668例新生儿药品不良反应报告分析

目的:了解新生儿药品不良反应发生的特点及规律,为药物的合理、安全使用及减少不良反应的发生提供依据和参考。方法:采用回顾性分析的方法,对2015—2018年收集的668份新生儿药品不良反应报告,按照患儿的性别、年龄、发生时间、给药途径、剂型、累及系统-器官、关联性评价及转归等情况进行统计分析。结果:668例新生儿药品不良反应中,男女比例为1.03∶1,平均年龄为6.5±0.11d;新生儿患者ADR发生时间最多的在用药后1~7 d内(248例,占37.13%);单给药途径以静脉滴注为主(43.41%),共涉及药物类别12种,其中引起ADR排名前三位的药物类别分别是抗菌药物(56.89%)、中成药(13.17%)、呼吸系统类药物(7.63%);668例ADR共累及多个系统,最常见的临床表现是皮肤及其附件损害共373例次(55.84%),其次为胃肠系统损害194例(29.04%),心血管系统损害36例次(5.39%)。结论:应对新生儿用药风险多加防范,采取多种措施促进新生儿合理、安全用药,尽量减少和避免新生儿不良反应的发生。     

2011-2020年某院儿童药品不良反应调查分析

目的:收集2011-2020年某院上报的<18岁儿童的药品不良反应(ADR)报告,了解儿童发生ADR的情况和特点,为儿童ADR监测与合理用药提供借鉴。方法:采用回顾性分析方法,统计分析ADR报告类型、患儿性别、年龄、引发ADR主要药品名称、药品品种、给药途径、联合用药、ADR累及器官等。结果:共收集到ADR报告389例,其中一般不良反应270例(69.41%),新的一般不良反应78例(20.05%),严重不良反应32例(8.23%),新的严重不良反应9例(2.31%)。发生ADR的患儿年龄主要集中在28 d～7岁。发生ADR的给药途径以静脉用药为主,其中静脉滴注279例(71.72%)、静脉注射55例(14.14%)。引发ADR的药品种类前三位分别为抗菌药物193例(38.91%)、中成药136例(27.22%)、抗病毒药物33例(6.65%)。ADR最高的前三种抗菌药物分别为注射用头孢哌酮钠/舒巴坦钠33例次、注射用头孢呋辛钠31例次、注射用头孢曲松钠28例次;前三种中成药分别为注射用双黄连(冻干)34例次、痰热清注射液29例次、热毒宁注射液26例次。引发ADR累及系统/器最多...     

134例药品不良反应报告回顾性分析

目的:了解我院药品不良反应(ADR)发生的特点及临床表现,为临床合理用药提供格对我院2009-2011年收集上报的134例ADR报告申患者的性别、年龄、过敏史、ADR严重程度、给药途径以及引起ADR药物的类别、ADR累及器官或系统、ADR的转归等进行统计分析.结果:134例ADR报告中,男性71例(52.99%),女性63例(47.01%);年龄最小16 d,最大96岁,年龄分布无差异性;以静脉滴注方式给药的ADR例次较高(119例);所涉及的药品中抗茼药物引起ADR例次较高(35例),其次是中药注射剂(33例);ADR临床表现以全身损害为主(38.01%),其次为皮肤及附件损害(21.27%);严重的ADR共5例(3.73%).结论:应重视抗茼药物及中药注射剂的规范用药,尽量避免静脉用药.     

玉林市儿童新的和严重的药品不良反应报告分析

目的探讨和分析玉林市儿童新的和严重的药品不良反应(ADR)发生的特点和规律,以提高儿童用药的安全性。方法收集2015~2016年玉林市各医疗机构上报国家药品不良反应监测中心的新的和严重的儿童ADR共402例,对ADR报告进行统计分析并评价。结果 >3~6岁儿童患者新的和严重的ADR发生率较高,共112例(27.86%);引发ADR的给药途径以静脉滴注途径为主,共326例(81.09%);引发新的和严重的ADR药物种类主要是抗肿瘤药物(43.53%),其次是中药及其提取物(18.41%);ADR累及器官或系统主要为血液系统,共167例(41.54%)。结论医疗机构应重点监测儿童用药过程中抗肿瘤药物、中药及其提取物制剂诱发的ADR,加强对儿童患者的用药监护,以提高儿童用药的安全性。     

2011年泰安市477例儿童药品不良反应回顾性分析

目的:分析泰安市儿童药品不良反应(ADR)的发生特点和规律,为规范临床合理用药,减少患儿ADR发生,促进儿童用药安全提供参考依据。方法:汇总2011年度泰安市477例儿童药品不良反应报告,分别从患儿性别、年龄、给药途径、药品种类、抗感染药物及累及器官/系统等方面进行统计、分析。结果:477例ADR中,抗感染药物引起的ADR377例(70.65%),以头孢菌素类药物最为多见;ADR临床表现以皮肤及其附件损害多见。结论:儿童抗感染药物的不良反应应予重视,要加强对ADR监测工作的重视程度,有效避免和减轻潜在的ADR。     

基于真实世界监测数据分析山东省2020年儿童药品不良反应

目的:挖掘分析儿童药品不良反应(ADR)的发生情况、规律及特点,为儿童安全用药提供参考。方法:调取2020年通过自发呈报系统上报至山东省ADR监测中心的11 904例儿童ADR数据,对报告类型、来源、报告人职业和患者性别、年龄、ADR转归及关联性评价、合并用药、怀疑药品类别、累及器官/系统进行统计分析。结果:11 904例儿童ADR报告中,一般ADR 9 732例(81.75%),严重ADR 1 143例(9.60%),新的ADR 1 029例(8.64%);报告主要来源于医疗机构(99.70%);报告人主要为医师(47.60%);患儿年龄3～7岁居多(26.89%),转归以痊愈和好转为主(99.11%);关联性评价主要为“很可能”(78.56%);合并用药占比22.88%;主要给药途径为静脉给药(71.72%);怀疑药品类别分布前5位依次为抗感染药物(59.32%)、中药制剂(10.63%)、呼吸系统用药(7.69%)、调节水电解质酸碱平衡用药(5.58%)以及中枢神经系统用药(2.82%),分别涉及94、188、40、81和101个品种;累及器官/系统主要为皮肤及其附件(47.98...     

