静脉滴注甘露醇注射液的观察体会

甘露醇是脱水药，高渗溶液。主要作用是降低颅内压和眼压并有利尿作用，静脉注射后血浆渗透压升高，使组织中水分向血浆转移引起组织脱水，由于其渗透性脱水使血容量增加，肾小球滤过率提高，另外，甘露醇进入肾小管后不能重吸收，使肾小管管腔渗透压升高，减少Na^ 和水的重吸收而利尿，临床用甘露醇药液需15～30min内滴注完毕。     

热敷法降低静脉滴注环丙沙星注射液的不良反应观察

目的　降低乳酸环丙沙星注射液在输液过程中的血管刺激症状。方法　观察 80例静脉点滴环丙沙星注射液的病人 ,随机分为两组 ,每组 4 0人 ,实验组病人在输液过程中采用热敷法 ,与对照组比较。结果　实验组有血管刺激症状 6例 (15 0 % ) ,对照组 2 8例 (70 0 % ) ,经 χ2 检验 ,P <0 .0 0 1,两组比较差异具有显著性。结论　热敷法能降低环丙沙星注射液的血管刺激症状     

静脉滴注血塞通注射液致过敏反应1例

1 病历介绍 患者，男，55岁，有冠状动脉硬化史，无任何药物过敏史，因做大生化检查示血液黏稠度增高，甘油三酯和胆固醇高于正常，医生建议给予5％的葡萄糖液250ml加入血塞通20ml静脉滴注，滴速为40滴／min，当滴入20ml时，患者突然出现呼吸困难，胸闷憋气，面部潮红，烦躁不安，出冷汗，脉搏116次/min，立即停止输液，给予氟美松10mg静脉推注，非那根25mg肌肉注射，同时氧气吸入，并用10％的葡萄糖酸钙20ml加入10％的葡萄糖注射液中缓慢静推，通过以上治疗，症状逐渐缓解，2h后患者恢复正常。     

氟康唑Ⅰ期临床药物耐受性试验

本文报道16例健康成年自愿受试者,随机分为5组,分别服氟康唑50、100、200、300和400mg后观察48小时。结果表明,50～300mg组无任何不良反应,400mg组可出现轻度头昏、思睡和稀便。全部受试者用药前后体检及实验室检查(血尿常规、肝肾功)均正常。本文提示成年患者氟康唑日剂量100～400mg耐受良好,一般不会产生严重不良反应。     

静脉滴注复方丹参注射液致高热3例

复方丹参注射液是以丹参为主的提取物，含脂溶性的多种甘参酮类及水溶性的原儿茶酚醛和儿茶酚的衍生物。临床上用于治疗心绞痛，心肌梗塞，脑缺氧，脑栓塞，神经衰弱等病，有一定的疗效。但其副作用报道甚少见。现将静滴复方丹参注射液引起高热3例报道如下：     

利福星与复方丹参注射液同时静脉滴注时应注意的问题

内科呼吸系统病人肺部炎症同时伴用血液粘稠者 ,用抗菌素同时用复方丹参治疗应用中发现 ,在用利福星与复方丹参换瓶时输液管内 ,尤其是莫菲氏滴管内立即出现白色混浊现象 ,为探讨原因 ,我们作了临床对比观察。1　实验1.1　将 10 %Ｇ .Ｓ .2 5 0ｍｌ+复方丹参 2 0ｍｌ、ｐＨ5配制成临床应用浓度与利福星液体接触 ,约 9秒钟出现肉眼可见的白色混浊物。1.2　将 5 %ＧＮＳ +复方丹参 2 0ｍｌ、ｐＨ5Ｓ配制成临床应用浓度与利福星液体接触 ,约 7秒钟出肉眼可见的白色混浊物。1.3　将 0 .9%ＮＳ 2 5 0ｍｌ+复方丹参 2 0ｍｌ、ｐＨ5配制成临床应用…     

静脉滴注鱼腥草注射液引起过敏两例

病例1女．22岁，因感冒发烧来我院就诊经医院检查诊断为上感，给了5％葡萄糖注射液250ml加鱼腥草40ml静脉滴注，滴人体内的半分钟．病人即感脸部火热，面色潮红，即刻撤去所输液体．让病人平卧休息，给予氧气吸入．半小时后病情逐渐好转，安全离院。     

