莫西沙星所致不良反应的临床特点及预防

目的：分析莫西沙星所致不良反应的临床特点及预防。方法选取2012年1月—2014年10月华容县人民医院收治的临床确诊的莫西沙星所致不良反应患者97例,整理患者的临床资料,针对患者的年龄、性别、用药情况、不良反应累及系统、临床表现等进行回顾性分析。结果97例患者男女比例比较,差异无统计学意义（ P>0.05）;年龄>50岁者所占比例最高（P<0.05）;静脉滴注给药所占比例高于口服给药（P<0.05）;合并用药所占比例高于单独用药（ P<0.05）;不良反应累及多个系统和器官,其中神经系统受累者所占比例最高;不良反应多发生在给药10～90min内;转归效果好。结论莫西沙星所致不良反应与患者年龄有关,且联合用药、静脉滴注等均增加莫西沙星所致不良反应的发生,在临床给药治疗中应予以足够重视,给药前详细询问患者病史、用药史、过敏史等,合理选择药物种类和给药方式。     

氟喹诺酮类药的临床应用与不良反应

目的：探讨氟喹诺酮类药的临床应用与不良反应情况。方法选取本院2012年9月-2013年9月收治的68例应用氟喹诺酮类药物出现不良反应的患者作为研究对象,对其临床资料及不良反应表现进行回顾性分析。结果年龄≥61岁者所占比例最高,为32.4%,高于其他年龄段患者比例,差异有统计学意义（ P﹤0.05）;左氧氟沙星所占比例最高,其次为环丙沙星、加替沙星;静脉注射给药例数比口服给药多,差异有统计学意义（ P﹤0.05）。结论临床上应进一步加深对氟喹诺酮类药不良反应的认识,合理用药,以降低药物不良反应发生率。     

我院抗生素不良反应及临床合理用药分析

目的 分析抗生素不良反应以及临床合理用药方法.方法 选取我院收治的抗生素所致不良反应患者84例,对患者临床资料进行回顾分析.结果 患者服用抗生素发生不良反应61 ～69岁年龄段之间患者不良反应发生率最高为35.7％,与其他年龄段相比差异具有统计学意义(P＜0.05).各类要素所致不良反应中,头孢菌素类药物发生不良反应患者最多,为36.9％,与其他种类抗生素相比差异具有统计学意义(P＜0.05).结论 抗生素药物所致不良反应种类较多,不良反应发病率高,临床用药需加强用药合理性,减少不良反应的发生.     

抗生素类药物的临床用药调查研究

目的:分析抗生素类药物的临床应用情况。方法:调查我院2016年10月至2017年9月期间收治的559例患者抗生素类药物使用比例、所在科室、使用抗生素类药物的种类、药物联合应用情况、合理用药情况。结果:559例患者中,共436例患者临床治疗中应用抗生素类药物,所占比例为78.00%,其中儿科患者所占比例为39.22%,明显高于其他科室患者所占比例(P0.05),种类上,头孢菌素类药物使用比例为49.08%,高于其他种类药物所占比例(P0.05),联合应用方面,单一用药患者所占比例最高。我院抗生素类药物不合理应用率为0.92%。结论:我院抗生素类药物临床应用基本合理,但仍应控制抗生素类药物的临床使用率。     

急诊内科中抗生素的临床合理应用及耐药分析

目的 分析急诊内科中抗生素的合理应用及耐药情况.方法 选择2012年1月～2013年4月本院急诊内科开具的2015张抗生素应用处方为研究对象,分析抗生素合理用药情况,并随机选取其中500例抗生素应用患者进行药敏试验及细菌培养,观察抗生素的耐药性情况.结果 实际应用中2种抗生素联用者占50.22％,明显高于1种抗生素、3种及以上抗生素联用的比例,差异有统计学意义（P＜0.05）;头孢类抗生素应用比例（占72.70％）明显高于其他种类抗生素（P＜0.05）;119例存在不合理用药现象,占5.91％,主要为药物配伍不合理、给药方式不合理、溶媒不对等.结论 临床中抗生素有严格的应用原则,但临床依然存在诸多用药不合理现象,应用时还需考虑其耐药性,合理选择药物种类.     

