临床药师参与1例骨髓炎治疗分析

目的：探讨临床药师参与骨髓炎患者治疗中发挥药学服务作用。方法：临床药师通过参与一例特殊骨髓炎患者的治疗过程,结合患者疾病特点、用药史及药品不良反应等情况,建议医师选择合适的药物,提供个体化的药学服务。结果：患者的药物治疗方案安全有效合理。通过临床药师提供个体化药学服务,及时发现和解决了患者药物治疗的问题,为合理有效的治疗方案制定提供了建议。结论：临床药师在为患者提供个体化药学服务方面具有自身的优势,在合理用药中发挥了重要作用。     

1例肝硬化失代偿期合并糖尿病痛性神经病变患者疼痛用药分析及药学监护

摘要：本文报道临床药师根据自身药学特长为医生找出可疑致不良反应的药物,并以糖尿病痛性神经病变相关指南及药物说明书、药物代谢动力学等为参考,结合1例肝硬化失代偿期合并糖尿病痛性神经病变患者实际病情,分析患者疼痛管理治疗药物的适宜性,给予个体化药物治疗方案的建议。临床药师参与临床治疗,为医生提供药学信息,优化药物治疗方案,为患者提供药学服务,保证用药安全性和有效性,为促进临床合理用药发挥了积极作用。     

一例阿莫西林克拉维酸钾致Stevens-Johnson综合征合并儿童肺炎支原体性肺炎的药学监护

目的 探讨临床药师在阿莫西林克拉维酸钾致Stevens-Johnson综合征合并儿童肺炎支原体性肺炎治疗中作用,为阿莫西林克拉维酸钾不良反应引起的Stevens-Johnson综合征合并肺炎支原体性肺炎治疗及药学监护提供参考。方法 临床药师参与1例阿莫西林克拉维酸钾致Stevens-Johnson综合征合并儿童肺炎支原体性肺炎患儿的诊疗过程,协助医师调整治疗方案,同时对患儿进行个体化的用药监护,针对药物进行用药宣教,从而保证药物疗效,降低治疗过程中不良反应的发生。结果 通过临床药师的药学监护,提高患儿用药的安全性、合理性、有效性,避免不良反应的发生。结论 临床药师合理的药学监护,协同临床医师优化治疗方案,对患儿的治疗用药提供安全和合理的保障,从而提高对患儿服务质量。     

对一例糖尿病肾病合并高血压和心衰病人的用药分析及药学服务

目的：探讨临床药师在合理用药中的作用。方法：临床药师通过参与1例糖尿病肾病合并高血压、心衰病人的治疗过程,建议医生选择合适的药物,并根据药物的临床疗效和病情变化及时调整用药方案,提供个体化的药学服务。结果：临床药师为病人提供药学服务,提高了病人治疗依从性和临床治疗效果,减少了药物的不良反应。结论：临床药师在为病人提供个体化药学服务方面具有自身的优势和地位,在合理用药中发挥了重要作用。     

社区获得性肺炎患儿门诊抗菌药物处方分析

目的：探讨临床药师在儿童哮喘规范化管理中的作用,为临床合理用药提供参考。方法：开设儿童哮喘医药综合门诊,并结合临床药师参与2例哮喘患儿的个体化诊疗过程,通过药物基因检测明确患儿对药物的敏感性,向患儿家长解读基因报告,并提出个体化用药建议,指导患儿正确使用雾化吸入制剂。结果：医师采纳临床药师的建议,结合患儿基因检测结果,制定个体化药物治疗方案。结论：临床药师运用自身所掌握的药学专业知识,在哮喘儿童个体化治疗中开展药学服务,可充分发挥专业协助作用,确保治疗过程的安全、有效、经济。     

临床药师参与1例肾炎型肾病合并高血压患儿治疗的实践

目的：探讨临床药师在临床中提供药学服务的切入点。方法：临床药师全程参与1例肾炎型肾病合并高血压患儿药物治疗方案的制定,并为患儿提供药学监护计划及用药教育。结果：结合患者的具体情况,对患儿的治疗方案进行制定、评估、调整,药品不良反应处理,患儿个体化治疗方案取得明显效果,病情好转出院。结论：临床药师利用药学专业知识,参与临床实践,保证患儿用药安全、有效。     

临床药师对1例高血压并糖尿病患者的药学服务

目的:探讨临床药师开展药学服务的方法。方法:临床药师通过参与1例高血压并糖尿病患者的治疗过程,结合患者疾病特点、用药史、药物相互作用及药品不良反应等情况,建议医师选择合适的药物,提供个体化的药学服务。结果:此高血压并糖尿病患者的药物治疗方案有效合理。通过临床药师提供个体化药学服务,及时发现和解决了患者药物治疗的问题,为合理用药提供了建议。结论:临床药师在为患者提供个体化药学服务方面具有自身的优势,在合理用药中发挥了重要作用。     

1例短肠综合征伴胆汁淤积患儿的营养支持治疗分析

目的:通过参与短肠综合征(SBS)伴胆汁淤积患儿的营养支持治疗以及药学监护,探讨临床药师合理参与临床SBS药学监护的方法,发挥临床药师在营养支持小组(NST)的作用。方法:临床药师通过参与1例SBS伴胆汁淤积患儿的营养治疗过程,参与制订个体化给药方案和药学监护计划。结果:合理的肠外肠内营养治疗有利于SBS伴胆汁淤积患儿维持生命,增强患儿的肠内耐受性,减少并发症,改善预后。结论:临床药师可协同临床医师、营养师优化治疗方案,实施药学监护,促进营养支持治疗的合理使用。     

1例糖尿病合并肾性高血压患者的药学服务

目的：探讨临床药师在临床药物选用方面的作用。方法：临床药师参与1例糖尿病合并肾性高血压患者的治疗过程,与医师共同制定药物治疗方案,提供个体化的药学服务。结果与结论：临床药师进行药学服务可优化药物治疗方案,增加患者的用药依从性,在临床合理用药中可发挥重要作用。     

临床药师参与1例难治性哮喘患儿治疗的药学实践

探讨临床药师参与难治性哮喘患儿治疗药学监护要点,以指导临床合理用药。临床药师参与难治性哮喘的治疗过程,分析产生难治性哮喘原因,寻找疗效与药物、剂量与疗效的关系,制定合理药物及合适剂量,并根据药物的临床疗效和病情变化及时调整用药方案,提供个体化的药学服务。临床药师通过对难治性哮喘的药学监护,可提高患儿的用药安全性及治疗效果。临床药师参与难治性哮喘的治疗的制定,使治疗更加规范、合理,为难治性哮喘的控制治疗提供参考。     

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.     

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.     

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.     

Immunomodulation by non-absorbable antibiotics given by the intragastric route

To test the role of bacterial fractions released from intestinal flora during immunomodulation by antimicrobial agents, BALB/c mice were treated with the non-absorbable antibiotics polymyxin B or teicoplanin by the intragastric route. The composition of faecal microbiota and the capacity of spleen cells to proliferate in response to B-cell and T-cell mitogens were assessed at several times during the treatment. Both antibiotics lowered the count of some bacteria of the intestinal flora and induced significant modifications in spleen cell ability to proliferate in response to mitogens. Thus, the active fractions released from intestinal bacteria during antibiotic treatments may be able to induce immunomodulating effects.