他汀类药物与其他药物联用的安全性评价

目的对门诊处方中他汀类药物与其他药物联用的安全性进行评价,以利临床合理用药。方法抽查门诊使用他汀类药物的处方,以药品说明书中的规定为标准,结合近年来公开发表的相关文献,分析他汀类药物与其他药物联用的安全性。结果他汀类药物与其他药物联用基本合理,没有发现联用CYP3A4抑制剂,但有5种CYP3A4底物和地高辛与他汀类药物联用,存在安全隐患。结论他汀类药物与其他药物联用时应注意观察,避免与CYP3A4抑制剂或其底物联用。     

他汀类药物多效药理作用及其机制研究进展

他汀类是临床上治疗高胆固醇血症主要药物, 广泛应用于冠心病一级及二级预防。近年来研究表明,他汀类药物还具有降脂外的多重作用,包括改善血管内皮功能、抗炎症、抗氧化作用、稳定动脉粥样硬化和抗肿瘤作用等。本文围绕他汀类药物对血管疾病和肿瘤的作用及机制展开综述。     

他汀类药物与慢性动脉炎性反应

<正>他汀类药物是近20年来发展起来的一类新型调脂药,已成为目前临床上应用最广泛的一类调脂药物。近年来多项研究结果表明,他汀类药物在影响血管内皮动脉粥样硬化进程中,不仅具有明确的降脂作用,而且具有独立的抗炎作用。来自多中心、随机、双盲等临床实验均证实了他汀类药物是高血压、冠心病及脑血管疾病的一、二级预防     

他汀类药物的临床合理应用

目的介绍近年来他汀类药物引发的不良反应及其药物动力学特性,探讨他汀类药物在临床上的应用及注意事项。方法收集与分析中国生物医学文献数据库及中国医院数字图书馆期刊全文库(2002年1月-2011年3月)相关文献,结合临床,进行综合分析及述评。结果他汀类药物应避免与抑制其代谢的药物合用,或选择无或很少相互作用的同类药物。结论随着适用人群的扩大,患者的临床情况千变万化,因此,须遵循个体化防治原则,选择更为理想的他汀类药物。     

我国他汀类药物申报现状与分析

目的:介绍他汀类药物在我国申报和批准状况,分析国内此类药物研发的特点,提出相关产品研发的思路与考虑。方法:通过回顾性分析方法,从国家食品药品监督管理局药品审评中心技术审评系统信息数据库中收录他汀类药物近年来申报受理及批准情况进行相关数据分析。结果:①我国近年来申报的他汀类药物占所有调脂药物的90.14%(640/710),是调脂类药物的主要申报事项;②国产他汀类品种的申报和批准以仿制为主,其次为仿制国外已上市产品和改剂型品种。国内仿制产品申报和批准多集中在辛伐他汀,分别占他汀药物总申报量和总批准量的47.98%(285/594)和46.57%(229/492);③申报和批准的新他汀类产品包括创新的他汀药物、新适应症、新复方制剂,此类申报以进口申报为主。结论:此类药物申报特点与国内药物研发总体趋势一致,此类药物的研发应更多关注创新,创新思路需结合该类药物的最新研究进展和临床需求等多方面因素综合考虑。     

降血脂药物应用及发展

高血脂会引起动脉粥样硬化,与高血压、冠心病、脑卒中及糖尿病密切相关。降血脂药物是近年来较为活跃的药物研发领域,而他汀类药物则是现今在药效、安全性方面均处于优势地位的一线降血脂药物,并且以他汀类药物为基础的药物联合应用也成为调脂药物的更丰富选择。本文对基于经典药物靶点和新颖作用机制的降血脂药物研发进行综述,以便对降血脂药物研究进行系统的了解。     

他汀类药物的临床应用

他汀类药物是3—羟基—3—甲基戊二酰辅酶A(HMG-CoA)还原酶抑制剂的总称。该类药物在国外的上市品种达20余个,国内主要有普伐他汀(Pravastatin)、洛伐他汀(Lovastatln)、辛伐他汀(Simvastatin)、氟伐他汀(Fluvastatin)、阿托伐他汀(Atorvastatin)、美伐他汀(mevastatin)等品种。近年的研究表明,该类药物除了具有显著的调脂疗     

