洛美沙星不良反应二例

1病例资料【例1】女,42岁。因锁骨骨折入院。查体:体温36.5℃,血压110/70 mmHg。意识清,皮肤黏膜未见结节,无皮疹;心肺未见异常。急诊行切开复位内固定术。术后第6天患急性支气管炎,给洛美沙星0.2 g加5%葡萄糖注射液250 ml静脉滴注,输液完毕后1.5 h,患者颈部及躯干部见6处     

洛美沙星治疗伤寒38例疗效观察

目的：探讨治疗伤寒的最佳首选药物和耐药菌株伤寒的药物治疗。方法：对３８例确诊伤寒患者。用国产洛美沙星（Ｌｏｍｅｆｉｏｘａｃｉｎ）治疗。剂量是成人０．６ｇ／ｄ,分２次服,疗程一周。结果：１．３８例均治愈,无复发和再燃。２．退热时间,平均为３．８天,３．无伤寒并发症。４．无不良副作用。结论：洛美沙星退热快,控制菌血症效果好。疗程短,简单、经济、患者容易接受,据临床观察是目前治疗伤寒的最佳首选药物和耐药菌株伤寒的最优治疗药物。     

洛美沙星不良反应二例

1病例资料【例1】女,42岁。因锁骨骨折入院。查体:体温36.5℃,血压110/70 mmHg。意识清,皮肤黏膜未见结节,无皮疹;心肺未见异常。急诊行切开复位内固定术。术后第6天患急性支气管炎,给洛美沙星0.2 g加5%葡萄糖注射液250 ml静脉滴注,输液完毕后1.5 h,患者颈部及躯干部见6处     

利巴韦林滴鼻治疗感冒优于静脉滴注

目的：比较利巴韦林滴鼻与静脉滴注（静滴）治疗感冒的疗效和不良反应。方法：２６４例门诊病人随机分为滴鼻组１３８例（男性６２例,女性７６例;年龄 ３６ ａ ± ｓ ７ ａ）,将利巴韦林注射液稀释为１０％滴鼻,ｑ ３—４ ｈ。静滴组 １２６例（男性 ５７例,女性 ６９例;年龄３８ａ± ｇａ）,将利巴韦林１０— １５ｍｇ．ｋｇ－１加于５％葡萄糖注射液５００－１０００ ｍＬ中,ｉｖ,ｇｔｔ, ｑｄ。结果： ２组在用药后 １, ２, ３, ４ ｄ治愈情况差异无显著意义,Ｐ＞０．０５;不良反应滴鼻组为０例,静滴组为１６例（１２．７％）,差异有显著意义（Ｐ＜ ０．０５）。结论：利巴韦林滴鼻治疗感冒疗效可靠,无不良反应,优于静滴。     

洛美沙星与环丙沙星治疗急性细菌性感染疗效比较

目的:比较洛美沙星与环丙沙星治疗急性细菌性感染的临床疗效和安全性.方法:144例患者随机分成两组,治疗组72例,用洛美沙星注射液0.2～0.4 g,iv,qd,疗程7～10 d;对照组72例,用环丙沙星注射液0.2～0.4 g,iv,bid,疗程7～10 d.结果:总有效率、致病菌清除率治疗组分别为88.9%,86.1%,对照组分别为84.7%,80.6%,不良反应的发生率治疗组和对照组分别为5.6%,6.9%.结论:洛美沙星是一个安全、有效的抗菌药物.洛美沙星比环丙沙星给药方便.     

科学静脉滴注在小儿静脉滴注中的应用效果

目的：分析科学静脉滴注在小儿静脉滴注中的应用效果。方法选取2013年5月—2014年5月在同煤集团燕子山矿医院接受静脉滴注的患儿120例,随机分为观察组与对照组,各60例。对照组患儿予以常规静脉滴注,观察组患儿予以科学静脉滴注。观察两组患儿疼痛程度、家长满意度及静脉炎发生率。结果观察组患儿疼痛程度轻于对照组（P<0.05）;观察组患儿家长总满意度为96.67%,高于对照组的73.33%（P<0.05）;观察组患儿静脉炎发生率为11.67%,低于对照组的26.66%（ P<0.05）。结论小儿静脉滴注过程中运用科学静脉滴注能有效减少患儿疼痛感,降低静脉炎发生率,提高静脉滴注效率和质量,提高家长满意度。     

