National Library of Medicine No, 82–18 Literature Search Drugs and Pharmacy in Developing Countries January 1977 through August 1982 172 Citations

Abstract

All general aspects of drugs were searched for this bibliography, including utilization, therapy, abuse, legislation, the industry, labeling, packaging, fees, and information services; specific drug names were not searched. Pharmaceutical technology and services and pharmacy education were also covered, as well as a limited number of citations to biological products and to World Health Organization reference standards.

The Appendix contains citations selected from the MEDLARS database CATLINE. Additional citations, especially to marketing and utilization of contraceptives, will be found in the POPLINE database.     

Drug effects on clinical laboratory tests

Drugs and xenobiotics can affect clinical laboratory test results either by interfering with the analytical systems themselves, or by influencing endogenous constituents. National and international bodies have brought widespread recognition to this problem and have proposed protocols for its thorough scientific study. In this survey the authors discuss studies in their laboratories concerning the effects of drugs on thousands of patients undergoing a routine clinical screen. A database is described for storing both patient information and a detailed analysis of the published literature on drug effects. Analytical interferences in clinical tests must be examined in validating the procedure. However, highly specific analytical techniques are increasingly helping to reduce such interferences. Biological effects can be classified as physiological, pharmacological or toxicological. In some cases, biological effects can be used to advantage in monitoring treatment by potentially hazardous drugs, such as the cardiac glycosides. The requirement for a well-defined reference population for each drug and for access to all clinical and medical data for each patient is discussed. The need for greater awareness of the influence of drugs on clinical laboratory results is considered, together with the suggestion that the health professions should try to exploit such effects in monitoring possible toxicity problems, in defining genetic constitution and in designing medication programmes.     

Drug Adverse Reaction Target Database (DART) : proteins related to adverse drug reactions.

An adverse drug reaction (ADR) often results from interaction of a drug or its metabolites with specific protein targets important in normal cellular function. Knowledge about these targets is both important in facilitating the study of the mechanisms of ADRs and in new drug discovery. It is also useful in the development and testing of rational drug design and safety evaluation tools. The Drug Adverse Reaction Database (DART) is intended to provide comprehensive information about adverse effect targets of drugs described in the literature. Moreover, proteins involved in adverse effect targets of chemicals not yet confirmed as ADR targets are also included as potential targets. This database gives physiological function of each target, binding drugs/agonists/antagonists/activators/inhibitors, IC(50) values of the inhibitors, corresponding adverse effects, and type of ADR induced by drug binding to a target. Cross-links to other databases are also introduced to facilitate the access of information about the sequence, 3-dimensional structure, function, and nomenclature of each target along with drug/ligand binding properties, and related literature. The database currently contains entries for 147 ADR targets and 89 potential targets. A total of 187 adverse reaction conditions, 257 drugs, and 1080 ligands known to bind to each of these targets are also currently described. Each entry can be retrieved through multiple search methods including target name, target physiological function, adverse effect, ligand name, and biological pathways. A special page is provided for contribution of new or additional information. This database can be accessed at http://xin.cz3.nus.edu.sg/group/drt/dart.asp.     

The effectiveness of hospital pharmacy in the UK: methodology for finding the evidence

