某院门诊不合理处方的分析

目的分析我院中心门诊处方不合理用药情况。方法随机抽取中心门诊2012年1月至12月处方12300张进行审查分析。结果不合理用药处方452张(占3.67%),不合理用药发生频率较高的是药物配伍联用不合理、药物选用不合理、药物用法不合理等。结论我院门诊处方存在一定程度的不合理用药现象。临床医师与药师应提高药学知识水平,做好药物临床的合理使用,应切实采取措施,从根本上解决不合理用药问题。     

我院2010年第一季度门诊抗菌药物不合理处方分析

目的了解我院门诊抗菌药物不合理使用情况。方法随机抽取我院2010年第一季度门诊处方38976张,对抗菌药物不合理的处方进行分析。结果 38976张处方中有21065张使用了抗菌药物,抗菌药物用药不合理处方1354张,分别表现在选药不合理、选用溶媒不合理、用法用量不合理、作用机制相同的抗菌药物联用、拮抗联用或配伍不当。结论我院存在一定程度的抗菌药物不合理用药,合理用药水平有待提高。     

门诊处方中的不合理用药现象分析

目的分析医院不合理用药现象,促进临床药物的合理应用。方法随机抽取我院2009年1～6月份门诊处方10985张,对其中的不合理处方进行统计分析。结果不合理处方占总抽查处方的6.3%（692/10985）,其中主要包括联合或配伍不合理,选用药不合理,用法用量不合理,滥用现象等。结论实行药师、医师和医院管理多方协作,建立合理用药的监管机制,是解决不合理用药的重要途径。     

我院门诊不合理用药处方分析

目的 调查我院门诊处方不合理用药的情况,分析原因并提出措施,以提高临床合理用药水平.方法 随机抽取我院2012年门诊处方5627张,对不合理用药处方进行统计分析.结果 门诊不合理用药处方173张,占抽查处方总数的3.07％.不合理用药主要表现为联合用药不合理（占46.82％）、用法不合理（占28.90％）、选药不合理（占24.28％）.结论 需要医生、药师以及医院管理三方面共同努力,才能解决门诊处方不合理现象,促进临床合理用药.     

我院门诊处方不合理用药分析

目的 了解本院门诊处方用药不合理的基本情况.方法 随机抽取本院2012年度每月门诊处方600张,共7200张,并对不合理处方进行归类、分析.结果 不合理门诊处方192张,占总处方数的2.4%,主要不合理用药包括用药剂量不合理、使用溶媒不当、用药时间不当、药物联用不当、用药方法不当及重复用药.结论 本院门诊处方不合理用药问题虽不是很严重,但也存在一些不合理应用问题,医院应加大合理用药监管力度,使不合理处方的发生率降到最低.     

我院门诊处方不合理用药分析

目的 分析我院门诊处方不合理用药,以促进安全、有效、经济、合理地用药.方法 从我院2005年6月～2006年5月门诊中每月随机抽取一周的处方,每周大约4000张,检查的处方数共计48000张.对处方用药情况进行分析,以了解我院不合理用药情况.结果 不合用药处方有1702张,占总处方数的3.55%.不合理用药类型主要为:合用相拮抗、合用增加毒性、重复用药、用法不合理、影响吸收代谢、择药不当、不必要合用等.结论 我院门诊用药尚有不少不合理用药现象,应引起临床工作者的重视,使药物能更好地防治疾病,减少药品的毒副作用.     

我院2010年门诊不合理处方情况分析

目的了解我院门诊处方中存在的不合理用药情况,分析原因,为临床合理用药提供参考。方法随机抽取我院2010年1月至2010年12月门诊处方6000张,总结分析不合理用药处方。结果不合理处方占总处方数的7.80%,不合理用药主要表现在书写不规范,用法用量不当,重复给药,溶媒不当等方面。结论我院存在一定程度的不合理用药现象,应提高医师用药水平,加强药师处方审核能力,确保患者的用药安全。     

2500张皮肤病医院门诊处方的评价与分析

目的：评价我院门诊用药情况,保障患者安全用药.方法：采用随机的方法抽取我院在2013年1-12月间的门诊处方2 500张,上下半年各抽取1 250张,分析各月份的用药情况,同时将不合理处方按选药不合理、药物使用方法缺乏合理性、滥用药物、用量不当等情况进行统计分析.结果：不合理用药处方占总调查处方的4.8％,共计120张.其中滥用药物处方18张、用量不当处方10张、配伍及联用不合理处方40张、药物使用方法缺乏合理性处方14张、给药方式不当处方10张、选药不合理处方12张、药物使用时间不当处方16张.结论：我院门诊处方合格率较高,但仍有不合理情况.应加强医师用药过程的监督,加强药师的审方力度,定期开展护理人员、医师及患者的培训教育活动,提高处方质量和用药合理性,保护患者的利益.     

我院门诊不合理用药处方探讨

目的了解医院门诊处方用药的现状,分析门诊处方的不合理之处,探讨其解决的对策。方法随机抽取医院2013年5-12月门诊处方8624张,统计处方中各类不合理用药的情况,并进行分析。结果在8624张处方中,主要存在药物选用不合理、不符合药代动力学、溶媒选用不当、毒性相加、理化性状改变、重复用药等不合理用药情况。结论医院门诊处方不合理用药情况尚存在,应针对具体问题采取相应的对策予以纠正,促进临床合理用药。     

我院门诊处方不合理用药分析

目的 了解该院2010年门诊患者基本用药情况.方法 随机抽取2010年全年各科室处方6000张,统计分析不合理用药处方张数和类型.结果 不合理用药处方276张,占总处方数的4.60%.门诊存在不合理用药现象,不合理用药原因为联用不合理、给药方法不当及溶媒选择不当、激素应用不合理、无指征使用抗生素、配伍或重复用药.结论 医院应加大合理用药监管力度,加强临床药学工作,促进临床合理用药,确保患者用药安全有效.     

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.     

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.     

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.     

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.