临床药师对1例难治性肺炎支原体肺炎合并肺栓塞患儿的药学监护实践

目的：探讨临床药师在难治性肺炎支原体肺炎合并肺栓塞患儿治疗中的作用,为肺栓塞患儿的药物治疗及药学监护提供参考。方法：临床药师参与1例难治性肺炎支原体肺炎合并肺栓塞患儿的诊疗过程,协助临床医师调整治疗方案,同时对患儿进行个体化药学监护,针对重点药物进行用药宣教,从而保证疗效,降低不良反应发生率。结果：通过临床药师的药学监护实践,提高了肺栓塞患儿用药的安全性、有效性,尽量避免了不良反应事件的发生。结论：临床药师积极实施药学监护,协同临床医师优化治疗方案,有利于患儿的用药安全与有效。     

临床药师对肺栓塞患者的药学监护

 目的: 通过临床药师对患者实施药学监护,保障肺栓塞患者用药的安全有效。方法：临床药师对1例肺栓塞患者进行密切观察与随访,制订相应的药学监护措施,针对性提出用药建议。结果：通过药学监护,明显提高了肺栓塞患者用药的安全性、有效性,尽量避免了不良反应事件的发生。 结论：临床药师积极开展药学监护,协同临床医师优化给药方案,有利于患者的用药安全有效。     

1例奥希替尼治疗后发生肺栓塞患者的药学监护

目的 加强对新型抗肿瘤药物奥希替尼治疗后发生肺栓塞患者的药学监护,为临床安全用药提供参考。方法 回顾临床药师参与1例肺腺癌患者接受奥希替尼治疗后出现肺栓塞的治疗过程,对治疗过程中出现的肺栓塞不良事件进行评估,并结合患者病情及个人意愿对抗凝药物的选择提供建议。结果 临床药师全程参与药物治疗并实施药学监护与药学随访,患者肺栓塞情况控制良好,为患者继续抗肿瘤治疗提供了保障。结论 临床药师通过优化治疗方案,提供药学监护,保障了患者用药安全有效。     

一例肺栓塞伴肺部感染患者的药学监护

目的通过临床药师对一例肺栓塞患者实施药学监护,保障肺栓塞患者用药的安全有效。方法临床药师对1例肺栓塞患者进行密切的观察与随访,制订相应的药学监护措施,针对性提出用药建议。结果通过药学监护,明显提高了肺栓塞患者用药的安全性、有效性,尽量避免了不良反应事件的发生。结论临床药师积极开展药学监护,协同临床优化给药方案,有利于患者的用药安全与有效。     

临床药师参与1例肺栓塞患者的药物治疗实践

目的探讨临床药师在肺栓塞患者临床治疗中的作用。方法对临床药师参与治疗的1例典型病例进行报告分析。结果临床药师参与患者药物治疗过程,提高了肺栓塞患者用药的安全性、有效性,避免了不良反应事件的发生。结论临床药师应积极开展药学监护,完善临床治疗方案,促进临床合理用药。     

三例急性大面积和次大面积肺栓塞患者的药学监护分析

目的探讨临床药师对三例急性大面积和次大面积肺栓塞患者治疗的药学监护的内容,为急性肺栓塞患者的药学监护提供思路。方法依据肺栓塞诊治指南,分析3例急性大面积和次大面积肺栓塞病例的治疗方案及药学监护。结果合理选择溶栓及抗凝药物、调整药物剂量、安全使用药物和制定个体化用药方案等药学监护,应该成为监护重点。结论临床药师应协助临床医生调整个体化用药方案,使肺栓塞患者的药物治疗更为合理、安全、有效。     

1例儿童肺栓塞的抗凝治疗分析和药学监护

目的:为临床药师参与儿童肺栓塞的抗凝治疗及药学监护提供参考。方法:临床药师参与1例肺栓塞患儿的抗凝治疗过程,提供个体化药学服务。结果:临床药师在抗凝药物选择、剂量调整、合并用药及饮食宣教方面提供了个体化建议和药学监护,保障了患儿抗凝治疗的安全、有效。结论:临床药师在儿科个体化抗凝治疗和安全用药中发挥了重要作用。     

急性胰腺炎伴肺部感染患者的药学监护

目的：分析临床药师对急性胰腺炎患者的药学监护,探讨临床药师如何在临床治疗中的作用。方法：临床药师在l例急性胰腺炎患者的治疗过程中,与临床医师共同制订治疗方案,监护患者用药全过程,针对患者用药提出用药注意事项。结果：临床药师和,临床医师共同参与制订治疗方案,真正做到治疗个体化,使患者治愈出院。结论：临床药师通过药学监护,避免了不良反应的发生,提高了患者的治疗依从性,取得了良好的,临床效果。     

临床药师对妇科术后并发急性肺栓塞患者的药学监护

目的:探讨临床药师对妇科术后并发急性肺栓塞患者的药学监护作用.方法:临床药师参与1例妇科手术后并发急性肺栓塞的抗凝治疗,根据患者病情变化情况,提出用药建议,调整用药剂量,并对患者进行全程药学监护.结果:患者经抗凝治疗后症状得到好转,各项检查指标基本恢复至正常范围.结论:临床药师积极参与临床治疗,发挥专业特长,为临床医生...     

肺栓塞合并慢性阻塞性肺疾病急性加重患者的药学监护

目的：探讨临床药师对临床药学监护的方法。方法通过参与1例肺栓塞合并慢性阻塞性肺疾病急性加重患者的全程药学监护,从抗凝和抗感染两方面协助医师制订治疗方案。结果与结论患者用药方法得以正确指示。临床药师协助医师制定个体化的治疗方案,有利于提高临床治疗水平,促进合理用药。     

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.