8例克林霉素所致临床不良反应分析

目的探讨克林霉素不良反应（ADR）发生的类型、特点及处理方法，为临床合理用药提供参考。方法对2005年1月至2008年1月医院门诊观察及住院治疗的8例患者发生克林霉素ADR的情况作回顾性总结分析。结果8例克林霉素ADR反应中，以过敏反应发生率较高，主要表现为皮肤损害，其中过敏性休克最为严重。其他不良反应还有胃肠系统损害和肝功能损害。结论临床应高度重视克林霉素的合理使用，警惕可能因药物的相互作用诱发严重ADR的潜在危害性。     

硫唑嘌呤不良反应的临床表现与安全用药

目的探讨硫唑嘌呤不良反应(ADR)发生的类型及其临床表现,为临床安全用药提供参考。方法检索国外有关硫唑嘌呤不良反应的病例报道,进行分析和总结。结果硫唑嘌呤的不良反应以血液系统损害最为多见,其次为肝功能损害、感染、胃肠道反应、肺毒性等不良反应。其中骨髓抑制、肺毒性、肝脏毒性可致命。结论临床医药人员应重视硫唑嘌呤引起的ADR,观察患者用药表现,以减少严重ADR的发生。     

182例药品不良反应分析

［摘要］目的了解药品不良反应（ADR）的发生特点，促进临床合理用药。方法采用回顾性方法，对用药种类、ADR表现及报告人等进行分析。结果抗感染药所致ADR位居第一，占54.95%，其次为中枢神经系统药及中药制剂。主要的ADR 类型为皮肤及附件损害，其次为消化系统损害。47.80%报告来源于药师。严重ADR 30例。结论应加强ADR的监测和ADR知识的宣传，保障患者用药安全。     

2012年医院87例药品不良反应报告分析

目的 了解医院药品不良反应（ADR）发生的特点,为临床合理用药提供参考.方法 收集医院2012年1月至12月上报的87例有效ADR报告,按涉及的药物种类、ADR损害类型及临床表现进行回顾性分析.结果 87例ADR报告中,最常见的临床表现为皮肤及其附件损害、胃肠道损害及输液反应,抗感染药物、中成药及抗肿瘤药发生不良反应较多.结论 医务人员应仔细观察ADR的发生,寻找有效的防治方法;对ADR采取“早发现、早报告、早处理”的原则;用药时严格把握适应证,加强用药监护,最大限度地保障患者的用药安全.     

2006～2009年我院309例药品不良反应报告分析

目的：探讨我院药品不良反应（ADR）的发生因素、一般规律及特征,为临床安全、合理用药提供参考。方法：对收集到的309例ADR,按患者年龄、性别、给药途径、ADR程度、药品类型、ADR涉及器官或系统及临床表现等进行分类统计与分析。结果：涉及ADR的药品共有309种,抗生素居首位,其次为中成药;静脉注射引发的ADR为205例（占66.34%）;ADR可发生于人体各个系统,但主要为变态反应,以皮肤及其附件损害最为严重,其次是神经系统损害;新的一般的ADR52例,新的严重的ADR1例。结论：医务人员在临床药品使用中应重视和加强ADR监测,结合ADR发生特点,合理用药,从而减少或避免药品不良反应的发生。     

964例丹红注射液不良反应报告关联规则分析

目的对丹红注射液药品不良反应(ADR)报告进行一般情况及关联规则分析,为临床合理用药提供参考。方法应用SPSS Modeler软件,对四川省药品不良反应监测中心2010年1月至2017年12月丹红注射液ADR报告进行关联规则分析。结果共964份有效报告,超过50%的病例为60岁及以上的老年人,ADR累及皮肤及其附件、心血管及呼吸等系统。严重ADR表现中,"皮肤及其附件损害+心血管系统一般损害+初次用药时发生ADR"等组合置信度可达100%;一般ADR报告中,"心血管系统一般损害+皮肤及其附件损害+初次用药时发生ADR"组合置信度可达77.273%。结论丹红注射液ADR病例多为一般类型,涉及不同器官和组织的ADR与患者自身年龄、原患疾病有很大关系,因此,在临床用药之前应做出安全评估。     

136例甲巯咪唑不良反应报告分析

目的为临床安全、合理使用甲巯咪唑提供参考。方法对136例甲巯咪唑引起的不良反应的临床资料进行描述性统计分析。结果 136例不良反应中,41～65岁人群最多,占44.9%;严重的、一般的不良反应构成比分别为29.41%、70.59%%;严重病例临床表现以肝损害和粒细胞缺乏最为突出,肝损害不良反应可发生在用药后7天至3个月内,粒细胞缺乏症可发生在用药后9天～2个月内。结论甲巯咪唑引起的不良反应不容忽视,临床使用时应注意用药剂量,加强用药肝功、血象监护,防止和减少不良反应的发生。     

中山大学附属第一医院241例药品不良反应报告分析

目的 了解药品不良反应（ADR）发生的规律、特点及引发的相关因素,为临床用药安全与合理用药提供参考.方法 统计中山大学附属第一医院2011～2012年上报的241例ADR报告,按患者性别、年龄、给药途径、引起ADR的药品类型、ADR涉及器官或系统,以及ADR临床表现等进行回顾性分析.结果 241例ADR报告中涉及的药品共12大类,其中抗菌药物引发的ADR最多,其次是心脑血管类药物;静脉注射给药引发的ADR最多;ADR累计的器官及系统以皮肤及其附件损害最为常见,其次是中枢神经系统损害.结论 药品不良反应的发生与多种因素有关,临床应坚持不良反应的报告和监测,以减少或避免ADR的发生,促进临床合理用药,保证患者用药安全.     

1142例药品不良反应报告分析

目的探讨药品不良反应（ADR）发生的相关因素及特点,为,临床合理用药提供参考。方法对嘉兴市药品不良反应监测中心2007年收集到的1142例ADR报告按性别、年龄、药物类别、给药途径、不良反应等临床表现进行统计、分析。结果1142例ADR报告中涉及的药品有219种,其中抗茵药物居首位,其次为中成药;用药途径以静脉给药为主;主要的ADR类型为皮肤及附件损害;较严重的ADR有69例。结论应重视和加强ADR监测工作,提高临床安全用药水平。     

门诊输液治疗中抗生素不良反应分析

目的分析门诊输液治疗中抗生素不良反应(ADR)发生的特点,为临床合理用药提供参考。方法采用Excel电子表和手工筛选方法,按患者性别、年龄、与ADR有关的抗生素种类、ADR的损害类型及其临床表现、ADR因果关系评价等资料进行统计分析。结果 ADR报告中男女比例为1:1.09,以<10岁和31～40岁患者较多,其中<10岁儿童发生率最高;引起ADR的药物主要集中在β-内酰胺类、喹诺酮类林可霉素;ADR损害以皮肤及其附件损害为主,共48例;新的、严重的ADR2例;经积极处理,所有患者均治愈或好转。结论加强医院输液室ADR报告和监测工作,分析有价值的信息,可以提高临床用药水平,保证用药安全有效。     

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.     

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.     

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.     

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.     

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.