OBJECTIVE: To describe the methodology used to identify United Kingdom (UK) hospital pharmacy practice research work from the last two decades. METHOD: A comprehensive search for citations that appeared to contribute to the overall evidence or in some way measure, demonstrate or evaluate the effectiveness of UK hospital pharmacy practice. This involved a search of thirteen electronic databases covering a wide variety of UK, European and international publications, hand searching of selected UK journals and conference proceedings, a written request for details sent to all UK Chief Pharmacists and Directors of Pharmacy and a bibliography search of each reference identified. All appropriate references were then added to a single computer database. MAIN OUTCOME MEASURE: Number of references identified by each strand of the search strategy. RESULTS: The search initially highlighted a total of 10,099 articles from the thirteen reference databases, but only 281 were considered suitable for inclusion in the final review. Hand searching of the selected journals and conference proceedings yielded another 173 references and the written requests to hospital chief pharmacists resulted in another 128 references being identified. Finally, bibliography searches of the articles identified by the above three methods resulted in another 242 references, bringing the total number of references to 824. CONCLUSION: This paper describes a strategy to identify a comprehensive collection of citations supporting the evidence for the effectiveness of hospital pharmaceutical services in the UK. The large number of references identified demonstrate that hospital pharmacists in the UK make significant contributions to both the research literature and to patient care. However, database searches alone highlighted just 34% of the total references finally included in this study, demonstrating that pharmacy practice research work may be difficult to access by conducting database searches alone. The results from this project provide a resource for the profession and can be utilised as a foundation for future developments in both the delivery and research of hospital pharmacy practice.     

抗精神病药物在老年痴呆症治疗中的应用

笔者通过检索万方数据库和PubMed数据库,对相关文献进行综述,建议在老年痴呆症治疗中选择抗精神病药物需格外谨慎,必须考虑到药物是否会造成或加重躯体疾病及其不良反应,并在用药后对患者进行治疗监测。     

Update on natural product--drug interactions.

The interactions of natural products with drugs are discussed. Interactions between natural products and drugs are based on the same pharmacokinetic and pharmacodynamic principles as drug-drug interactions. Clinically important interactions appear to involve effects on drug metabolism via cytochrome P-450 isoenzymes, impairment of hepatic or renal function, and other possible mechanisms. Natural products that have been reported to interact with drugs in humans include coenzyme Q10, dong quai, ephedra, Ginkgo biloba, ginseng, glucosamine sulfate, ipriflavone, melatonin, and St. John's wort. In many cases, more research is needed to confirm these interactions and to determine whether other natural products may also interact with drugs. To effectively counsel patients about interactions involving natural products, pharmacists should be familiar with the most commonly used products and have access to information on more obscure products. In view of the less than stringent provisions of the Dietary Supplement Health and Education Act, pharmacists should consult reliable, independent sources of information on natural products rather than rely on literature provided by manufacturers. Pharmacists should recommend only those products that are manufactured to high quality-control standards. Natural products can interact with drugs and with other natural products by the same mechanisms as drugs.     

国家基本药物制度的现状及其完善对策探讨

目的:完善国家基本药物制度,满足公众的健康医疗需求。方法:采用文献研究、对比分析方法,阐述国家基本药物制度存在的问题,提出完善国家基本药物制度的对策。结果:我国虽制定了与《国家基本药物目录》相关的药物政策,但与世界卫生组织倡导的基本药物目标尚有较大差距,且存在法规体系不健全、政府宏观调控乏力、公众对基本药物认识不够、民众可获得基本药物不公平、基本药物制度建设滞后等问题。结论:我国基本药物法规体系亟待完善,民众对基本药物的认知和可获得性有待提高。应进一步提高基本药物的法律地位,强化《国家基本药物目录》的科学遴选、使用与监管,从而保障公众基本用药需求。     

Choice of antiepileptic drugs for the elderly: possible drug interactions and adverse effects

