我院儿科门诊输液处方用药分析

目的:分析门诊儿科输液处方用药情况,为临床合理用药提供参考。方法:抽查我院2006年6月门诊儿科输液处方4522张,并根据临床药理知识和文献资料,对联合用药和不合理用药处方进行分类统计分析。结果:联合用药较多,占调查处方的69.64%,不合理用药处方共1287张,占调查处方的28.46%,主要表现为重复用药、联合用药不当、选用药物不当和用法不当。结论:我院门诊儿科合理用药水平需进一步提高。     

小儿临床合理用药调查与分析

目的 调查小儿临床合理用药水平,提出不合理用药原因与解决方法.方法 回顾性分析我院自2009年3月至12月儿科门诊及住院开具处方8652张,对8652张处方从联合用药和不合理用药两方面进行分析,调查分析不合理用药的原因及相关对策.结果 ①本组不合理用药处方498张,占5.76%.②本组联合用药2种处方4633张,占73.79%:3种处方865张,占13.78%;4种609张,占9.69%;5种115张,占1.83%;5种以上57例,占0.91%.抗生素处方总数5431张,占全部联合用药处方的86.49%.③本组联合用药不当、药物选择不当、用法不当处方分别为275(55.22%)、102(20.48%)、121(24.30%),占输液处方比例分别为4.22%、1.56%、1.85%.结论 小儿临床不合理用药情况普遍存在,联合用药不当、药物选择不当、用法不当为主要原因,加强药物使用监督、严格遵守药物使用指征等可降低不合理用药发生率.     

基层医院儿科门诊输液处方不合理用药浅析

目的:保障患儿用药安全,促进合理用药.方法:随机抽查我院2005年9～10月儿科门诊输液处方5 673张,对联合用药和不合理用药处方进行分类和统计分析.结果:联合用药比较普遍,占调查处方的66.34%;不合理用药处方共151张,占调查处方的2.66%,多为联合用药不当、重复用药、用法不当、用量不当等.结论:医生与药师应加强协作,互相支持,以促进合理用药.     

医院门诊处方不合理用药分析

目的：通过对门诊处方不合理用药分析,加强门诊合理用药。方法：随机抽查2009年1～12月处方18 921张,对不合理处方情况如处方前记录不完整、诊断与用药不符、用法用量不当、重复用药、溶媒选用不当、配伍禁忌、选药不合理、联合用药不合理等进行分类统计、分析。结果：不合理处方558张,占被抽查处方总数的2.9%。其中处方前记录不完整57张,占不合理用药处方的10.22%;诊断与用药不符55张,占不合理用药处方的9.86%;用法用量不当102张,占不合理用药处方的18.28%;重复用药98张,占不合理用药的17.56%;溶媒选用不当34张,占不合理用药处方的6.09%;配伍禁忌52张,占不合理用药处方的9.32%;选药不合理76张,占不合理用药处方的13.62%;联合用药不合理84张,占不合理用药处方的15.05%。结论：通过分析,县级医院门诊处方不合理用药存在一些问题,其中用法用量、重复用药、联合用药不合理存在的问题更为突出,主要是临床医生对所用药物的药理知识缺乏全面了解,因此药师应主动深入临床,加强与医生沟通,提高合理用药水平。     

门诊中不合理用药处方分析

目的:了解门诊中不合理用药处方情况,以促进和提高门诊合理用药水平。方法:随机抽查门诊中2008年全年处方21752张,对不合理用药情况如重复用药、诊断与用药不符、溶媒选用不当、用法用量不当、配伍禁忌、联合用药不合理、选药不合理等进行了全面分析。结果:不合理用药处方696张,占抽查处方总数的3.2%。其中重复用药86张,占不合理用药处方12.4%;诊断与用药不符105张,占不合理用药处方15.1%;溶媒选用不当78张,占不合理用药处方11.2%、用法用量不当240张,占不合理用药处方34.5%;配伍禁忌60张,占不合理用药处方8.6%,联合用药75张,占不合理用药处方10.8%;选药不合理52张,占不合理用药处方的7.5%。结论:门诊中用药基本合理,但仍存在一些问题。药师与医生、护士应加强沟通,并主动参与临床药物治疗的全过程。     