静脉滴注复方丹参注射液发生过敏反应1例护理

复方丹参注射液治疗冠心病在临床收到较好的效果。常用于治疗冠心病，脑血栓，颈性眩晕，突发性耳聋，随着复方丹参注射液在临床应用日益增加，不断出现一些过敏反应，现将我院抢救1例静脉滴注复方丹参注射液，发生过敏性反应患者的护理体会报告如下。     

静脉滴注鱼腥草注射液的观察及护理

2003年1月-2005年6月，我院用鱼腥草注射液治疗上呼吸道感染、支气管肺炎、化脓性扁桃体炎等效果好，副作用小。现将观察及护理报告如下。     

Brain Tissue Pulsation in Healthy Volunteers

It is well known that the brain pulses with each cardiac cycle, but interest in measuring cardiac-induced brain tissue pulsations (BTPs) is relatively recent. This study was aimed at generating BTP reference data from healthy patients for future clinical comparisons and modelling. BTPs were measured through the forehead and temporal positions as a function of age, sex, heart rate, mean arterial pressure and pulse pressure. A multivariate regression model was developed based on transcranial tissue Doppler BTP measurements from 107 healthy adults (56 male) aged from 20–81 y. A subset of 5 participants (aged 20–49 y) underwent a brain magnetic resonance imaging scan to relate the position of the ultrasound beam to anatomy. BTP amplitudes were found to vary widely between patients (from ∼4 to ∼150 µm) and were strongly associated with pulse pressure. Comparison with magnetic resonance images confirmed regional variations in BTP with depth and probe position.     

Intraosseous Pressure Monitoring in Healthy Volunteers

Study Objective: Invasively monitoring blood pressure through the IO device has not been thoroughly demonstrated. This study attempted to establish baseline values of IO pressure in a healthy human population. Methods: This was a prospective, healthy volunteer, observational study. Participants had two IO devices placed (humerus and tibia), and participant IO pressures, vital signs, and pain scores were monitored for up to 60 minutes. Participants were contacted at 24-hours and 7 days post-testing to assess for adverse events. Summary statistics were calculated for systolic, diastolic, and mean humeral and tibial IO pressure. The ratio of IO to non-invasive blood pressure was calculated, and Bland Altman plots were created. The slope (linear) of the mean humeral and the tibial IO pressures were also calculated. Results: Fifteen subjects were enrolled between April and July 2015. Fourteen of 15 humeral IOs were placed successfully (93.3%) and all 15 of the tibial IOs were placed successfully. Mean tibial systolic, diastolic, and mean IO pressure were 55.8 ± 27.9, 49.3 ± 27.1, and 48.4 ± 29.4 mm Hg, respectively. Humeral systolic, diastolic, and mean IO pressure were 32.9 ± 16.0, 27.4 ± 15.2, and 24.5 ± 14.3 mm Hg. The mean tibial IO pressure was 52.5% ± 32.0% of external cuff pressure ratio. The mean humeral IO pressure was 26.5% ± 15.2% of the external mean blood pressure. The Bland Altman plots showed an inconsistent relationship between the systolic and diastolic cuff pressure and the IO pressures. We observed a 1% per minute decrease in IO pressure from the initial placement until the final reading. Conclusions: Intraosseous pressure readings can be obtained in healthy human volunteers. However, absolute IOP values were not consistent between subjects. Future research may determine how IO pressure can be used to guide therapy in ill and injured patients.     