INTRODUCTION: Antiepileptic drugs are prescribed to patients of all ages and are commonly prescribed to patients over the age of 65. When prescribing these drugs to patients of this age bracket, treatment should be based not only on the diagnosis and seizure type but also on the propensity of the drugs for adverse effects and their drug-drug interactions. AREAS COVERED: This article reviews antiepileptic drugs currently used for treating the elderly and highlights the adverse effects and potential drug-drug interactions for these treatments. The article was complied through literature searches of the Cochrane database of systematic reviews, MEDLINE and SCindeks. EXPERT OPINION: In elderly patients who have hepatic diseases, antiepileptic drugs that are not metabolized in the liver, such as levetiracetam, are preferred; in patients with moderate and severe renal failure, carbamazepine and valproic acid are the preferred antiepileptic drugs. Phenytoin, fosphenytoin, carbamazepine, oxcarbazepine and lamotrigine should not be prescribed in elderly patients with cardiac conduction abnormalities or a history of ventricular arrhythmia. While the majority of antiepileptic drugs interact with other drugs, hepatic enzymes and plasma proteins, a few newer antiepileptic drugs are free from such interactions (e.g., gabapentin, levetiracetam and tiagabine), which make them suitable candidates for elderly patients. However, in order to make further recommendations regarding the choice and dosing regimens of antiepileptic drugs in elderly patients, more extensive clinical research in this specific population is necessary.     

基于ASP.NET技术的Web应用系统安全机制分析与设计

本品系用肝素钠经亚硝酸裂解，精制而得的硫酸氨基葡聚糖的钙盐。其重均分子量应为3000～4500，分子量小于8000的级分不少于总量的85％。按干燥品计算，每1mg中抗Xa因子效价不得少于90IU；抗Xa因子效价与抗Ⅱa因子效价的比值不得少于3.0-4．5。     

Analysis of drug abuse data reported by medical institutions in Taiwan from 2002 to 2011

Drug abuse has become a global issue of concern. It affects not only individual users, but also their families and communities. Data were retrieved from the database of the Taiwan Surveillance System of Drug Abuse and Addiction Treatment (SSDAAT) from 2002 to 2011, and 147,660 cases reported by medical institutions in Taiwan were reviewed. This study showed that the top five reported abused drugs by medical institutions during the last decade were heroin, methamphetamine, benzodiazepines, ketamine, and zolpidem. Heroin and methamphetamine continued to be the first two abused drugs reported by medical institutions. Heroin abuse was significant, but has shown a downward trend. However, emerging abused drugs, such as ketamine and zolpidem, presented upward trends. 3,4-Methylenedioxy-N-methylamphetamine (MDMA) abuse seems to have re-emerged and has increased gradually since 2010. Injection without needle sharing has become the most common route of administration of abused drugs since 2002. The majority of causes for these reported drug abuses were drug dependence, followed by peer influence and stress relief. Hepatitis C was the most commonly reported infectious disease, followed by hepatitis B and AIDS in the drug abusers reported by medical institutions. It should be noted that access to drugs via the Internet increased year by year, and this is clearly an area needing constant monitoring.     

Key articles and guidelines in the management of pulmonary arterial hypertension: 2011 update

Pharmacotherapeutic approaches for the management of pulmonary arterial hypertension (PAH) have expanded greatly in the last 10?years. Pulmonary arterial hypertension is a relatively rare disease and is associated with myriad disease processes. The older term for PAH, primary PAH, has been changed to represent these differences and to distinguish it from postcapillary PAH associated with left-sided heart failure. Limitations in evaluating treatment approaches for PAH include its rarity, the small number of patients included in clinical trials, and issues regarding the use of placebo-controlled trials in a disease with such a high mortality rate if left untreated. Management options include the use of prostacyclin and prostacyclin analogues, endothelin receptor antagonists, and phosphodiesterase inhibitors, as well as traditional background therapy with diuretics, digoxin, calcium channel blockers, and warfarin. Numerous drugs are under investigation to evaluate their possible roles in management. Combination therapy is increasingly becoming a standard approach to therapy, with mounting literature to document effectiveness. Current or emerging roles for the pharmacist in the management of PAH largely involves ensuring access to drug therapy, facilitating specialty pharmacy dispensing, and providing patient counseling. Newer roles may include future drug development, optimized use of investigational drugs, and specialized disease management programs. This compilation includes a series of articles identifying important literature in cardiovascular pharmacotherapy. This bibliography focuses on pharmacotherapeutic management of pulmonary arterial hypertension (PAH). Most of the cited works present the results of significant human clinical studies that have shaped the management of patients with PAH. Limited primary literature is available for some topics, so in addition, consensus documents prepared by expert panels are reviewed. This compilation may serve as a teaching tool, reference resource, or update of the literature for pharmacy clinicians, physicians, and students.     

