654-2与红霉素配伍可减轻其副作用的效果观察

红霉素的抗菌谱与青霉素相似，常用于治疗革兰氏阳性菌感染。红霉素主要用于治疗耐青霉素的金黄色葡萄球菌感染和对青霉素过敏病人。为减轻静脉滴注红霉素时常伴有恶心、呕吐、上腹部疼痛等胃肠道反应及静脉炎和静脉内疼痛不适感受，近几年来我们经临床试用和观察发现，654-2注射液与红霉素配伍静滴可使以上副作用明显减轻或消失，效果好于维生素B6，现将观察结果报告如下。     

山莨菪碱减少红霉素副作用的效果观察

红霉素注射液在治疗小儿下呼吸道感染性疾病中 ,占有非常重要的地位 ,但其胃肠道反应及注射部位疼痛的发生率非常高。将山莨菪碱 ( 6 5 4 - 2 )注射液与红霉素注射液混于一起 ,同时静脉滴注 ,观察红霉素副作用发生率的变化 ,报道如下。1　资料与方法1.1　病例选择为本院从 2 0     

思密达、654-2预防小儿静滴红霉素消化道反应机制的探讨

目的 探讨思密达、654－2预防红霉素(EM)抗菌剂量对消化道反应的机制.方法 思密达口服加654－2静滴50例,口服思密达组46例,静滴654－2组42例,三组作为治疗组,37例为对照组,观察175例静滴EM患儿消化道反应发生情况.结果治疗组发生率分别为12%、30.4%、28.6%,较对照组75.7%明显减少(P<0.005),且程度明显减轻.单用思密达组与单用654－2组之间无差异(P>0.05),而两药合用效果明显好于单药组(P<0.05).结论 提示两药对预防红霉素消化道反应均有明显效果,而作用机制不同,红霉素与思密达尽量避免共同服用.     

思密达,654—2预防小儿静滴红霉素消化道反应机制的探讨

目的 探讨思密达、６５４－２预防红霉素（ＥＭ）抗菌剂量对消化道反应的机制。方法 思密达口服加６５４－２静滴５０例，口服思密达组４６例，静滴６５４－２组４２例，三组作为治疗组，３７例为对照组，观察１７５例静滴ＥＭ患儿消化道反应发生情况。结果治疗组发生率分别为１２％、３０．４％、２８．６％，较对照组７５．７％明显减少（Ｐ〈０．００５），且程度明显减轻。单用思密达组与单用６５４－２组之间无差异（Ｐ〉０．     

减少红霉素静滴副作用的临床探讨

红霉素为大环内酯类抗生素的代表药物,其抗菌范围与青霉素相似而稍广,对某些 G~-杆菌特别是肺炎支原体有明显的抑制作用,且其毒性低,还可适用于对青霉素类过敏及耐药的患者故临床应用较为广泛。但红霉素的副作用亦很常见,其中静滴时主要有胃肠道平滑肌和血管平滑肌痉挛,我们根据654—2和司迈特的药理特性联合应用以减轻或阻止其副作用的发生,疗效显著,现报道如下:1 临床资料选择本院2001年12月至2003年1月,因患肺     

山莨菪碱减少红霉素不良反应的疗效观察

自2003年10月～2004年10月,应用山莨菪碱(654-2)注射液加入红霉素液中静脉滴注以减少其所致的不良反应取得较好效果,现报道如下。1 资料与方法1.1 临床资料:选择因支原体或细菌感染住院的患儿 196例,其中男 90例,女 106例,年龄 3~12岁之间,均为非危重病例,且无恶心、呕吐、腹痛     

碳酸氢钠合并654-2治疗偏头痛30例

本文采用碳酸氢钠加654-2注射液合并静脉注射治疗偏头痛取得了满意疗效,现报道如下.     

