注射用盐酸头孢替安不良反应56例相关因素评析

目的:探讨注射用盐酸头孢替安在临床应用的不良反应及特点.方法:对我院药品不良反应(ADR)监测室收集的56例注射用盐酸头孢替安不良反应报告进行回顾性分析.结果:盐酸头孢替安ADR以皮肤系统损害(51.79%)及消化系统(26.79%)为主,其次为神经系统(21.42%)且好发于儿童和老年患者.结论:规范合理用药确保用药安全以减少或控制ADR的发生.     

基于加权TOPSIS法的头孢替安药物利用评价

目的建立头孢替安药物利用评价标准,为临床合理使用提供参考依据。方法参考头孢替安药品说明书及相关文献制定头孢替安评价标准,收集我院2013年10月—2014年2月使用头孢替安的相关病例85份并采用加权TOPSIS法进行评价。结果 85份病例中相对接近程度为1.0的有10例(12%),介于80%~90%之间有11例(占13%),介于70%~80%之间和60%~70%之间均都为20例(24%),小于60%有24例(28%)。结论采用加权TOPSIS法作为头孢替安药物利用评价方法是合理可行的,本院头孢替安的使用情况基本合理,但还存在适应证把握不准、主观经验性用药等问题。     

剖宫产术围手术期预防应用抗菌药物100例调查分析

目的调查该院剖宫产术围手术期预防应用抗菌药物的现状,为临床合理用药提供参考依据。方法采用回顾性调查方法,对该院2011年1～12月100例剖宫产患者围手术期预防应用抗菌药物的情况进行统计、分析。结果 100例剖宫产患者围手术期均预防性应用抗菌药物;应用品种以头孢唑啉、头孢西丁、头孢尼西、头孢替安、氨曲南、奥硝唑为主;结扎脐带后立即给药67例;中位用药天数为4.82d。结论该院剖宫产患者围手术期预防应用抗菌药物基本符合规范要求,但尚存在给药时机不当及用药时间过长等不合理之处;应进一步加强用药监管,以促进抗菌药物的合理使用。     

我院2012年8月-2013年3月注射用盐酸头孢替安异常用药调查及干预

目的:探讨临床药师对异常使用药品的专项调查和干预这一促进临床合理用药的重要手段。方法:对我院2012年8月-2013年3月住院药房监测到的注射用盐酸头孢替安用量异常这一情况,进行异常时间研究、异常科室研究及用药合理性研究,并针对分析结果进一步与临床科室进行沟通干预。结果:我院部分科室大量选用注射用盐酸头孢替安预防用药,选药不合理;盐酸头孢替安单次给药剂量超量;预防用药时间普遍过长可能为导致住院药房注射用盐酸头孢替安异常增长的主要原因。经调查分析与沟通干预,使住院药房注射用盐酸头孢替安用量明显下降,并呈逐渐下降趋势。结论:临床药师通过与住院药房密切配合,对异常用量药物进行动态监测、超常预警、专项调查及干预,促进了我院合理用药工作的开展。     

剖宫产围术期预防用抗菌药物调查分析

目的为促进临床合理用药,调查该院剖宫产术围术期预防应用抗菌药物的现状。方法采用回顾性分析的调查方法,对该院2013年1-6月120例剖宫产患者围术期预防应用抗菌药物的情况进行统计、分析。结果120例剖宫产患者围术期均预防性应用抗菌药物;应用品种以头孢西丁、头孢替安、头孢曲松为主;120例均术前未用术后用;平均用药天数为2.04d。结论该院剖宫产围术期预防应用抗菌药物存在不合理现象,主要问题是部分用药品种选择不当、给药时机不当和用药时间偏长等;应加强用药监管,以促进围术期合理使用抗菌药物。     

药源性发热伴皮疹病例的分析及其警示意义

目的：探讨临床合理用药的重要性。方法：调查分析1例药疹后再发药源性发热患者的临床表现与用药的关联性,分析合理用药的价值。结果：头孢菌素类、丹红注射液及桂哌齐特注射液致患者发生药源性发热伴皮疹的可能性较大。结论：对已发生药源性损害的患者更应遵循＂能不用就不用、能少用不多用＂的用药原则,以免遭受二次药物损害。     

360例住院患者抗菌药物应用评价

目的调查分析我院住院患者抗菌药物的使用情况,为促进抗菌药物的合理应用提供科学依据。方法随机抽取我院360份住院病例进行统计分析。结果我院住院患者抗菌药物使用率为76.1%,单一用药为43.4%,二联用药为43.4%,三联及以上用药为13.1%;平均用药时间为(8.9±3.5)d。围手术期预防用药时机合理(切皮前0.5～2h)的占66.7%,术后预防用药合理的占55.0%。抗菌药物以头孢他定、甲硝唑、头孢哌酮/舒巴坦钠、头孢替安、头孢呋辛的使用频次较高。结论我院住院患者抗菌药物的使用情况与指导原则有一定差距,需进一步规范。     