心律平静脉注射与顿服转复房颤疗效比较

1986年Frabetti首次报道了顿服普罗帕酮(心律平)转复阵发性房颤的方法。心律平经肝脏的首过作用后产生比其作用更强的5-羟基普罗帕酮。在实际工作中,无论急诊或住院患者,医生更倾向于静脉给药,起效迅速,而口服心律平转复房颤耗时较长,首次使用可能出现窦性停搏、晕厥等不良反应,顿服心律平转复房颤在临床远没能得到充分利用。本研究旨在观察静脉输注与顿服心律平转复房颤的效果。     

洛美沙星注射液和口服片剂治疗泌尿系统感染疗效比较

合理应用抗生素的原则除安全、有效外,经济也是临床治疗方案决策的一个重要因素。应用抗菌药物治疗急性泌尿系统感染性疾病时,静脉给药和口服给药,其疗效是否一致有待观察。本文采用洛美沙星静脉滴注和口服给药治疗80例泌尿系统感染患者，对比两种方案临床疗效，并运用药物经济学的原理进行成本一效果分析，为临床选择安全、有效、经济、合理用药提供参考。     

静脉滴注法莫替丁致过敏反应

[病例]男,45岁.因上腹部持续疼痛2小时来我院就诊,既往无药物过敏史,有胃十二指肠溃疡病史.患者面色苍白、出冷汗,伴恶心、呕吐,呕吐物为咖啡色胃内容物.查体:体温36.9℃,脉搏89/min,血压110/70 mmHg.心肺未见异常,全腹压痛、反跳痛.X线腹部检查示急性十二指肠溃疡穿孔.急诊行穿孔修补术.     

静脉滴注磷霉素钠致过敏性休克

[病例]女,70岁.因胸部外伤后左侧胸痛1h以左侧多发性肋骨骨折、脾挫伤人院.既往无过敏史.经专科处理后予抗感染等对症治疗.因青霉素皮试阳性,遂予磷霉素钠3g(东药集团生产,批号0607407)加入生理盐水100mL静脉滴注,滴速50/min.     

地尔硫微量注射泵静脉注射法与静脉滴注法治疗高血压急症的比较

目的：观察地尔硫静脉注射治疗高血压的疗效。方法：高血压急症病人５４例，分为Ａ组２３例，采用微量注射泵静脉注射法，将注射用地尔硫２００～４００ｍｇ溶于０．９％氯化钠注射液或５％葡萄糖注射液５０ｍＬ，给药剂量按３～１０μｇ／（ｋｇ·ｍｉｎ），根据血压情况，因人而异调整剂量；Ｂ组３１例采用常规静脉滴注法，将注射用地尔硫５０ｍｇ溶于０．９％氯化钠注射液或５％葡萄糖注射液２５０ｍＬ在２～４ｈ内滴完。结果：Ａ组总有效率９６％与Ｂ组的９３％差别无显著意义（Ｐ＞０．０５）。２组治疗后１０，２０，３０，６０ｍｉｎ收缩压和舒张压与其前一观察时刻的相应血压值配对ｔ检验，差别均有非常显著意义（Ｐ＜０．０１）。２组组间相应４个时段的降压幅度差别均无显著意义（Ｐ＞０．０５）。２组不良反应均轻微。结论：注射用地尔硫治疗高血压急症见效快，安全性好，微量注射泵静脉注射给药可获持久而稳定的降压效果。     

The pharmacokinetics of diclofenac sodium following intravenous and oral administration

Summary The pharmacokinetics of diclofenac were examined following single rapid intravenous injection and also following single oral doses to healthy female volunteers. After intravenous injection plasma levels of diclofenac fell rapidly and were below the limits of detection at 5.5 h postdosing. Individual drug profiles were described by a triexponential function and mean half-lives of the three exponential phases were 0.05, 0.26 and 1.1 h. After oral doses of enteric-coated tablets, the lag time between dosing and the appearance of drug in plasma varied between 1.0 and 4.5 h. However once drug absorption had commenced similar plasma drug profiles were obtained in different individuals. Peak plasma diclofenac levels ranged from 1.4 to 3.0 µg · ml^–1. The mean terminal drug half-life in plasma was 1.8 h after oral doses. This value was not significantly greater than the value of 1.1 h following intravenous doses. Fifty percent of orally dosed diclofenac did not reach the systemic circulation due, predominantly, to first-pass metabolism.     