他汀类调脂药在心脑血管疾病中的应用

他汀类药物是治疗高胆固醇血症的首选药物。目前常用的他汀类药物有:洛伐他汀,辛伐他汀,普伐他汀,氟伐他汀,阿托伐他汀等。此外,他汀类药物还具有抗氧化、抗炎症、抗血小板聚集、抗肿瘤、抑制血管增殖和调节免疫系统以及通过增加一氧化氮的生物合成改善内皮细胞功能等多种     

他汀类药物致横纹肌溶解症1例

他汀类调脂药物在临床应用上已20余年。大量循证证据表明,此类药物在心、脑血管疾病的一级及二级预防中占有重要地位。他汀类药物的调脂机制为竞争性抑制细胞内胆固醇合成过程中限速酶的活性,继而上调细胞表面低密度脂蛋白（LDL）受体,加速血浆LDL分解代谢;此外,还可抑制LDL的合成。近年研究显示,他汀类药物还具有调脂以外的作用,包括改善内皮功能、稳定及逆转动脉粥样斑块、减少血栓形成和改善动脉粥样硬化斑块处的炎症反应、增加一氧化氮的合成与分泌、抑制血小板聚集等作用。随着他汀类药物的广泛应用,我们在关注他汀类调脂药物疗效的同时,更应关注其安全性问题。     

他汀类药物的相互作用

目的介绍他汀类药物的相互作用,为临床合理用药提供参考。方法依据近年来公开发表的相关文献,综合、分析他汀类药物的相互作用。结果他汀类药物相互作用较多。结论应掌握他汀类药物的相互作用,合理使用他汀类药。     

胸苷酸合成酶和二氢叶酸还原酶双抑制剂的研究进展

胸苷酸合成酶和二氢叶酸还原酶在肿瘤、病菌的化学治疗中都是重要靶点,已有多种抑制剂应用于临床。近年来,随着对胸苷酸合成酶和二氢叶酸还原酶作用机制和抑制剂的耐药机制的不断阐明,人们设计和合成了一系列新的抑制剂,其中胸苷酸合成酶和二氢叶酸还原酶双抑制剂成为研究的热点之一。文中对胸苷酸合成酶和二氢叶酸还原酶抑制剂药物临床应用进行综述,并介绍胸苷酸合成酶和二氢叶酸还原酶双抑制剂的研究进展。     

The safety of anidulafungin

The echinocandins are a new class of antifungal that have shown promising results in treating a variety of fungal infections. Anidulafungin is the newest approved echinocandin and may have some advantages over existing antifungals. It has activity against a broad range of fungi. It is unique because it undergoes a process of slow chemical degradation rather than being metabolised. Studies evaluating the use of anidulafungin in combination with other commonly used drugs have not demonstrated any significant drug–drug interactions or adverse events. Thus far, anidulafungin appears to have an excellent safety profile with few adverse events. Based on early clinical experience, it appears that anidulafungin will be a valuable and safe asset in the management of serious and difficult-to-treat fungal infections.     

Pharmacotherapy of obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is a potentially devastating illness, both to the patient and family members. Its etiology is unclear, but some evidence points toward dysfunction in an orbitofrontal striatal-limbic neuronal loop. Although many agents have been used, clomipramine, a tricyclic antidepressant, appears to be the most promising therapy. Clomipramine was approved by the Food and Drug Administration and released for general use in early 1990 under the brand name Anafranil. Clomipramine's adverse effect profile is similar to that of currently marketed tricyclic antidepressants; however, it is associated with a higher frequency of seizures, estimated to be 0.7%. Although other serotonergic agents such as fluoxetine have shown promise in OCD, they have been studied only in a limited number of patients. Other agents, with the possible exception of monoamine oxidase inhibitors, either have resulted in inconsistent improvement or have been reported in an anecdotal fashion.     