椒江区230例儿童药品不良反应报告回顾性分析

目的 了解儿童药品不良反应(ADR)发生情况,分析原因及影响因素,为临床安全用药提供建议.方法 采用回顾性分析方法 收集椒江区2013-2015年230例儿童药品不良反应报告,对引起ADR的药品种类、剂型、给药途径、联合用药、临床表现、抗菌药使用情况及药品说明书标注情况等进行统计与分析.结果 230例儿童ADR报告中,男女比例为1.32:1;药品剂型和给药途径以注射剂型和静脉滴注为主,共涉及9类药品,引起ADR排名首位的药品类别是抗菌药(84.94%),其次为中成药制剂(6.28%);ADR累及多个器官/系统,其中最常见的临床表现为皮肤及其附件损害(79.64%),其次为消化系统损害(10.18%);单独用药引发ADR的药品说明书中明确标注儿童用法用量及注意事项的占78.26%,模糊标准的占2.72%,未标注的占19.02%.结论 应加强儿童用药的使用管理,完善药品说明书,加强儿童ADR监测.     

我院495例药品不良反应报告分析

目的:了解我院药品不良反应(ADR)发生规律、特点和临床表现,为临床合理用药提供参考。方法:采用回顾性研究方法,对我院2014年1月–2015年12月收集的495例ADR报告进行汇总,从ADR发生的年龄、性别分布、给药途径、药物类别与品种数、累及系统/器官及临床表现、不良反应类型、严重ADR报告等进行统计分析。结果:495例ADR报告中,男性发生率(55.56%)明显高于女性发生率(44.44%);60岁以上患者发生ADR的比例最高(29.29%);抗感染药物引起ADR的比例最高(26.87%),其次为消化和循环系统药物(分别为15.76%);静脉用药引发的ADR最多(71.92%);消化系统损害133例(26.87%),其次为皮肤及附件损害130例(26.26%);严重ADR报告占比12.73%,消化系统损害23例,血液系统损害12例,全身性反应11例。结论:需进一步重视ADR监测工作,充分发挥临床药师作用,确保临床用药安全有效。     

2015年某儿童医院267例药品不良反应分析

目的:分析儿童药品不良反应(ADR)发生的特点及一般规律,为临床合理用药提供参考。方法:收集2015年某儿童医院ADR监测管理系统中心报告的267例ADR,对患儿性别、年龄、引起ADR药品种类、给药途径、剂型、累及系统、主要临床表现、原患疾病及新的/严重的ADR等情况进行统计分析。结果:267例ADR中,新的/严重的ADR 38例(14.23%);发生ADR的患儿男女比例为1.24∶1,0~3岁患儿占50.19%(134/267);给药途径以静脉滴注为主(82.77%);共涉及药物类别排名前3位的为抗感染药物(61.42%)、中药注射剂(7.49%)、平喘药物(4.12%);累及系统最常见的为皮肤及其附件(46.44%),其次为胃肠道(30.71%)、全身性损害(11.99%)。结论:应加强对儿童尤其0~3岁患儿的用药监护,规范抗感染药物、中药注射剂、平喘药物等在儿科临床的使用,重视ADR监测及药物咨询等工作,避免或减少严重ADR的发生。     

762例3岁及以下儿童药品不良反应分析

摘要：目的:了解宝鸡市3岁及以下儿童药品不良反应(ADR)的发生情况,分析其特点,为婴幼儿安全用药提供参考。方法:对2017年1月～2019年8月宝鸡市药品不良反应监测中心提供的762例3岁及以下儿童ADR报告进行回顾性分析,对患者性别、年龄、既往ADR史和家族史、原患疾病、药品种类、用药途径、ADR累及的器官/系统及临床表现、ADR分级(新的严重的ADR)、ADR转归、关联性评价等项目进行统计分析。结果:762例3岁及以下儿童ADR病例中,男490例(64.30%),女272例(35.70%);1岁<年龄≤3岁的幼儿ADR共395例(51.84%),29 d～1岁的婴儿ADR 343例(45.01%)。静脉滴注是引发ADR最主要的给药途径,共626例(82.15%)。抗感染药物引起的ADR居首位,共465例(61.02%),其次中成药120例(15.75%)。皮肤及其附件损害是ADR最主要的临床表现,共517例(67.84%)。762例ADR中新的ADR 230例(30.18%),严重的ADR 47例(6.17%)。关联性评价结果:肯定23例(3.02%),很可能241例(31.63%),可能498例(65.35%)。762例ADR中痊愈452例,好转299例,未好转的5例,不详的6例。结论:3岁及以下儿童的ADR数量多,需加强抗菌药等药物的使用管理,降低静脉输液率,保障婴幼儿用药安全。     

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.