上海市119家医院2008年—2010年抗感染药物的用药分析

目的:分析上海市119家医院2008年—2010年抗感染药物用药变化趋势。方法:统计2008年—2010年上海市119家样本医院抗感染药物用药销售金额居前20位品种,结合临床使用进行分析。结果:抗感染药物为上海医院第一大类用药品种,近年来其占全部药物金额的份额维持在21%～22%;常用品种有头孢替安、头孢呋辛、左氧氟沙星、头孢克洛、阿奇霉素等,用药量增速较快的有头孢替安、头孢西丁、帕珠沙星等,用量下降较快的有头孢曲松、头孢拉定、头孢哌酮/舒巴坦和加替沙星等。结论:抗感染药物是临床常用的药物之一,应加强药政管理,合理使用。     

上海市119家医院2008年—2010年抗感染药物用药分析

目的:分析上海市119家医院2008年—2010年抗感染药物用药变化趋势。方法:统计2008年—2010年上海市119家样本医院抗感染药物用药销售金额居前20位品种,结合临床使用进行分析。结果:抗感染药物为上海医院第一大类用药品种,近年来其占全部药物金额的份额维持在21%～22%;常用品种有头孢替安、头孢呋辛、左氧氟沙星、头孢克洛、阿奇霉素等,用药量增速较快的有头孢替安、头孢西丁、帕珠沙星等,用量下降较快的有头孢曲松、头孢拉定、头孢哌酮/舒巴坦和加替沙星等。结论:抗感染药物是临床常用的药物之一,应加强药政管理,合理使用。     

头孢地尼致药源性发热1例

药源性发热（ DIH）为临床上常见的药源性损害,国外报道其在住院患者中约占10％［1］。在国内药品应用广泛、过度用药情况严重的背景下,DIH的发生率可能会更高,应该会高于国外水平,故应高度重视。本文为对1例头孢地尼致药源性发热的情况进行分析,现报道如下。     

2例药源性发热病人的用药分析

目的分析2例药源性发热病人的用药情况,为临床合理用药提供参考。方法依据病人临床表现与用药关系,分别认定为低分子右旋糖酐氨基酸注射液、鹿瓜多肽注射液引起。结果与结论为减少药源性疾病的发生及其危害,应规范手术后用药,尽量避免抗菌药物与中药类注射剂等联合使用。     

头孢替安皮试液配制浓度改进探讨

目的分析头孢替安皮试液使用及配制时所出现的问题并探讨解决问题的方法。方法配制浓度为100mg·L-1的头孢替安皮试液,进行皮内注射0．1mL,20min后观察患者反应。以300mg·L-1的头孢替安皮试液做为对照。结果75例进行头孢替安皮试的患者,67例患者皮试阴性,占89．3％,可以使用头孢替安进行治疗;2例患者出现伞身过敏反应,占2．7％;6例患者发生局部反应,占8．0％,后采用300mg·L-1的头孢替安进行皮试,结果相同。皮试阳性者都换用他抗生素进干了治疗．．结论采用的配制浓度及方法具有简便、易行、安全、可靠的优点,值得在临床上推广应用。     

Efficacy and safety of cefotiam hexetil in the treatment of ear, nose and throat infections.

In 60 patients suffering from acute ear, nose and throat infections the efficacy and safety of cefotiam hexetil (SCE-2174, CAS 61622-34-2) which is a pro-drug of cefotiam was studied. The clinical success rate (improvement/cure) achieved with a daily administration of 600 mg was 90%. In 63% of the cases being evaluable for bacteriological response an eradication of the causative pathogens at the end of the treatment period was found. The majority of the patients tolerated well the compound. Side effects which were possibly, likely or definitely related to the treatment were observed in 12 patients. In 7 of these patients the treatment had to be stopped due to side effects which is equivalent to an intolerance rate of 12%. The data obtained in the present study indicate that cefotiam hexetil is a potent drug for the treatment of acute and acute on top of chronic infections of the upper aerodigestive tract.     

Clinical studies on combination therapy of cephem antibiotics in chronic complicated urinary tract polymicrobial infections due to Pseudomonas aeruginosa and other bacteria

Patients with chronic complicated urinary tract polymicrobial infections due to Pseudomonas aeruginosa and other bacteria were treated with cefsulodin using cefotiam or cefmenoxime as a concomitant drug. Each drug was given to the patients in daily dose of 1 or 2 g by drip infusion twice a day for 5 to 16 days. The results were as follows: Overall clinical efficacy was excellent in 7 cases (44%), moderate in 6 cases (38%) and poor in 3 cases (19%), the effectiveness rate being 81.3%. Bacteriologically, 38 strains (88.4%) were eradicated, 1 strain decreased and 4 strains unchanged out of the 43 clinical isolates from the patients. No side effects and no abnormalities of laboratory findings were observed.     

