我院442例药品不良反应报告分析

目的:探讨我院药品不良反应(ADR)发生的特点及规律,为临床合理用药及药品安全性评价提供参考。方法:对我院2009-2010年收集到的442例有效ADR报告进行统计、分析。结果:442例ADR报告中,涉及药品159种,60岁以上患者发生ADR的比例最高(138例,占31.22%);静脉注射给药引发的ADR最多(349例,占78.96%);最易引起ADR的药物为抗感染药(209例,占47.29%),其次为中药制剂(64例,14.48%);ADR损害类型主要以皮肤及其附件损害为主(223例,占50.45%),其次为消化系统和心血管系统损害;新的ADR11例,以中药制剂引发的为主;严重ADR32例,以过敏性休克较多(7例,占严重ADR病例的21.88%),其次为肝功能异常和高热。结论:临床应重视和加强ADR监测,合理用药,减少或避免ADR的发生。     

544例药品不良反应报告分析

目的:了解辽宁省人民医院(以下简称"我院")药品不良反应(ADR)发生的特点及规律,为临床合理用药提供参考,以期进一步提高我院ADR监测工作水平。方法:对2006年1月—2014年1月我院上报的544例有效ADR报告进行回顾性分析。结果:我院ADR共涉及222种药品(588例次),以抗微生物药为主(226例次,占总例次数的38.4%);剂型以注射剂型为主(474例次,占总例次数的80.6%);累及系统以皮肤及附件损害最为突出。结论:临床医护人员需重视ADR的监测和上报,注意抗微生物药、中药注射剂和复方制剂的合理使用,减少和防止ADR的重复发生。     

西安市36家医院1372例药品不良反应报告分析

目的:了解西安市二级以上医院药品不良反应(ADR)发生的特点和规律,为临床合理用药提供参考。方法:回顾性统计并分析西安市36家二级以上医院2012年10月-2014年6月收集并上报的有效ADR报告1 372例。结果:1 372例ADR报告中,年龄≥60岁的患者发生ADR比例最高(407例,占29.67%);引发ADR最多的药物为抗微生物药,所占比例最高,达45.77%,其次为中药制剂(15.82%)以及循环系统药(9.55%);注射剂是引发ADR最多的药物剂型,共1 210例,占88.19%;ADR损害类型主要以皮肤及其附件损害为主,占44.16%;左氧氟沙星注射液为引发ADR最多的药物,共95例。结论:掌握该地区ADR的发生特点与规律,有助于管理者规范临床合理用药,保证患者用药安全。     

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。     

我院90例药物不良反应/事件分析

目的:探讨我院药物不良反应(ADR)发生的特点,为临床合理用药及药品安全性评价提供参考。方法:对我院2012年收集到的90例有效ADR报告进行统计分析。结果:90例ADR报告中,66例19⁶5岁患者发生ADR,占73.33%;静脉注射给药引发的ADR 43例,占47.78%;最易引起ADR的药物为中药制剂41例,占49.38%,其次为抗感染药物19例,占21.11%;ADR损害类型主要以皮肤及其附件损害为主(32例,占36%);新的ADR 32例,主要为中药制剂引发;严重ADR9例,其中皮肤及其附件损害为6例。结论:临床应重视和加强ADR监测,合理用药,减少ADR的发生。     

87例中药制剂不良反应报告分析

目的:分析中药制剂不良反应(ADR)的特点及影响因素,促进临床合理用药。方法:采用回归性分析方法,对我院2006年87例涉及中药制剂的ADR报告分别从临床表现、相关药品及剂型、发生时间等方面进行统计分析。结果:87例ADR几乎涉及人体各个系统,发生率最高的是过敏反应;中药注射剂是引起ADR的主要剂型(67.34%);用药当天发生ADR的比例最大(67.82%)。结论:及时报告中药制剂ADR,加强对其监测与研究,有助于减少和避免中药制剂ADR的发生,保障患者用药安全。     

抗菌药物致不良反应547例分析

目的:探讨我院抗菌药物致不良反应(ADR)发生的相关影响因素,为临床用药安全提供参考。方法:对我院2011-2012年上报的抗菌药物致ADR 547例进行回顾性研究,统计、分析患者性别、年龄、ADR分级、ADR转归、ADR涉及药品、给药途径、ADR累及器官或系统及临床表现等。结果:ADR发生集中在41⁵0岁年龄段,女性比男性发生ADR的比例高;新的、严重的ADR分别占总数的0.73%、5.12%;其中,静脉滴注367例(占67.09%),口服给药153例(占27.97%);左氧氟沙星引发ADR比例最高(占23.40%);ADR临床表现以皮肤及其附件损害(占34.90%)和消化系统损害(占27.84%)为主。β-内酰胺类是引起严重ADR的主要抗菌药物。结论:抗菌药物致ADR影响因素较为复杂,医务工作者应加强对抗菌药物应用监测,促进临床合理用药,保障患者用药安全。     

我院332例药品不良反应报告分析

目的:了解我院药品不良反应(ADR)发生的特点及一般规律。方法:采用回顾性研究方法,对我院2009年1月-2010年12月收集到的332例ADR报告进行统计、分析。结果:332例ADR报告中,涉及药品85个品种,其中抗感染药的ADR发生率最高(168例,占50.60%),其次为中药制剂(76例,占22.89%);主要的给药途径为静脉注射(218例,占65.66%);药物剂型以注射剂为主(223例,占67.17%);ADR累及器官或系统主要为皮肤及其附件(126例,占37.95%),其次为消化系统和神经系统。ADR转归中,331例ADR治愈或好转,1例出现后遗症。结论:ADR的发生与诸多因素有关,临床需加强ADR的监测和报告,提高ADR的预防、诊断和治疗,促进临床安全合理用药。     

某院105例药品不良反应报告的分析

目的分析我院药品不良反应(ADR)的发生及分布情况,为临床合理、安全用药提供科学依据。方法回顾性分析2010年1月至2012年2月我院收集的105例ADR病例报告。结果 105例ADR报告中,50岁以上较多,占55.24%(58/105);静脉给药引起的ADR占80.95%(85/105);ADR涉及药品种类以抗菌药物为主,占43.81%(46/105),中药制剂次之,占21.90%(23/105);ADR所涉及的器官和(或)系统损害临床表现主要为皮肤及其附件最为多见,占42.86%(45/105)。结论应重视ADR的监测工作,尤其是抗菌药物和中药制剂,尽可能降低或避免ADR的发生,保证临床合理、安全用药。     

212例药品不良反应报告的分析

目的为了解我院药品不良反应(ADR)的发生特点,促进临床合理用药,减少ADR的发生。方法对我院2011～2012年收集的212例ADR报告进行了回顾性分析。结果 212例ADR中,涉及用药品种45个,>50岁以上患者出现ADR的例数最多(138例,占65.09%);静脉用药为引发ADR的主要途径(192例,占90.57%);抗感染药引发的ADR位居首位(130例,占61.32%),其次是中药制剂(44例,占21.69%);临床表现以皮肤及附件损伤最为常见,其次是全身性损伤、心血管系统及消化系统损伤;212例ADR以一般属性ADR为主,新的或严重ADR占有一定比重;ADR报告职业中,护士报告最多。结论给药途径、药物种类等因素均会影响ADR的发生,应重视ADR的报告和监测,特别是抗感染药物和中药注射剂的ADR监测,促进临床合理用药,进而有效的减少ADR的发生。     

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.