红霉素加654-2治疗支原体肺炎32例疗效观察

支原体肺炎是学龄儿童及青少年常见的一种肺炎,治疗上常使用红霉素,但红霉素常引起上腹部疼痛、恶心、呕吐等胃肠道反应,造成患儿极大痛苦。本组于1996年6月至1998年10月采用红霉素治疗支原体肺炎的同时加用654-2以减轻胃肠道反应,取得很好效果,现报告如下。1　病例选择　1996年6月至1998年10月住我院或门诊观察室的患儿64例,支原体肺炎诊断符合《实用儿科学》第4版[1]临床诊断标准,实验室检查冷凝试验1∶32以上或咽拭子支原体聚合酶链反应(PCR)阳性而确诊的病例。64例患儿中,男36例,女28例,年龄2～10岁。随机分为654-2治疗组(简称治疗组)…     

乳糖酸红霉素静脉滴注给药的几个问题

红霉素是大环内酯类抗生素最常用的一个品种,属快速抑菌剂,其抗菌谱与青霉素G类似而较广,但抗菌活性较青霉素弱。临床上主要用于支原体、衣原体、弓形体、立克次体及军团菌感染和对青霉素过敏或耐药的敏感菌株感染。红霉素的抑菌作用,对敏感菌株的MIC为0.5~3μg/ml[1],浓度在5μg/ml时,对部分细菌可呈杀菌作用。其抑菌或杀菌作用与细菌对药物的敏感程度有关。T1/21.4~2h,蛋白结合率70~90%。儿科临床除轻度感染的适应症多口服外,中重度感染者多以乳糖酸红霉素静脉滴注给药,以便较快达到有效抑(杀)菌浓度。乳糖酸红霉素在临床静脉给药时,以…     

Reversal of citalopram-induced junctional bradycardia with intravenous sodium bicarbonate

The cardiotoxicity of tricyclic antidepressants is a well-described phenomenon requiring serious consideration in patients who have taken an overdose. In patients who are at high risk for suicide attempts, selective serotonin reuptake inhibitors (SSRIs) were thought to constitute a safe alternative. However, evidence is accumulating that they, too, possess proarrhythmic properties, which must be reconciled in the setting of an overdose. An 82-year-old woman intentionally ingested citalopram 1.6 g. Several hours after presentation, she developed sinus arrest and junctional bradycardia that resolved after infusion of intravenous sodium bicarbonate solution. Thereafter, she demonstrated no further electrocardiographic abnormalities and was safely transferred to the psychiatry service without the need for a temporary transvenous pacemaker. The dramatic effect of the sodium bicarbonate on the arrhythmia represents a probable event according to the Naranjo probability scale. Intravenous sodium bicarbonate may serve as an effective antidote to SSRI-induced bradyarrhythmias.     

山茛菪碱减轻红霉素不良反应临床观察

目舶：探讨山莨菪碱减轻红霉素胃肠道不良反应临床疗效。方法：随机选择需用红霉素治疗的病人120例分成观察组和对照组，观察组在静脉滴注红霉素的同时加人山莨菪碱，而对照组则只静滴红霉素，另选30例上呼吸道感染病人为另一组，观察三组胃肠反应及胃电图情况。结果：对照组输注红霉素1小时后胃肠反应及胃电图表现与正常组差异有显著性，而观察组与另一组无统计学差异，对照组与观察组比较差异有显性著。停药后2～3天胃电节律三组无统计学差异。结论：山莨菪碱能有效减轻红霉素胃肠道反应而无明显副作用。     

