某院儿科140例药品不良反应回顾性分析

目的 了解儿科用药致不良反应的特点及规律,为临床安全有效用药提供参考。方法 对某院2011年～2019年上报的140儿科用药致不良反应报告进行回顾性分析。结果 140例不良反应中,以抗菌药物最多（104例次,占总计155例次的67.10%）;给药途径以静脉滴注所占比例为最高（110例,占总计155例次的70.97%）;累及多个系统-器官,以皮肤及其附件损害最为常见（96例次,占总计148例次的64.86%）。结论 应加强儿科临床用药的规范性、合理性,加强宣传教育以及临床用药过程中的监测,以避免或减少不良反应的发生。     

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。     

279例抗感染药致不良反应报告分析

目的:了解和分析荆州市第一人民医院抗感染药致药品不良反应(ADR)发生的特点及规律,为临床合理用药提供依据。方法:对我院2010年临床各科室上报的279例抗感染药致ADR报告进行回顾分析。结果:279例抗感染药致ADR中,静脉滴注导致的ADR最多(262例,占93.55%);以头孢菌素类引起的ADR例数最多(101例,占36.20%),其次为氟喹诺酮类(68例,占24.37%);ADR累及的器官和(或)系统主要为皮肤及其附件(139例,占49.82%),其次为消化系统(77例,占27.60%);上报科室以外科最多(121例,占43.37%)。结论:不合理使用抗感染药是ADR产生的主要原因之一,应加强抗感染药的临床合理应用和ADR监测,保障公众用药安全。     

1419例新的或(和)严重的药品不良反应报告分析

目的:了解新的或(和)严重的药品不良反应报告(ADR)的特点,促进合理用药。方法:收集2013年宿州市上报的1 419例新的或(和)严重的ADR报告,从患者信息、给药途径、涉及药物种类和累及器官和(或)系统等方面进行统计分析。结果:1 419例患者中,≥60岁患者所占比例最大(323例,占22.76%);新的ADR为1 378例,严重的ADR(包括新的、严重的ADR)为41例;发生严重的ADR的药物剂型以注射制剂为主(321例次,占严重的ADR例次数的62.75%),发生新的ADR的药物剂型以口服制剂为主(1 044例次,占新的ADR例次数的75.05%);新的ADR涉及药物以中成药为主(1 329例次,占总计1 824例次的72.86),严重的ADR涉及药物中,抗感染药所占比例最大(40例次,占总计78例次的51.28%);胃肠道损害最为常见。结论:应提高宿州市新的和严重的ADR的监测水平,促进临床合理用药,减少ADR的发生。     

187例抗菌药物致不良反应报告分析

目的:了解抗菌药物致不良反应(ADR)发生的特点、规律及影响因素,为临床合理用药提供参考。方法:对2009年度已上报国家食品药品监督管理局(SFDA)ADR监测中心的187例抗菌药物ADR报告进行回顾性分析和评价。结果:187例报告中,18岁以下的患者有62例,占33.16%(62/187);怀疑药品以头孢匹胺钠为最多,共26例,占13.90%(26/187);给药途径以静脉输注为主,共180例,占96.26%(180/187);ADR所累及的系统和(或)器官以皮肤及其附件损害最为普遍,共136例,占70.47%(136/187)。结论:严格按照《抗菌药物临床应用指导原则》,加强ADR监测,选择适宜的品种、给药途径,完全有可能在达到最佳临床疗效的同时使ADR降至最低。     

2008—2013年103例抗肿瘤药致不良反应报告分析

目的:了解抗肿瘤药致不良反应的特点及规律,探讨临床药师在抗肿瘤药的药学监护方面的作用。方法:收集2008—2013年广西壮族自治区第二人民医院(以下简称"我院")上报的103例抗肿瘤药致不良反应报告,对患者性别与年龄、不良反应发生时间、涉及药物种类、累及器官和(或)系统及临床表现等进行统计分析。结果:使用抗肿瘤药发生不良反应的103例患者中,男性53例,女性50例,男女比例为1.06∶1;18~79岁患者所占的比例最高(101例,占总病例数的98.06%);用药当日发生的ADR所占比例最高(53例次,占总病例数的51.46%);发生不良反应例次数居前3位的药品分别为奈达铂(13例次)、薄芝糖肽(11例次)、核糖核酸Ⅱ(10例次);抗肿瘤药致不良反应可累及多个器官和(或)系统,居前3位的分别为皮肤及其附件(38例)、呼吸系统(20例)及消化系统(11例)。结论:临床药师应关注重点人群、不良反应发生时间及临床表现,加强对抗肿瘤药用药过程的观察和监护,以减少不良反应的发生,减轻不良反应造成的损害,促进合理用药。     