Pharmacokinetics of Mezlocillin in Healthy Volunteers

Mezlocillin in doses of 1.0, 2.0, and 5.0 g and carbenicillin in doses of 2.0 g were given as bolus injections intravenously to 10 healthy volunteers. For mezlocillin, dose-dependent pharmacokinetics was detected. This is reflected by a more than proportional rise in serum concentrations and a decreased total body clearance as doses were increased. Per dose unit, the areas under serum concentration curves to infinity were 33.5 μg·h/ml for the 1.0-g dose, 47.2 μg·h/ml for the 2.0-g dose, and 54.8 μg·h/ml for the 5.0-g dose. The body clearance fell from 31.2 liters/h with the 1.0-g dose to 17.0 liters/h with the 5.0-g dose. This can be explained mainly by a marked depression of nonrenal clearance, which fell from 12.2 to 3.8 liters/h, compared with a parallel change in renal clearance from 19.0 to 13.2 liters/h. Contributing to the non-linearity may be biotransformation, evacuation via bile, or another process. With dose increments, rising amounts are recovered unchanged in the urine—61% after a 1.0-g dose compared with 69% after a 5.0-g dose. This clearly defines metabolism as a major factor of elimination. Carbenicillin, for which the first-order, two-compartment open model was applicable here as in previous studies, had a longer serum half-life than did mezlocillin. For the 2.0-g doses, the former had a half-life of 1.4 h, compared with 0.8 h for the latter (calculated as if the two-compartment model were fully valid). The relative area under the curve (see above) was 76.1 μg·h/ml after the 2.0-g dose.     

Effect of Terbinafine on Theophylline Pharmacokinetics in Healthy Volunteers

Twelve healthy volunteers were enrolled in an open-label, randomized, crossover study. Subjects received single doses of theophylline (5 mg/kg) with and without multiple-dose terbinafine, and 11 blood samples were collected over 24 h. The study phases were separated by a 4-week washout period. Theophylline serum data were modeled via noncompartmental analysis. When the control phase (i.e., no terbinafine) was compared to the treatment phase (terbinafine), theophylline exposure (the area under the serum concentration-time curve from time zero to infinity) increased by 16% (P = 0.03), oral clearance decreased by 14% (P = 0.04), and half-life increased by 24% (P = 0.002). No significant changes in other theophylline pharmacokinetic parameters were evident.     

Pharmacokinetics of Cephanone in Healthy Adult Volunteers

Five volunteers received intramuscular injections of 7 mg (approximately 500 mg) of cephanone, a new cephalosporin for parenteral use per kg. Peak serum concentrations averaged 36 mug/ml, about four times as high as with the same doses of cephalothin, twice as high as with cephaloridine, and slightly lower than with cefazolin. With a constant intravenous infusion of 100 mg/h, a steady-state serum concentration of 31 mug/ml was attained in four volunteers. The serum half-life was similar for the intramuscular and intravenous studies, 2.4 and 2.6 h, respectively. Over 90% of the dose administered was recovered in the urine. The factor mainly responsible for the higher and more sustained serum concentrations of cephanone was its low renal clearance of 47 ml per min per 1.73 m(2). Cephanone has a small apparent volume of distribution, probably related to its high serum protein binding of 88%.     

Ultrasound Evaluation of Diaphragmatic Mobility and Contractility After Osteopathic Manipulative Techniques in Healthy Volunteers: A Prospective,Randomized, Double-Blinded Clinical Trial

ObjectiveThe purpose of this study was to investigate the effect of a session of osteopathic manipulative techniques on diaphragmatic motion and thickness in healthy participants.MethodsThis was a prospective, randomized, double-blinded, case vs sham vs control clinical trial performed in an outpatient osteopathic clinic in Rome, Italy. Sixty-seven healthy participants, mean age 40.4 ± 14.5 years, received an ultrasound evaluation of diaphragmatic motion and thickness, followed by a systematic osteopathic evaluation. After randomization, the experimental group (n = 22) received osteopathic manipulation, whereas the sham (n = 22) and the control (n = 22) groups had a light touch approach and simple observation, respectively. After a 1-session intervention, new osteopathic and ultrasound assessments were repeated in all participants.ResultsA statistically significant increase in diaphragmatic mobility was observed in the experimental group after the osteopathic manipulation (Δ = 14.5 mm, P < .001; analysis of variance P < .001 vs both sham: Δ = -0.22 mm, and control: Δ = -2.09 mm groups). A strong linear relationship was observed between the diaphragmatic motion gradient, measured with ultrasonography, and the score assigned by the operator evaluating the change of diaphragm mobility after intervention.ConclusionOsteopathic techniques used in this study improved the diaphragmatic motion (but not the muscle thickness) in healthy participants. Further studies are needed to confirm our findings and eventually identify the clinical conditions that may benefit from osteopathic manipulative treatment of the diaphragm.     