非那雄胺的不同用药方式对前列腺经尿道电切除术影响的观察

目的探讨非那雄胺以长期常规剂量和短期大剂量两种术前给药方式对经尿道前列腺电切除术（TURP）治疗前列腺增生症（BPH）的影响。方法本研究以确诊的120例中重度前列腺增生患者为处理对象，所有患者随机分成A、B、C3组。A组术前口服非那雄胺3个月，每日1次，每次5mg；B组术前口服非那雄胺5d，每日1次，每次15mg：C组术前未服用任何抗雄激素药物。患者均经同一术者使用OLYMPUSF26电切镜进行TURP术。3组以术中术后出血量、灌洗液量、手术时间和手术野的满意度进行计量比较。结果A组在术中出血量、术中灌洗液量、手术时间、术中视野的满意度与B、C组相比，差异均有统计学意义（P〈0．05），而B、C两组间差异无统计学意义（P〉0．05）。A、B组的术后1～3d出血量和冲洗液量与C组相比差异均有统计学意义（P〈0．05），而A组与B组间差异无统计学意义（P〉0．05）。结论术前长期常规剂量应用非那雄胺可显著减少中重度BPH患者的TURP术中术后出血量。与术前短期大剂量非那雄胺用药相比，长期常规剂量用药明显有益于TURP，值得临床推广应用。     

山莨菪碱减少阿奇霉素不良反应的临床观察

目的观察山莨菪碱减少阿奇霉素不良反应的临床疗效。方法选择呼吸道感染患儿100例,随机分为观察组50例和对照组50例,两组均给予阿奇霉素静脉滴注,观察组给予阿奇霉素的同时加入山莨菪碱静脉滴注,对两组患者的不良反应进行比较分析。结果观察组患儿轻度、重度不良反应以及因不良反应停药的患儿均较对照组明显减少,总不良反应发生率相比较,差异有统计学意义(P<0.05)。结论山莨菪碱能够有效减少阿奇霉素静脉用药过程中的胃肠道不良反应,值得临床推广。     

Pharmacokinetics of sulpiride in humans after intravenous and intramuscular administrations.

The pharmacokinetics of sulpiride in plasma, red blood cells (RBC), and urine were investigated after administration of 100 mg by the iv route to 15 subjects and by the im route to 12 subjects. The concentrations of sulpiride in plasma, RBC, and urine were measured by HPLC. All the data were consistent with a two-compartment, open-body model. After iv administration, the mean +/- SD apparent elimination half-life of sulpiride was 6.47 +/- 1.00 h, and the mean +/- SD volume of distribution at steady state was 0.94 +/- 0.23 L/kg. Renal clearance (119.5 +/- 28.2 mL/min) was very close to total clearance (127.8 +/- 26.2 mL/min). In urine, the mean +/- SD recovery in form of the unchanged drug was 90.0 +/- 9.68% of the administered dose, and the excretion rate versus time showed an elimination half-life similar to that found in plasma. The values of all these parameters were very close to those obtained after im administration. The sulpiride partition coefficient between RBC and plasma did not show any significant change as a function of time and concentration, with a mean value +/- SD of 1.00 +/- 0.043, indicating that sulpiride is evenly distributed between RBC and plasma. The pharmacokinetic parameters determined from the plasma and the RBC data were similar.     

静脉留置针不同部位留置时间观察及护理

目的 了解静脉留置针穿刺的最佳部位及护理体会.方法 将120例患者随机分成五组,进行不同部位(手背静脉、肘正中静脉、头皮静脉、贵要静脉、大隐静脉等)静脉留置针穿刺并观察.观察项目包括平均穿刺时间、留置时间及留置针应用期间是否有皮下血肿、液体渗漏、导管堵塞、静脉炎、静脉血栓形成等.结果 经临床观察,血管弹性、穿刺时间、护理等方面均影响静脉留置针留置时间.其中头皮静脉固定不宜滑动、静脉回流好,留置针留置时间及并发症的发生与其他部位比较,差异均有统计学意义(P＜0.05).结论 留置针穿刺最好选在固定不易滑动的部位,如头皮静脉,静脉留置针置管期间应加强穿刺部位及留置针的护理,以延长留置针的使用时间及预防并发症的发生.     