门诊中不合理用药处方分析

目的:了解门诊不合理用药处方情况,以促进和提高门诊合理用药水平。方法:随机抽查2011年新疆哈密地区中心医院门诊处方24 750张,按照处方点评,将处方分类为不规范处方、用药不适宜处方、超常处方三类,对用药不适宜处方如选药不合理、诊断与用药不符、重复用药、溶媒选用不当、用法用量不当、联合用药不合理、重复用药、配伍禁忌等进行了全面分析。结果:不合理用药处方792张,占抽查处方总数的3.20%。其中重复用药86张,占不合理用药处方10.8%,诊断与用药不符105张,占不合理用药处方13.2%;溶媒选用不当78张,占不合理用药处方9.8%;用法用量不当240张,占不合理用药处方30.3%;配伍禁忌34张,占不合理用药处方4.3%;联合用药125张,占不合理用药处方15.8%;选药不合理124张,占不合理用药处方的15.6%。结论:门诊中用药基本合理,但仍存在一些问题。药师与医生、护士应加强沟通,并主动参与临床药物治疗的全过程。     

儿科门诊输液处方用药分析

目的评价我院儿科门诊输液处方,以促进合理用药,保障患儿用药安全。方法采用回顾性调查方法,随机抽查我院2008年7月~2009年6月中的门诊输液处方3429张,根据临床药理学知识、药品说明书及文献资料,对输液处方中用药情况进行分类和统计分析。结果输液处方抗菌药物使用率为91.34%,联合用药比较普遍,占调查处方的86.84%;不合理用药处方共1243张,占调查处方的36.25%,多为给药方案不当、联合用药不当、用量不当等。结论输液处方中抗菌药物使用普遍,联合用药比率较高,存在不合理用药现象,合理用药水平有待进一步提高。     

儿童医院门诊输液处方不合理用药浅析

目的:保障患儿用药安全,促进合理用药。方法:随机抽查我院2004年12天中的门诊输液处方33001张,根据临床药理学知识及文献资料,对不合理用药处方进行分类和统计分析。结果:联合用药较多,占调查处方的60.56%;不合理用药处方共1354张,占调查处方的4.10%,多为重复用药、联合用药不当、用法不当。结论:将用药信息及时反馈给临床医师,可减少不良反应的发生。     

儿科门诊不合理处方用药分析

随机抽取富阳市人民医院2007年3~6月份儿科门诊处方5150张,对联合用药和不合理用药处方进行分类和统计分析,结果联合用药处方共4704张,占调查处方的91.34%;不合理用药处方共235张,占调查处方的4.563%;主要表现为:选药不合理、联用不合理、重复用药、用法不合理、用量不合理等。     

2011—2014年冀中能源峰峰集团有限公司总医院儿科住院抗菌药物处方不合理用药的分析

目的 调查2011—2014年冀中能源峰峰集团有限公司总医院儿科住院抗菌药物处方不合理用药的情况,为促进临床合理应用抗菌药物提供依据。方法 抽取2011年—2014年冀中能源峰峰集团有限公司总医院儿科住院抗菌药物处方10 000张,对不合理用药情况进行回顾性分析。结果 不合理抗菌用药处方1 037张,占抗菌药物处方总数的10.37%;儿科住院抗菌药物处方不合理用药情况主要体现在疗程不当、给药频次不合理以及溶媒选择不当,分别占不合理用药处方的23.82%、21.31%、17.74%;头孢类和青霉素类应用较多,而不合理用药处方率仅为7.20%、6.04%;应用较少的大环内酯类、碳青霉烯类等不合理用药处方率较高,分别为21.65%、18.97%;并且联合用药品种数越多,不合理用药的发生率就越高。结论 冀中能源峰峰集团有限公司总医院儿科住院患者抗菌药物应用基本合理,但仍存在诸多不合理用药现象,需进一步加强管理和处方点评力度。     

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.