普罗布考片单次口服给药的人体药物代谢动力学研究

目的采用高效液相色谱-质谱联用法(HPLC-MS/MS)研究普罗布考片的人体药物代谢动力学变化规律。方法 2010年10月-11月,24例健康男性受试者单次口服普罗布考片0.5 g,采用HPLC-MS/MS法测定给药后不同时间点血浆中普罗布考的经时血药浓度,采用DAS 2.0软件进行药动学参数计算。结果受试者单次口服普罗布考片,达峰时间为(11.50±6.66)h,峰浓度为(2 894.72±1 320.53)ng/mL,药-时曲线下面积(AUC)0-t为(238 876.96±131 873.67)ng/mL.h,AUC0-∞为(259 989.08±146 112.88)ng/mL.h,半衰期为(278.52±164.72)h。结论普罗布考片体内过程符合二室模型,单次口服具有较好的安全性。     

Intrapulmonary Pharmacokinetics of GSK2251052 in Healthy Volunteers

The plasma and intrapulmonary pharmacokinetics (PK) of intravenous (i.v.) GSK2251052, a novel boron-containing antimicrobial, were evaluated in healthy adult subjects. Thirty subjects underwent bronchoscopy and timed bronchoalveolar lavage (BAL) either following a single dose (cohort 1) or after 5 twice-daily doses (cohort 2) of 1,500 mg GSK2251052 i.v. Serial PK and safety assessments were obtained throughout the study. Bronchoscopy was performed on a single occasion in each subject at 2, 6, or 12 h after start of infusion. Noncompartmental analysis was performed to calculate PK parameters. Thirty subjects completed the study. The mean clearance (CL), volume of distribution at steady state (V_ss), and half-life (t_1/2) values were 22 liters/h, 231 liters, and 10.7 h, respectively. Approximately 30% of the dose was excreted unchanged in urine. The GSK2251052 concentrations in epithelial lining fluid (ELF) and alveolar macrophages (AM) were approximately 50% and 500 to 600%, respectively, compared to the concentration in plasma. the GSK2251052 exposures in ELF and AM were comparable following single- and repeat-dose administration. The most frequently reported drug-related adverse event (AE) was mild to moderate infusion site reactions (7 subjects) that occurred primarily in the repeat-dose cohort. No serious drug-related AEs or clinically significant trends in laboratory values, vital signs, or electrocardiograms were observed. GSK2251052 given as a 1,500-mg infusion was generally tolerated following single- or repeat-dose administration. GSK2251052 distributes into both the ELF and AM of healthy volunteers, which supports further study in patients with pneumonia.     

Effects of Tourniquet Ischemia on Current Perception Thresholds in Healthy Volunteers

Abstract: The neuroselective effects of tourniquet isch‐ emia/compression in healthy volunteers were evaluated using the automated electrodiagnostic sensory Nerve Conduction Threshold (sNCT) test. The sNCT evaluation generates reliable, painless Current Perception Threshold (CPT) measures. Standardized CPT measures using constant alternating current sinusoid waveform stimulus at 3 different frequencies 5 Hz, 250 Hz, and 2 kHz (NeurometerEG CPT/C Neurotron, Inc. Baltimore, MD) were obtained from 10 individuals at baseline and after 5, 10, 15, and 20 minutes of tourniquet ischemia and 30 minutes post‐tourniquet release. The data were analyzed to determine the significance of any changes in CPTs. Increases in CPTs after 15 and 20 minutes of tourniquet ischemia at 2000 Hz and 250 Hz reached statistical significance. There were no significant changes in 5 Hz CPT measures. The results of this study demonstrate the ability of the sNCT test to quantify previously described differential neuroselective effects of tourniquet ischemia on sensory nerve function. Demonstration of statistically significant increases in CPT values at 2000 Hz and 250 Hz secondary to tourniquet ischemia, with no change in 5 Hz CPT values, is consistent with the understanding that 2000 Hz sine wave stimuli activate the large myelinated sensory fibers, 250 Hz sine wave stimuli activate small myelinated sensory fibers, and 5 Hz sine wave stimuli activate small unmyelinated sensory fibers.