国家基本药物制度历程与合理用药

目的：为完善基本药物制度,促进合理用药提供参考资料。方法：采用文献研究、对比分析方法．阐述国家基本药物制度存在的问题与促进临床合理用药的措施。结果与结论：我国基本药物法规体系亟待完善．民众对基本药物的认知和可获得性有待提高。应进一步提高基本药物的法律地位．从而保障公众基本用药需求。推广基本药物概念可减少不合理用药。     

Database size and power to detect safety signals in pharmacovigilance

Most regulatory agencies and pharmaceutical companies focus the majority of their pharmacovigilance on safety signal identification in large databases. GlaxoSmithKline (GSK) has > 100 drugs marketed worldwide. In order to determine which database has the highest statistical power to detect safety signals in three large global databases, ten GSK marketed drugs were randomly selected for review in the three databases. At the time of data lock, the FDA database (Adverse Event Reporting System [AERS]) contained approximately 6.2 million total records of adverse drug reactions (ADRs). The WHO database (VIGIBASE) contained 7.2 million total records of ADRs. GSK's global safety database (OCEANS) contained approximately 2 million total ADRs for all of its marketed drugs. For the ten drugs selected, there was an average of 7566 reports found in AERS, 8661 reports found in VIGIBASE and 15,496 reports in OCEANS. The information from all three databases was used in pairs (AERS/OCEANS; AERS/VIGIBASE; and OCEANS/VIGIBASE) to calculate power using the maximum likelihood estimation. The OCEANS database contained more ADRs for all 10 drugs than AERS. OCEANS also contained more ADRs for 8/10 drugs than VIGIBASE. The highest statistical power to detect safety signals was determined by the pair of databases which had the greatest number of reports for the given drug. Based on this data, it was concluded that the highest power may be achieved by combining those databases with the most drug-specific data. It is also believe that early safety signal detection should involve the use of multiple large global databases because this permits the use of the largest number of reports for a given drug, and that reliance on a single database may reduce statistical power and diversity of ADRs.     

A systematic review on pharmacokinetic changes in critically ill patients: role of extracorporeal membrane oxygenation

Objective

Several factors including disease condition and different procedures could alter pharmacokinetic profile of drugs in critically ill patients. For optimizing patient''s outcome, changing in dosing regimen is necessary. Extracorporeal Membrane Oxygenation (ECMO) is one of the procedures which could change pharmacokinetic parameters.The aim of this review was to evaluate the effect of ECMO support on pharmacokinetic parameters and subsequently pharmacotherapy.

Method

A systematic review was conducted by reviewing all papers found by searching following key words; extracorporeal membrane oxygenation, ECMO, pharmacokinetic and pharmacotherapy in bibliography database.

Results

Different drug classes have been studied; mostly antibiotics. Almost all of the studies have been performed in neonates (as a case series). ECMO support is associated with altered pharmacokinetic parameters that may result in acute changes in plasma concentrations with potentially unpredictable pharmacological effect. Altreation in volume of distribution, protein binding, renal or hepatic clearance and sequestration of drugs by ECMO circuit may result in higher or lower doses requirement during ECMO. As yet, definite dosing guideline is not available.ECMO is extensively used recently for therapy and as a procedure affects pharmacokinetics profile along with other factors in critically ill patients. For optimizing the pharmacodynamic response and outcome of patients, drug regimen should be individualized through therapeutic drug monitoring whenever possible.     

