门急诊不合理用药处方分析

目的了解我院门急诊不合理用药情况,促进合理用药.方法根据药品说明书、临床药理学知识及文献资料,对我院2004年4月～2005年3月门急诊不合理用药处方分析.结果不合理用药处方占所审核处方的0.30%,抗生素滥用处方占不合理用药处方的68.80%;不合理用药主要反映在给药方案、重复用药、药理拮抗和配伍等方面.结论我院门急诊合理用药仍是主流.应针对存在问题制定相应措施.     

门急诊处方不合理用药分析

目的了解我院门急诊处方不合理用药情况。方法随机抽取我院2008年6月～11月门急诊处方3278例,对不合理用药处方进行统计分析。结果不合理用药处方占抽查处方数的3.87%,不合理用药主要体现在用法用量不合理、溶媒使用不合理、重复用药、药物联用不合理、选药不合理、激素滥用等方面。结论我院门急诊用药处方存在不合理之处,医院应加强处方审核工作,增进医师与药师的交流,促进临床合理用药。     

我院门急诊处方不合理用药分析

目的了解我院门急诊处方不合理用药情况。方法随机抽取我院2011年1-11月门急诊处方4250例,对不合理用药处方进行统计分析。结果不合理用药处方占抽查处方数的4.27%,不合理用药主要体现在给药方法不合理、溶媒使用不合理、重复用药、药物联用不合理、选药不合理、激素滥用等方面。结论我院门急诊用药处方存在不合理之处,医院应加强处方审核工作,增进医师与药师的交流,促进临床合理用药。     

门急诊药房720张不合理用药处方的调查及分析

目的了解门急诊药房不合理用药处方情况,并对不合理用药处方进行统计,对典型不合理用药处方进行分析。选取我院2017年1~8月所有的处方共计48000张作为研究对象,从中挑选出不合理用药处方720张,按照不同的分类对不合理用药处方进行登记。方法使用药品说明书,中国国家处方集,新编药物学,马丁代尔药典等资料对不合理用药处方进行分析。结果我院2017年1~8月不合理用药处方总计720张,其中给药时间间隔不合理处方132张,占了不合理用药处方的18.3%;给药剂量不合理总计121张,占到了不合理用药处方的16.8%。结论我院门急诊药房不合理用药处方占到了1.5%,虽然占比并不是很高,但是药品直接关系到患者疾病的治疗与生命安全,应该采取积极措施从根源杜绝不合理处方的发生。     

某院2014年1～6月门急诊不合理用药处方的分析

目的通过分析我院门急诊处方不合理用药情况,以提高处方质量,促进临床合理用药。方法提取我院2014年1~6月门急诊58833张处方数据,并从中随机抽取1765张,对不合理处方进行评价和分析。结果抗菌药物使用率为11.68%,国家基本药物使用率为19.95%,中成药使用率为43.39%,不合理用药处方156张(占抽查处方数的8.84%)。主要为处方处方书写不规范及内容缺项、用法用量不合理、重复用药、抗菌药物使用不合理、适应证不适应、联合用药不适应等。结论我院门急诊处方基本合理,但仍存在一些问题,需加强对临床医师、药师的相关培训,规范处方用药,提高用药水平。     

我院门急诊处方不合理用药分析

目的调查我院门急诊不合理用药的情况,促进临床合理用药。方法抽取我院2008年11月7 597张门急诊处方,根据文献资料等标准,判断不合理用药处方,进行归类分析。结果不合理用药处方204张,不合格率为2.68%。不合理用药发生频率较高是药物用法用量不合理,依次为药物配伍不合理及择药不合理等。结论我院存在不合理用药现象,应提倡临床药师深入临床,为医师和患者提供药学服务,加强用药指导,促进合理用药。     

2012年~2013年某院门急诊不合理用药处方的分析

目的通过分析我院门急诊不合理处方用药情况,讨论合理用药方案,提高我院临床用药水平。方法随机抽取我院2012年3月至2013年3月的门急诊处方30000张,进行归类分析。结果不合理用药处方293张,处方合格率99.02%。结论我院门急诊用药的处方合格率属于合理范围,但是仍存在不少问题。需要我们药师不断加强专业理论学习,配合临床医师指导患者合理用药。     

我院门急诊儿科处方不合理用药分析

目的:探究我院门诊急诊儿科处方不合理用药问题。方法:抽取我院2014年7~12月0~14周岁以下2380张门急诊处方,分析不合理用药问题。结果:用药不合理处方352张,占处方总数的14.79%,不合理用药体现在给药方法不合理、联合用药不合理、重复用药、药物配伍、适应证不适宜等。结论:我院门急诊用药处方存在很多不合理用药情况,需加强用药审核,加强临床医师、护士、药师间沟通,使临床用药更加规范、科学。     

我院门急诊电子处方点评结果与分析

目的：通过对我院门急诊电子处方进行点评,并对点评结果进行分析,促进临床合理用药。方法：随机抽取我院2014年第三季度每月门急诊电子处方1000张,共3000张,进行点评、分析和总结。结果：不合理处方106张（3.53%）,其中不规范处方11张（10.38%）,不适宜处方78张（73.58%）,超常处方17张（16.04%）。结论：我院门急诊电子处方基本合理,但仍然存在不合理用药的现象,医院还需加强管理和干预,落实处方点评工作,提高医生合理用药的水平。     

我院372951张门/急诊处方分析

目的:了解门急诊处方不合理用药情况,促进医院合理用药。方法:抽取我院2009年门急诊处方,以《处方管理办法》、《新编药物学》及《中华人民共和国药典·临床用药须知》为依据,按2010年新颁发的《医院处方点评管理规范(试行)》标准,从处方书写规范性及用药合理性角度,判断不合理处方并进行归类分析。结果:不合理处方1568张,占总处方数的0.42%,其中书写不规范、用药不合理处方各占不合理处方总数的24.55%、75.45%,前者主要表现为医师随意延长用药疗程、处方前记与患者信息不符等,后者主要表现为用法用量不适宜、适应证不适宜、遴选的药品不适宜等。结论:我院门急诊处方书写及用药情况基本合理,但仍存在一定问题,需进一步改善和提高。     

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.     

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.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

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.     

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.