant actions of β-melanocyte-stimulating hormone did not appear to account for its capacity to antagonize morphine. The fall of blood pressure which follows the administration of morphine in this preparation was not antagonized by the prior administration of either polypeptide.     

Analgesia induced by brief footshock is inhibited by 5-hydroxytryptamine but unaffected by antagonists of 5-hydroxytryptamine or by naloxone

Exposure to footshock (1 mA) for 30 sec induced a marked analgesia that was enhanced by pretreatment with the 5HT synthesis inhibitor, p-chlorophenylalanine, and attenuated by the 5HT releasing drugs p-chloroamphetamine and fenfluramine, by the 5HT re-uptake inhibitor, fluoxetine and by the 5HT agonists, 5-methoxy-N,N-dimethyltryptamine and MK212. However, agonists, quipazine and trifluoromethylphenylpiperazine, with greated reported affinities for 5HT binding sites on rat brain membranes than MK212 were without effect as were the antagonists metergoline, methysergide, cyproheptadine, mianserine and methiothepin. The specific opioid antagonist naloxone was also without effect. The results in general indicate that analgesia induced by brief footshock (1 mA, 30 sec) is inversely related to 5HT availability but thereis little evidence of involvement of known 5HT receptors.