探讨抗生素使用的不良反应及合理应用措施

目的探讨抗生素使用的不良反应及合理应用措施。方法随机选取2016年11月至2017年11月期间采用抗生素治疗的患者共488例为研究对象,分析抗生素使用不良反应情况。结果不良反应的发生概率为60.66%,组间比较存在明显差异(P<0.05);应用头抱菌素类和应用青霉素类抗生素所致不良发生的概率,明显高于其他种类抗生素(P<0.05);出现恶心、瘙痒、皮疹不良反应所占的比例,明显高于其他种类不良反应(P<0.05)。结论头抱菌素类和青霉素类抗生素易出现不良反应,不良反应类型主要为恶心、瘙痒、皮疹等,应积极采取措施,合理应用抗生素,确保临床用药安全。     

氟喹诺酮类药物不良反应调查及临床合理用药的分析

目的调查分析氟喹诺酮类药物(FQNS)不良反应(ADR)情况及特点,为临床合理用药提供依据。方法回顾性分析我院2010年1月至2013年9月间53例应用氟喹诺酮类药物发生不良反应患者的临床资料,对引起不良反应发生的药物名称、给药途径、累及系统的分布及临床表现进行整理统计。结果本次调查中药物不良反应共涉及6种药品,其中左氧氟沙星所致不良反应所占的比例最大,为35.8%,静脉滴注氟喹诺酮类药物所致的不良反应所占比例最高,为52.8%,静脉注射所占的比例最低,为13.28%,不良反应累及神经系统所占的比例最高,占39.6%。结论临床使用氟喹诺酮类药物时应严格掌握用药适应证和给药方法,加强对不良反应的监测,以降低不良反应的发生。     

他汀类药物的不良反应

目的:对他汀类药物的不良反应及防治对策进行分析探讨,为今后的临床工作提供有价值的参考信息。方法:抽取在2012年1月~2017年5月间我院收治的明确为他汀类药物所致不良反应报告102例,总结分析他汀类药物不良反应防治对策。结果:本组102例不良反应患者中,男性略多于女性,两者比较无差异(P0.05);年龄在50岁以上者所占比例最高(P0.05);不良反应累及系统已肝胆系统为主,其次为胃肠道系统等;不良反应设计药品种类包括有辛伐他汀、阿托伐他汀、氟伐他汀、普伐他汀、瑞舒伐他汀等。结论:他汀类药物所致不良反应的发生率相对较高,在今后的临床用药过程中,规范药品使用,控制用药剂量,有效降低不良反应的发生。     

我院西药抗生素药物不良反应监测

目的研究并分析西药抗生素药物临床应用中的不良反应基本规律及其特点,为合理用药提供指导。方法选取本院2012年1～12月所收治住院患者中出现抗生素不良反应的患者共计620例为研究对象,就抗生素药物不良反应涉及药物品种、抗生素类型以及临床表现进行归纳与分析。结果抗感染药物是出现西药抗生素药物不良反应的最主要药种类型,占41.13%（255/620）;β-内酰胺类抗生素是出现药物不良反应的最主要类型,占51.29%（318/620）;皮肤及皮肤附件损害是抗生素不良反应的最主要临床表现,占48.06%（298/620）。结论西药抗生素不良反应问题值得重视,需要慎用此类药物,加强合理用药。     

药品不良反应报告147例的回顾性分析

目的 掌握南京鼓楼医院集团安庆市石化医院药品不良反应(ADR)发生的特点和规律。方法 利用Excel,回顾性分析2011年1月至2013年12月上报的147例药品不良反应报告。结果 147例ADR报告中,A型不良反应有140例,占95.24%,B型不良反应有7例,占4.76%,无C型不良反应。60岁以上老年病人所占比例最高,为41.50%;给药途径中,静脉给药所占比例最高,为81.63%;涉及药品种类中,抗感染药物所占比例最高,为49.66%;临床表现以皮肤及其附件损害最多,为42.18%;上报科室以呼吸内科最多,为38.78%;上报人以临床医师最多,为75.51%。结论 ADR的发生不可完全避免,但是在临床实践中,因不合理用药导致的A型不良反应(有140例,占95.24%)却占有重要比例。要提升药师的药学服务能力,促进药学监测工作的开展,才能确保病人用药安全,做到合理用药。     

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.     

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.