我院347例抗菌药物致不良反应分析

目的:了解我院抗菌药物致药品不良反应(ADR)发生的原因及特点。方法:对我院2005～2009年收集到的347例抗菌药物致ADR报告进行回顾性统计、分析。结果:我院347份ADR报告中共涉及9类抗菌药物,头孢菌素类及喹诺酮类引发的ADR最多,分别占36.60%(127例)、22.77%(79例)。其中,左氧氟沙星和头孢曲松所占比例最大,分别占14.70%、12.39%;ADR累及的器官或系统以皮肤及其附件损害最多,有158例(占42.36%);由于不合理用药而导致的ADR有175例,占50.43%,其中,剂量选择错误是主要原因,无感染指征用药、选药不当、联合用药不合理、溶媒选择错误均占有一定比例。175例不合理用药导致的ADR中,头孢菌素类抗生素所占比例最高,占46.29%。结论:抗菌药物致ADR的发生与多种因素有关,临床应重视抗菌药物的合理使用,警惕可能由于抗菌药物的不合理使用而诱发的严重ADR,从而合理、规范地使用抗菌药物,减少ADR的发生。     

某院535例抗菌药物不良反应报告的相关因素分析

目的:分析医院抗菌药物不良反应(ADRs)发生特点,为促进临床合理使用抗菌药物提供参考。方法:抽取2016年1月—2018年12月间上报的535例抗菌药物ADRs报告,分析其抗菌药物ADRs涉及的相关因素。结果:535例抗菌药物ADRs报告中,其中男性248例,女性287例,女性多于男性;抗菌药物ADRs上报例次逐年增加;静脉给药方式引发的ADRs为最多(占93.46%),其次为口服给药(占6.16%);报告中涉及药品种类中头孢菌素类占26.83%;ADRs报告一般的占93.27%,新的ADRs占4.67%,严重的ADRs占2.06%。结论:医院行政部门应重视抗菌药物不良反应报告和监测工作,合理使用抗菌药物,慎用喹诺酮类药物,以确保患者用药的合理性和安全性。     

《中国药学文摘》收录的抗菌药物致不良反应统计分析

目的:统计分析抗菌药物引起药品不良反应(ADR)的情况,以有效预防和减少ADR的危害,提高ADR的监测能力。方法:对2008-2009年《中国药学文摘》收录的抗菌药物致ADR文献进行检索。通过Excel电子表对发生ADR的药品种类、给药途径、累及器官或系统及临床表现、ADR发生例数居前10位药品进行回顾性统计、分析。结果:抗菌药物致ADR报道篇数1249篇,病例656例,涉及药品123种。以头孢菌素类(18.90%)发生例次最多,其次为喹诺酮类(16.16%)、青霉素类(14.18%);静脉滴注最易导致ADR(81.10%);ADR临床主要表现为皮肤及其附件损害(19.05%),其次为消化系统损害(16.31%)和中枢或外周神经系统损害(14.63%);左氧氟沙星的ADR发生率最高(89例)。结论:临床应加强对抗菌药物致ADR的重视和监测工作,以保证用药的安全性。     

2007年抗菌药物不良反应报告回顾性分析

目的 了解首都医科大学附属北京天坛医院抗菌药物不良反应情况,为临床合理、安全用药提供依据.方法 汇总2007年收集的94例的抗菌药物不良反应报告,按患者年龄、性别、给药途径、药物类别、临床表现及ADR发生数量、及前5位药物进行统计分析.结果 60岁以上的老年患者ADR发生率最高(38例,占40.43%);发生ADR的给药方式以静脉注射为主(72例,占76.6%);ADR最常见临床表现为对皮肤及其附件的影响(49例,占52.13%);喹诺酮类引起ADR数量最多(35例,占37.23%).结论 抗菌药物不良反应与药物性质、临床使用量、个体因素等密切相关.应重视抗菌药物的ADR监测,以促进临床合理、安全用药,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.