A study of the effect of aspirin on the pharmacokinetics of oral and intravenous diclofenac sodium

Summary Previous studies have shown that aspirin interacts with orally administered diclofenac sodium, causing reduced peak concentrations, lower levels and decreased areas under curves. In this study, diclofenac sodium was administered orally and intravenously with and without aspirin, to 6 healthy female volunteers. After intravenous dosing both plasma levels and areas under curves were significantly reduced although none of the rate constants was affected. The volume of distribution of diclofenac was increased as was the plasma clearance. Oral administration with aspirin also resulted in lower plasma levels, particularly peak levels, and areas under curves. Comparison of AUC's for both modes of administration with and without aspirin suggested that lower levels after oral administration were not due to impaired absorption. These observations are best explained by decreased protein binding and increased biliary excretion of diclofenac in the presence of salicylate.     

氧氟沙星与哌拉西林治疗伤寒疗效比较

目的：观察氧氟沙星与哌拉西林治疗伤寒疗效。方法：本院经血、骨髓、粪培养有伤寒杆菌生长的102例住院患者随机分成2组,分别给予氧氟沙星0．2g或哌拉西林4g,加入5％GS250ml ,iv gtt,q12h,疗程14d。观察2组总有效率、细菌清除率、体温恢复正常时间及不良反应。结果：2组总有效率细菌清除率均为100％,体温恢复正常时间2组差异无显著性,不良反应发生率分别为21．2％及16％。结论：氧氟沙星与哌拉西林均为治疗伤寒的有效药物,均有治愈率高、退热快的特点,但哌拉西林的不良反应明显低于氧氟沙星。     

Pharmacokinetics of intravenous and oral L-arginine in normal volunteers

AIMS: Recent studies in patients with cardiovascular diseases suggest potential for the use of orally administered L-arginine, the precursor of nitric oxide, as a therapeutic agent. This crossover study was designed to examine the pharmacokinetics of single i.v. and oral doses of L-arginine in healthy volunteers (n = 10). METHODS: A preliminary control study (n = 12) was performed to assess the variation in plasma L-arginine concentrations when ingesting a normal diet. The observed variation was taken into account when interpreting the pharmacokinetic data obtained after exogenous administration. RESULTS: The mean baseline plasma concentration of L-arginine in the control study was 15.1+/-2.6 microg ml(-1). After intravenous administration (30 g over 30 min), the plasma concentration reached 1390+/-596 microg ml(-1). The disappearance of l-arginine appeared biphasic, with an initial rapid disappearance due to concentration-dependent renal clearance followed by a slower fall in plasma concentrations due to nonrenal elimination. The peak concentration after oral administration (10 g) was 50.0+/-13.4 microg ml(-1), occurring 1 h after administration. Renal elimination was not observed after oral administration of this dose. The absolute bioavailability of a single oral 10 g dose of L-arginine is approximately 20%. CONCLUSIONS: This study provides basic knowledge of L-arginine pharmacokinetics in healthy humans. Intravenous and oral administrations show at minimum a biphasic pattern. Further studies will assess whether a similar profile is observed when the drug is administered to patients.     

