头孢菌素类药物严重不良反应的原因与措施探讨

目的分析头孢菌素类药物严重不良反应发生的原因,并结合针对性的措施进行探讨,进而降低严重不良反应的发生概率。方法本文将2014年1月至2016年12月我院发生头孢菌素类药物严重不良反应的患者35例作为研究组,将同期未发生头孢菌素类药物严重不良反应的患者35例作为对照组,回顾性分析两组患者的临床资料,对头孢菌素类药物严重不良反应发生的原因与措施进行分析。结果患者发生头孢菌素类药物严重不良反应的因素主要包括过敏体质、过敏史以及饮酒,差异具有统计学意义(P<0.05);头孢菌素类药物常见严重不良反应包括过敏反应、消化系统反应、神经系统反应、血液系统反应、呼吸系统反应以及泌尿系统反应等,其中以过敏反应和消化系统反应发生率居高。以第3代头孢菌素类药物的严重不良反应较为多发。结论临床上应该科学、合理的使用头孢菌素类药物,严格依据适应证用药、掌握其禁忌证以及导致严重不良反应发生的原因等,积极的预防和制止不良反应的发生,以保证患者用药的安全、有效、经济,提升患者预后质量。     

研究头孢菌素类药物致临床不良反应调查分析

目的研究头孢菌素类药物诱发的不良反应类型,探讨相应的处理方法。方法选择本监测中心80例头孢菌素类药物致临床不良反应的患者,对其临床资料开展回顾性分析,分析其不良反应症状,研究不良反应诱发原因和解决办法。结果 80例研究对象中出现变态反应54例,占总研究人数67.5%,其余患者则出现消化系统不良反应或其他不良反应。第二代药物以及第三代药物诱发的不良反应明显比第一代药物和第四代药物高,经静脉滴注治疗诱发的不良反应明显比口服药物和其他方式治疗诱发的不良反应严重。结论选择头孢菌素类药物针对患者开展治疗的过程中,必须要科学选择给药方式,正确挑选抗菌药物品种,加强用药检查及针对性处理。     

头孢菌素类药物不良反应发生原因分析

目的:探讨头孢菌素类药物发生不良反应的原因,以期为临床提供用药指导.方法:回顾性分析我院2013年1月-2016年12月发生头孢菌素类药物不良反应89例的临床资料,总结发生不良反应的原因,采用Person对诱发不良反应的原因行相关性分析.结果:本组89例患者的诱发不良反应的原因有药物联用不当、给药时间过长、药液浓度过高、药物滴速过快、药物剂量过大、药物没有及时停用、未做皮试及其他因素等;发生不良反应的主要部位有皮肤和软组织、消化系统等;与不良反应发生有着密切关系的因素有药物联用不当、给药时间过长、药液浓度过高、滴速过快、剂量过大等.结论:临床用药中,充分了解头孢菌素类抗生素的特点、作用机制以及不良反应等,安全、规范、有效、合理地使用头孢菌素类药物,是避免不良反应,保障患者的预后的关键.     

第三代头孢菌素类药物临床不良反应原因分析及风险预防机制探索

目的：分析第三代头孢菌素类药物临床不良反应发生原因,探讨风险预防机制,为临床合理用药提供依据。方法回顾性分析本院2012年1月~2013年12月334例第三代头孢菌素类药物临床不良反应资料。结果全部334例第三代头孢菌素类药物临床不良患者均停药观察,给予对症治疗后均治愈;第三代头孢菌素类药物不良反应类型包括过敏反应、消化系统反应、神经系统反应、血液系统反应及二重感染,构成比分别为58.4%、23.1%、9.3%、4.2%、3.5%。结论第三代头孢菌素类药物抗感染治疗疗效确切,但应注重药物合理科学应用,掌握指证、用药剂量及方法,预防为主,消除或减少不良反应发生风险。     

头孢菌素类药物的临床不良反应和预防措施探讨

目的：探讨头孢菌素类药物的临床不良反应和预防措施。方法：本次医学研究以我院2013年1～12月收治的5000例头孢菌素类药物治疗患者为观察对象,回顾分析患者不良反应发生情况。结果：主要不良反应症状包括过敏反应、神经系统症状、血液系统症状、泌尿系统症状和消化系统症状等,原因包括：药物质量、药物用量、用药后24h内饮酒、患者心理因素、年龄过小或过大、个体差异、环境原因、饮食因素和患者自身生理因素等。结论：在患者头孢菌素类药物治疗过程中,采取有效的预防措施,有助于不良反应发生率的降低。     

头孢菌素类药物不良反应发生因素分析

目的：了解头孢菌素类药物不良反应的发生原因,指导临床安全用药,减少头孢菌素类药物不良反应。方法：回顾性分析我院2012年3月～2014年3月收治的98例应用头孢菌素类药物出现不良反应的患者临床资料,基于了解并掌握患者实际状况综合相关文献资料,深入探究不良反应的发生原因,并制定预防策略。结果：头孢菌素类药物不良反应主要诱导因素包括合并用药、原发病、年龄、饮酒、饮食、输液速度、药物质量、个体差异等。结论：在临床头孢菌素类药物的应用过程中,要关注抗菌效应,深入分析不良反应诱导因素,基于常规治疗强化服务意识,掌握药理知识,把握常用剂量、不良反应、注意事项,提高头孢菌素类药物的规范使用水平,减少不良反应。     