Azacitidine-associated hyperthermia and interstitial pneumonitis in a patient with myelodysplastic syndrome

The DNA hypomethylating agent azacitidine was approved by the United States Food and Drug Administration after the drug demonstrated superiority over the best supportive care for treatment of myelodysplastic syndrome in patients unable to undergo stem cell transplantation. Mild adverse reactions, both hematologic and nonhematologic, are not uncommon; however, severe adverse effects are rare. We describe a 55-year-old woman who was treated with azacitidine for myelodysplastic syndrome and experienced hyperthermia that was not attributable to other causes. The patient's treatment course was further complicated by interstitial pneumonitis and hypoxic respiratory failure that ultimately led to acute respiratory distress syndrome. Hyperthermia develops when discord occurs between metabolic heat production and heat dissipation. The process of temperature regulation can be altered by drugs such as succinylcholine, phenothiazines, monoamine oxidase inhibitors, atropine, benztropine, antihistamines, cocaine, Ecstasy, amphetamines, and haloperidol. The hyperthermia in this patient was refractory to antipyretic therapy and was not due to other drug-induced hyperthermic syndromes. She eventually responded to high-dose methylprednisolone. The Naranjo adverse drug reaction probability scale score indicated that the association between azacitidine and hyperthermia was probable. Clinicians should be aware of this rare, severe, potential adverse effect of azacitidine.     

1例克林霉素药源性发热分析和文献复习

药源性发热(drug-induced hyperthermia)是常见的药源性损害之一,抗菌药物引起药源性发热较常见,故在病情不危急却有发热的情况下,不应盲目大量地使用抗菌药物。否则,可能掩盖病因,加重病情,重者危及生命。     

回顾性分析本院抗生素等药物致肾毒性28例

目的 回顾性分析抗生素等药物所致的肾损害.方法 对本院2005年1月至2008年12月所发生的药物所致肾损害,进行归类统计分析和评价.结果 导致肾损害、急性肾衰竭、急性肾功能不全、急性间质性肾炎、慢性肾炎、肾病综合症的药物,主要包括:抗生素(13/28),NSAIDs(6/28)、抗肿瘤药物(2/28),抗高血压药(4/28)、其他(3/28);全部病例人院后,治愈10例,好转11例;转为慢性3例,自动出院3例,死亡1例.结论 要做到合理用药,早期干预,预防药源性肾损害的发生.     

548例注射用盐酸头孢替安不良反应相关因素评析

目的 探讨注射用盐酸头孢替安所致不良反应的特点及规律.方法 对山东省自2006年以来收集的548例注射用盐酸头孢替安不良反应病例报告进行回顾性分析.结果 注射用盐酸头孢替安ADR以皮肤及其附件损害(59.49％)及胃肠系统损害(14.60％)为主,其次为中枢及外周神经系统损害(10.40％)且好发于婴幼儿、儿童和老年患者.结论 进一步规范注射用盐酸头孢替安的用法、用量,避免超剂量用药,并加强用药后监测,减少不良反应的发生.     

Laboratory and clinical studies of cefotiam in digestive diseases

Experimental and clinical studies on cefotiam (CTM), a new synthetic cephalosporin, were performed in digestive diseases. Among the 7 cases of 'cholelithiasis and cholangitis', 6 cases (86%) showed better response than "effective". Among the 9 cases of infections except 'cholelithiasis and cholangitis' which had no connection with cancers, 6 cases (67%) showed better response than "effective". Among the 15 cases of 'infections following advanced cancers', 7 cases (47%) showed better response than "effective". This inferior result was due to the relation to factors coming from cancers. CTM was effective in not only infections of the aged but that which resisted antibiotics of penicillins and the other cephems. Sensitivity of E. coli, Klebsiella and S. aureus was made a comparative study of by MIC and disc test. It was found as a result that CTM had the equal or superior antimicrobial activity to other antibiotics of cephems, penicillins and aminoglycosides.     

药物性眼部损伤156例中文文献分析

目的:了解可致眼部损伤的药物及与给药方法的关系。方法:检索1997-2003年国内公开发行的28种医药学期刊上有关药物所致眼部损伤的文献105篇,并对病例进行统计分析。结果:42种药物引起眼部损伤156例,临床表现包括青光眼、视力障碍、失明、结膜、视网膜损伤等;诱发药物以抗感染药、激素类药、抗肿瘤药所占比例较大。结论:全身给药所致眼部损伤多为正常用法、用量下的不良反应,而眼部用药所致眼部损伤则有错误用药、错误操作、眼部手术中及手术后用药不当等原因。