彩色多谱勒超声诊断甲状腺肿块302例分析

目的 探讨超声在甲状腺肿块上的参考价值。方法 回顾性分析我院从1995年2月-2001年1月间,应用高分辨率超声诊断的302例甲状腺肿块的二维超声图象表现和彩色多谱勒特征,并与病理结果对照,结果 本组诊断符合率88.1%,误诊率11.9%。其中甲状腺腺瘤156例,结节性甲状腺肿81例,甲状腺癌42例,多源性病变23例,均误漏诊。结论 高频彩色多谱勒超声在甲状腺肿块的诊断方面具有重要的应用价值。但在鉴别良恶性方面尚无绝对可靠的指征,对多源性甲状腺病变及不典型肿物仅凭二维超声及彩色多谱勒作出定性诊断,尚有一定的局限性。     

Recent developments in the treatment of sepsis

Despite advances in supportive care, septic shock remains a major cause of morbidity and mortality. With the identification of the systemic inflammatory response as a major component in the pathogenesis of the septic shock syndrome, much of the recent work has focused on modulating this response. This includes antiendotoxin therapies in patients with Gram-negative sepsis, and therapies to modulate the pro-inflammatory mediators produced in response to infection, such as TNF-α, platelet-activating factor and complement. High-flow haemofiltration has the potential advantage of clearing both endotoxin and pro-inflammatory mediators. Antithrombotic strategies have been investigated and have yielded the first major success in the treatment of sepsis with activated protein C. Nitric oxide produces the cardiovascular features of sepsis and investigators have looked at both reducing its production and mopping up the excess. Attempts to reduce apoptosis have been a new focus in the treatment of sepsis. There have also been recent developments in supportive care suggesting a role for vasopressin and replacement corticosteroid therapy.     

Physico-chemical aspects of lactose for inhalation

A dry powder inhaler (DPI) is a dosage form that consists of a powder formulation in a device which is designed to deliver an active ingredient to the respiratory tract. It has been extensively investigated over the past years and several aspects relating to device and particulate delivery mechanisms have been the focal points for debate. DPI formulations may or may not contain carrier particles but whenever a carrier is included in a commercial formulation, it is almost invariably lactose monohydrate. Many physicochemical properties of the lactose carrier particles have been reported to affect the efficiency of a DPI. A number of preparation methods have been developed which have been claimed to produce lactose carriers with characteristics which lead to improved deposition. Alongside these developments, a number of characterization methods have been developed which have been reported to be useful in the measurement of key properties of the particulate ingredients. This review describes the various physicochemical characteristics of lactose, methods of manufacturing lactose particulates and their characterization.     

酮的心血管药理作用研究进展

天然多酚类化合物酮及其衍生物具有广泛的生物学和药理学活性。最近研究发现,酮在多种心血管疾病中发挥保护作用,其中包括:缺血性心脏病,动脉粥样硬化,高血压和血栓性疾病。酮的心血管保护作用机制主要涉及抗氧化,抗炎,保护血管内皮功能,抑制血小板聚集,抗凝血以及舒血管效应。     

手足口病1984例临床分析

目的了解昆明地区儿童手足口病的临床特点。方法对1984例手足口病患儿进行临床分析。结果手、足、口部病变均有,首发病变部位口腔,占24．24％;手或足者,占30．04％;手、足、口病变同时出现者658人,占33．17％。出现于臀部、肘、膝部者,占12．5％。发热占20．11％。发病以学龄前儿童为主,占95．71％,除幼托儿童、学生外,散居儿童（大部分是外来流动人口及农村患儿）占58．42％,明确接触史者,占53．68％。结论手足口病发病以学龄前儿童为主,以手、足、口、臀等部位发生丘疱疹为主要临床表现。     

Potential use of non-classical pathways for the transport of macromolecular drugs

Since an increasing number of drug delivery strategies utilising proteins and peptides exhibiting ‘non-classical’ transport activities have been proposed, studies have begun to establish underlying functional relationships between different vectors. These attempts to find common factors have been hampered by a lack of biophysical data for the various potential protein and peptide transporters, as well as by the structural and functional diversity of the group as a whole. We describe the various types of vectors being considered for use and the preliminary therapeutic successes that have been achieved. Additionally, the various models that have been proposed for non-classical import and export are outlined and discussed in relation to therapeutic delivery. Possible future developments are also discussed.