硝酸酯类药物不同途径给药后的药动学比较

目的 :评价 5 单硝酸异山梨酯 (5 ISMN)片剂和注射剂及硝酸异山梨酯 (ISDN)注射剂在中国健康受试者中的药动学特征。方法 :18名男性健康受试者采用自身对照交叉给药的方式 ,单剂量口服5 ISMN片剂 2 0mg或静脉滴注 (静滴 ) 5 ISMN注射剂 (5mg·h- 1,维持 4h)或ISDN注射剂 (5mg·h- 1,维持 4h) ,采用气相色谱法测定血药浓度。结果 :18名受试者口服 5 ISMN片剂和静滴 5 ISMN注射剂后的药动学参数为 :Tmax 分别为 (0 .7±s 0 .6 ) ,(4 .1± 0 .7)h ;Cmax分别为 (389± 86 ) ,(2 83± 5 9) μg·L- 1;AUC0 ∞ 分别为 (32 6 6± 6 2 4 ) ,(3179± 76 9) μg·h·L- 1。静滴ISDN注射剂后IS DN ,2 单硝酸异山梨酯 (2 ISMN )和 5 ISMN的Cmax分别为 (18± 7) ,(5 9± 4 ) ,(2 0 9± 5 0 ) μg·L- 1;AUC0 t分别为 (85± 2 8) ,(380± 5 9) ,(1384± 4 2 7)μg·h·L- 1;T1/2 分别为 (1.0 0± 0 .2 0 ) ,(2 .6±0 .8) ,(6 .1± 0 .9)h。结论 :5 ISMN片剂与注射剂相比 ,两者的AUC等效 ,但片剂的达峰时间明显快于注射剂。ISDN注射剂给药后能较快达到稳态浓度 ,而且迅速代谢成活性代谢产物。     

静脉滴注丁咯地尔出现尿频、尿急、排尿困难2例

丁咯地尔(buflomedil)化学名为：4-(1-吡咯烷基)-1-(2，4，6-三甲氧基苯基)-1-丁酮盐酸盐。用于治疗外周血管疾病，如间歇性跛行、雷诺综合征、Burger综合征，血管性痉挛和慢性脑血管供血不足引起的眩晕、耳鸣、智力减退、记忆力或注意力消退、定向障碍等症状，是种新型的血管扩张剂。临床不良反应的报道尚不多见，到目前作者未见有丁咯地     

Plasma timolol levels after oral and intravenous administration

Summary The plasma kinetics of timolol administered orally and intravenously to 5 male subjects were examined. Bioavailability was reduced by 25% when the drug was taken orally. Mean plasma half-life after oral dosing was 4.86 h, and after intravenous administration it was 4.56 h; the difference was not significant. The volume of distribution was 3.5 l/k. It is suggested that timolol is little affected by the first pass effect, even though there is marked interindividual variation in availability and peak plasma level.     

地尔硫静脉滴注治疗高血压急症

目的：观察地尔硫静脉滴注治疗高血压急症的疗效。方法：３２例病人（男性２１例，女性１１例，年龄５７±ｓ１４ａ），以地尔硫５０ｍｇ加于５％葡萄糖注射液２５０ｍＬ中静脉滴注，于６０～１２０ｍｉｎ滴完。结果：观察血压总有效率为９０％，在用药后５ｍｉｎ血压已开始下降，在１５～２０ｍｉｎ时已降至正常。结论：本品为治疗高血压急症的安全有效降压药。     

Pharmacokinetics of intravenous and oral tolmesoxide

Summary A high pressure liquid chromatographic assay was developed for simultaneous measurement of the plasma levels of tolmesoxide and its principal metabolite, RX71112. The assay was used to study the disposition of intravenous and oral tolmesoxide in ten normotensive subjects. Two exponential terms were required to describe the disposition of the drug following intravenous administration, whilst a single exponential term sufficied to account for the decay in the plasma concentration after oral administration. The bioavailability of oral tolmesoxide from capsules averaged 84.5% and was independent of dose. The mean half-life after i. v. dosing was 2.6 h (±0.3 SEM) compared to values of 1.9 h (±0.1 SEM) and 2.7 h (±0.5 SEM) following 200 and 400 mg oral doses respectively. In all subjects RX71112 appeared in plasma shortly after tolmesoxide following both routes of administration. The terminal half-life of the metabolite was significantly longer than tolmesoxide with a mean value of 4.9 h (±0.9 SEM) following the 200 mg oral dose of tolmesoxide. The binding of tolmesoxide and RX71112 at therapeutic plasma concentration was 36.8% (±0.5 SEM) and 58.5% (±0.3 SEM) and this remained unchanged at higher concentrations.