Pharmacokinetics of valerenic acid in rats after intravenous and oral administrations

Valerenic acid (VA), a sesquiterpenoid, is one of the major secondary bioactive metabolites of VALERIANA OFFICINALIS L. Until now IN VIVO studies on the absorption, bioavailability, disposition, and metabolism of VA are limited. We established and validated an LC-MS/MS assay for the determination of VA in rat plasma and successfully used this method for pharmacokinetic studies in rats after intravenous (i. v.) and oral administrations. The plasma concentration-time data was analyzed by both non-compartmental and compartmental approaches using WinNonlin software. Following i. v. administration, the disposition of VA in rat plasma was biphasic, subdivided into a fast distribution and a slow elimination phase. The half-life of the distribution phase was 6-12 min, and that of the terminal elimination phase 6-46 h, indicating a possible large tissue binding. Disposition PK of valerenic acid after oral treatment was also described by a two-compartment model with a clearance (CL/F) of 2-5 L · h (-1) · kg (-1) and volume of distribution of (V (d)) 17-20 L · kg (-1). The extent of absorption (F) after oral administration was estimated to be 33.70 % with a half-life of 2.7-5 h. Dose proportionality was observed in terms of dose and AUCs, suggesting linear pharmacokinetics at the dose levels studied in rats.     

碳酸氢钠注射液中细菌内毒素的含量测定

目的:对碳酸氢钠注射液进行细菌内毒素检测,建立检测碳酸氢钠注射液细菌内毒素的实验方法。方法:采用2005年版中国药典细菌内毒素检查法,用盐酸对碳酸氢钠注射液的 pH 值进行调整,在 pH>7和 pH<7两种条件下,对样品进行4倍稀释,分别用凝胶法和动态浊度法对样品中的内毒素进行测定。结果:当样品的 pH>7时,凝胶法和动态浊度法均存在干扰,凝胶法为抑制,动态浊度法为增强;当样品的 pH<7时,凝胶法和动态浊度法均无干扰,实验方法成立。结论:用凝胶法和动态浊度法检测碳酸氢钠注射液中的细菌内毒素是可行的。动态浊度定量法较凝胶法具有方便、快捷、定量、可以观察动态反应过程、利于分析干扰情况等优势。     

Pharmacokinetics of huperzine A in dogs following single intravenous and oral administrations

The pharmacokinetics of huperzine A in dogs after single intravenous and oral administrations was investigated. Concentrations of huperzine A were determined by a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Pharmacokinetic parameters were calculated by non-compartmental methods. After single intravenous administration, the Cmax, T1/2, AUC0-t, AUC0-infinity, CL, Vd and Vss were 5.55 +/- 1.61 microg/L, 5.02 +/- 0.31 h, 16.04 +/- 5.24, 16.49 +/- 5.29 microgh/L, 0.66 +/- 0.19 L/h/kg, 4.76 +/- 1.46, and 3.93 +/- 1.54 L/kg, respectively. After single oral administration, the Cmax, Tmax, T1/2, AUC0-t, AUC0-infinity and oral bioavailability were 2.60 +/- 0.60 microg/L, 1.25 +/- 0.50 h, 5.71 +/- 2.25 h, 12.90 +/- 3.19, 13.78 +/- 3.24 microgh/L, and 94.4 +/- 36.5%, respectively. In conclusion, huperzine A had a rapid and nearly complete oral absorption and was extensively distributed into tissues after drug administration in dogs.     

Studies on the intravenous pharmacokinetics in rabbit and in vitro protein binding of two new salts of erythromycin: erythromycin maltobionate and erythromycin fumarate.

Pharmacokinetics in rabbits following intravenous administration and in vitro protein binding were studied for two new salts of erythromycin (erythromycin maltobionate and erythromycin fumarate). Serum erythromycin levels following intravenous injection were described by two compartment model kinetics, and values for the distribution volume of the central compartment, the peripheral compartment and overall distribution volume were calculated. The elimination half-lives of erythromycins in serum were 83 min, 168 min, and 103 min for erythromycin maltobionate, erythromycin fumarate, and erythromycin lactobionate (reference standard), respectively. The erythromycin salts were highly (c. 90 per cent) protein bound, but the binding was found to be reversible. Differences in the pharmacokinetic parameters after administration of equivalent doses of the salts, indicate possible variation in efficacies of different salts.