Extracting and characterizing gene-drug relationships from the literature

A fundamental task of pharmacogenetics is to collect and classify relationships between genes and drugs. Currently, this useful information has not been comprehensively aggregated in any database and remains scattered throughout the published literature. Although there are efforts to collect this information manually, they are limited by the size of the published literature on gene-drug relationships. Therefore, we investigated computational methods to extract and characterize pharmacogenetic relationships between genes and drugs from the literature. We first evaluated the effectiveness of the co-occurrence method in identifying related genes and drugs. We then used supervised machine learning algorithms to classify the relationships between genes and drugs from the Pharmacogenetics and Pharmacogenomics Knowledge Base (PharmGKB) into five categories that have been defined by active pharmacogenetic researchers as relevant to their work. The final co-occurrence algorithm was able to extract 78% of the related genes and drugs that were published in a review article from the literature. Our algorithm subsequently classified the relationships between genes and drugs from the PharmGKB into five categories with 74% accuracy. We have made the data available on a supplementary website at http://bionlp.stanford.edu/genedrug/ Gene-drug relationships can be accurately extracted from text and classified into categories. Although the relationships that we have identified do not capture the details and fine distinctions often made in the literature, these methods will help scientists to track the ever-growing literature and create information resources to support future discoveries.     

A qualitative exploration of perceived gender differences in methamphetamine use among women who use methamphetamine on the Mexico–U.S. border

The purpose of this study is to extend the research on contextual factors that influence the initiation and continued use of methamphetamine (meth) by women on the U.S.-Mexico border. At present, a minimal body of literature exists that explores meth use on the Mexico-U.S. border. A purposeful sample of 20 women who were active meth users aged ≥18 years was recruited by trained outreach workers from a variety of meth-user networks in Ciudad Juárez, Mexico, the city bordering El Paso, Texas. Respondents participated in in-depth, semi-structured interviews including questions on users’ perceived familial, social, and environmental influences of meth use. Gender-based themes emerged from the analysis: (1) patterns of meth use; (2) places where drugs were used; (3) effects of relationship networks on meth use; (4) differential access to drugs; (5) trading sex for drugs; (6) perceived class differences; and (7) long-term drug use and its consequences. Respondents reported a preference for using meth as powder or pills as opposed to smoking or injecting the drug. They reported being introduced to meth by men they trust and relying on men for drug acquisition in spaces less accessible and more dangerous to women. They described how the drug changed their lifestyle and their behavior towards family members and friends, including instances of physical and psychological violence. Interventions for women on the Mexico-U.S. border should be developed based on users’ social networks to target social processes to prevent initiation and to bring active meth users into treatment.     

Historical overview of generic medication policy

OBJECTIVE: To provide a historical perspective on controversies surrounding the use of generic drugs. DATA SOURCES: Articles were indexed initially using terms such as generic medications, generic drugs, multisource medications, and multisource drugs. These terms were used to search indexing services such as MEDLINE, International Pharmaceutical Abstracts, CINAHL (a database of nursing and allied health literature), Science Citation Index, Psychological Abstracts, and Wilson Indexes to Journal Articles. STUDY SELECTION: Performed by the authors, with preference given to events from 1951 to the present. DATA EXTRACTION: Not applicable. DATA SYNTHESIS: The history of generic drug use is a history of conflict from a variety of perspectives. The primary conflict is economic, in which manufacturers of brandname pharmaceuticals aggressively seek to protect their patents from a variety of groups (e.g., the federal government, managed care organizations, consumer groups) that want access to less expensive medications. Another conflict is professional, especially for the members of the pharmacy profession who view drug product selection as an important opportunity for pharmacists to use their professional judgment. The most confusing conflict is the scientific discussion of bioequivalence and product quality. The brand manufacturers suggest that not all products are bioequivalent and of the same quality. This position has been opposed by the pharmacy profession, generic drug manufacturers, health care institutions, and the Food and Drug Administration. CONCLUSION: Generic drug use has increased dramatically during the past 50 years and is an accepted part of health care. However, the economic consequences of generic drug use are sufficiently high for this activity to continue as a source of controversy in the future.