治疗风湿病的中成药数据库及其处方分析

目的:研究风湿病中成药的组方原则、用药规律。方法:建立风湿病中成药数据库,并对单味药的用药情况、不同给药途径的用药情况、药物的功效分类及治疗原则等内容进行查询与统计分析。结果:单味药使用频率排在前10位的药物依次是:当归、川芎、牛膝、川乌、红花、独活、防风、甘草、桂枝、羌活。对使用频率前50位的药物进行归类分析,主要为活血祛瘀药、祛风湿药、辛温解表药、补益药及祛寒药。结论:现有风湿病中成药数量众多,用药纷繁复杂,运用数据库技术对处方进行归类分析,可发现一些用药规律,对临床与新药开发工作有一定的参考价值。     

Quality of medicines stored together in multi‐compartment compliance aids

Background and Objective: Dispensing medicines into compliance aids is a common practice in pharmacy contrary to manufacturers’ advice and studies have shown the appearance of light‐sensitive tablets is compromised by such storage; we previously found evidence of reduced bioavailability at elevated temperature and humidity. Our objective was to examine the physicochemical stability of two generic atenolol tablets in different compliance aids and with aspirin co‐storage at room temperature and at 40 °C/75% relative humidity. Methods: The physicochemical stability of atenolol tablets was evaluated after 28 days of storage and compared with controls by examining visual appearance, weight, disintegration, dissolution, friability and hardness to accepted standards and using a previously validated HPLC method for chemical assay. Results and Discussion: The response to storage was brand‐dependent and not straightforward. With one make of atenolol (Alpharma), storage in compliance aids even at room temperature impacted on physical stability, reducing tablet hardness, with storage in Dosett^® exerting a greater impact than storage in Medidos^® (t‐test P < 0·001). Co‐storage at elevated temperature and humidity also impacted on the appearance of non‐coated aspirin tablets (Angette?). The chemical stability of atenolol was not affected and we did not find evidence of changes to bioavailability with either make. Certainly data for one atenolol make (CP Pharmaceuticals) co‐stored with aspirin (Angette? and Nu‐Seals) in both compliance aids at room temperature provided evidence of short‐term stability. But medicines are dispensed into compliance aids in multi‐factorial ways so our study highlights not only the lack of evidence but also a realization that evidence to support real practice may not be accomplished through research. Conclusion: Reassuring practitioners of the continued stability of medicines in compliance aids under the countless condition in which they are dispensed in practice may requires a different approach involving medical device regulators and more definitive professional guidance.     

The prescription to grieve

This clinical note presents a method of bereavement counseling. It describes a technique for structuring a time-limited grief experience for the bereaved client as a way to provide encouragement and direction for an emotional catharsis. Three specific activities: journaling, the life review, and dialoguing with the deceased, are each briefly discussed as suggested tasks for the client's grief work.