临床药师参与临床抗感染治疗典型案例的合理用药分析

目的:分析临床药师参与临床抗感染治疗的典型案例的合理用药,为临床药师更好地参与临床合理用药提供参考。方法:精选临床药师参与查房、会诊中的典型病例资料,分析其临床抗感染治疗方案中的合理用药。结果:临床药师在抗菌药物的选用、多重耐药菌的诊治、用药期间药物不良反应等方面提出的建议,提高了临床抗感染治疗效果。结论:临床药师深入临床积极参与临床查房诊治,及时提出用药建议,促进了抗菌药物的合理使用。     

临床药师参与临床抗感染治疗会诊的实践与体会

目的:分析临床药师参与临床抗感染用药会诊病例的特点,探究其参与临床会诊工作的切入点和药学监护.方法:临床药师从多方面切入参与抗感染病例会诊,提出给药建议(如解读药敏报告、判断污染菌和定植菌、根据抗菌药物PK/PD特点优化给药方案和特殊人群的用药方案)以及治疗过程中药物不良反应的判断和处置.结果:临床药师基于药学专业知识参与制订抗感染治疗方案并实施用药监护,协助临床医师正确解读药敏报告,提高了抗感染治疗的成功率.结论:临床药师参与抗感染用药的临床会诊,得到临床医生的认可和患者的赞誉,促进了临床合理用药,减少了不良反应的发生.     

临床药师参与制定抗感染治疗方案典型病例分析

目的总结临床药师会诊参与制定抗感染治疗方案的经验。方法查阅临床药师参与抗感染治疗病例会诊记录及临床治疗效果跟踪记录。结果重点讨论3个病例,治疗效果良好。结论临床药师参与制定抗感染治疗用药方案,确保抗菌药物的合理应用,有助于提高合理用药水平,应坚持开展此项工作。     

临床药师参与抗感染治疗的实践与体会

目的:介绍临床药师参与临床抗感染治疗的工作体会.方法:精选临床药师查房、会诊的典型病例,对抗感染治疗进行分析和总结.结果:临床药师在用药指征、药敏报告解读、药物选择、多重耐药菌诊治等方面发挥了较好的作用.结论:临床药师参与临床抗感染治疗,提高了治疗效果,促进了抗菌药物的合理使用.     

临床药师参与术后感染病例的药学会诊实践与体会

目的:总结本院药师在术后感染会诊方面的实践经验和体会,供临床药学工作者参考。方法:结合本院临床药师参与会诊的典型术后感染病例,分析术后感染的及时诊断、个体化的抗菌药物应用和疾病的转归,总结术后感染药师会诊的经验。结果:判断术后发热是否是感染性发热,是药学会诊的关键点和难点;早期准确的判断感染部位,是药学会诊经验性用药的重要依据;及时评价术后感染程度、调整治疗方案,是降低死亡率的重要措施;临床药师应结合患者的具体情况,制订个体化抗感染治疗方案;掌握药品的特点,监测患者相关指标的动态变化,关注患者的用药安全,制订个体化药学监护计划。结论:复杂的术后感染要及时地控制,不仅需要对致病菌正确的判断和合理的应用抗菌药物,还需要对患者术中及术后病情变化正确的分析、判断和评估,在个体化的药学监护下应用安全、有效、合理的抗菌方案。     

临床药师参与临床抗感染治疗典型案例分析与体会

目的:介绍临床药师参与临床抗感染治疗的典型案例体会,以便为临床药师更好地参与临床合理用提供参考。方法:通过临床药师参与抗感染治疗方案制订取得的效果,精选临床药师查房会诊中遇到的典型病例进行分析和总结。结果:临床药师参与临床在抗菌药物的选择、剂量、疗程、不良反应等方面提出了合理建议,取得明显效果。结论:临床药师参与临床抗感染治疗方案的制订,提高临床抗感染治疗的效果,确保抗感染药物的合理使用起着极大的推动作用。     

临床药师参与抗感染治疗的实践与体会

目的介绍我院临床药师参与临床抗感染治疗的工作体会。方法对临床药师会诊参与抗感染方案制定的个别病例进行叙述和分析。结果临床药师参与抗感染方案的制定,促进了抗菌药物的合理使用。结论临床药师可以促进合理用药,减少药品不良反应和药源性疾病的危害,能够成为临床治疗团队的一员。     

临床药师参与抗感染药物治疗方法探索

目的探索临床药师参与抗感染药物临床应用会诊的方式与方法。方法对临床药师参与抗感染药物治疗案例的经验进行总结。结果通过总结,得出药师可通过掌握多重耐药菌用药知识,形成自已的经验处方,与细菌培养室建立合作关系等方法参与抗感染药物的治疗。结论临床药师参与抗感染药物使用,可保证抗菌药物的合理应用。     

临床药师参与疑难病例抗感染治疗的典型案例分析及其药学监护

目的:分析临床药师参与疑难病例抗感染治疗的典型案例及其药学监护过程,为其今后参与临床合理用药提供参考。方法:临床药师参与临床查房、病例讨论及会诊时,分析疑难病例合理用药和药学监护过程,对典型案例的用药提出合理建议。结果:临床药师参与疑难病例的治疗在抗菌药物品种的选择、用法用量的调整、多重耐药菌的防治、药品不良反应的监测以及用药教育等方面都发挥了重要的作用,取得了明显的效果。结论:临床药师深入临床,积极参与查房,及时提出用药建议及用药教育和参与临床个体化治疗方案的制订,促进了临床合理用药。     

抗感染临床药师参与临床治疗的实践及体会

目的:介绍我院临床药师参与抗感染治疗的实践与体会.方法:精选临床药师查房、会诊的典型病例,对其干预的治疗建议进行分析和总结.结果:临床药师在抗菌药物选择、用药剂量调整、多重耐药菌诊治、药物不良反应等方面发挥了重要作用.结论:临床药师参与抗感染治疗查房与会诊,充分发挥药师的作用,有效提高了药学的影响力,值得推广.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.