头孢菌素类药物严重不良反应的原因与措施探讨

目的分析头孢菌素类药物严重不良反应产生的原因,探讨应对措施,以期能够降低严重不良反应发生率,提升患者预后质量。方法选取2010年2月至2014年2月期间我中心监测到的83例使用头孢菌素类药物后发生严重不良反应的患者为观察组,选取同时期的256例使用头孢菌素类药物后未发生不良反应的患者为对照组,回顾性分析上述两组患者的临床资料,分析头孢菌素类药物严重不良反应的发生原因。结果经统计,发生头孢菌素类药物严重不良反应的相关危险因素包括患者具有过敏体质、具有过敏史以及饮酒等(P<0.05),差异具有统计学意义。头孢菌素类药物常见严重不良反应包括过敏反应、消化系统不良反应、泌尿系统不良反应、心血管系统不良反应、神经系统不良反应、二重感染、"双流醒"样反应等,发生率依次为44.58%、28.92%、13.25%、6.02%、2.41%、2.41%、1.20%。头孢菌素类药物严重不良反应多发于3代头孢菌素类药物,其中尤以头孢哌酮钠、头孢曲松钠不良反应发生率最高。结论可采取依据患者个体情况给药,改变患者不良生活习惯,避免与乙醇等药物合用、避免使用头孢哌酮钠、头孢曲松钠等药物等措施降低不良反应发生率,缓和医患关系,提升患者预后质量。     

医疗机构头孢菌素类抗菌药物皮试规范化管理

摘要：目的 探讨取消常规头孢菌素皮试的规范化管理和成效。方法 制定我院常规头孢菌素皮试操作规范、严重过敏 反应抢救流程及严重过敏反应抢救标准操作规范。回顾性分析2020年1月—2020年11月和2019年1月—2019年11月我院头孢菌 素皮试相关数据以及药品不良反应发生情况。结果 我院头孢菌素皮试人次显著下降,2020年1月—2020年11月头孢菌素皮试 人次数仅为1969人次,明显低于2019年同期。2020年进行头孢菌素皮试的主要原因包括：①部分医生仍存在一定疑虑(1808, 91.82%);②患者对是否有头孢菌素过敏史作出模糊回答(32,1.63%);③患者要求头孢菌素皮试(67,3.40%);④其他原因(62, 3.15%)。头孢菌素类抗菌药物次均费用明显下降,有统计学差异(t=37.23,P＜0.05)。因直接使用头孢菌素类抗菌药物导致药品 不良反应事件无统计学差异,取消头孢菌素皮试前后皮试阳性率结果有差异。结论 规范化管理常规头孢菌素皮试,不仅显著 降低头孢菌素皮试人次数和医疗费用,也有效保证了医疗质量与安全。     

临床应用头孢菌素类抗生素的不良反应及合理用药研究

目的探讨临床应用头孢菌素类抗生素产生的不良反应及合理用药措施。方法通过回顾性分析法对68例采取头孢菌素类抗生素治疗出现不良反应的患者的临床资料进行收集、分析、整理,对头孢菌素类抗生素不良反应出现的原因、具体类型、头孢菌素类抗生素药物应用类型进行归纳总结,同时制定头孢菌素类抗生素药物的合理应用措施。结果头孢菌素类抗生素引起的不良反应药物类型包括头孢哌酮、头孢曲松、头孢唑林、头孢西丁、头孢呋辛、头孢他啶、头孢地嗪,占比分别为14.71%、13.24%、11.76%、7.35%、13.24%、20.59%、19.12%。常见不良反应类型包括血液系统反应、变态反应、胃肠道反应、肾肝毒性反应,占比分别为11.76%、26.47%、57.35%和7.35%;头孢菌素类抗生素不良反应发生的主要原因包括超剂量用药、未进行药敏试验、无指征用药、重复用药,占比分别为32.35%、4.41%、23.53%和39.71%。结论临床应用头孢菌素类抗生素过程中,应保证药物应用的合理性及安全性,利用合理用药方法可降低不良反应发生率。     

头孢菌素类药物各种不良反应表现及预防措施

目的:分析头孢菌素类药物各种不良反应表现,结合实际情况对预防措施进行分析。方法:选择近一年我院收治的80例由于头孢菌素类药物不合理应用引起的各种不良反应患者作为案例,对患者的临床资料进行分析,总结不良反应的原因,对预防措施对比分析。结果:在本次研究中对头孢菌素类药物的不良反应的影响因素分析,包括:不良饮食习惯、药后饮酒、过敏体质、过敏史、不良情绪等,不良反应类型多。结论:头孢菌素类药物各种不良反应比较多,直接对患者产生异常影响,要求医护人员从实际情况入手,做好适应症和禁忌症分析,确定切实可行的预防措施,预防不良反应的发生。     

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.     

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.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

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.