我院药物不良反应调查分析

目的了解药物不良反应（ADR）的发生与药物的关系,促进合理用药。方法对收集的2006年1月至2007年12月药物不良反应报告进行综合分析。结果抗微生物药和循环系统用药是引起ADR高发的药物种类。结论ADR的发生率与抗微生物药的滥用有关,临床医师应合理使用,以减少ADR的产生,     

2011年赣州市药品不良反应监测报告分析

目的分析我市药品不良反应报告情况,为临床合理用药提供科学依据。方法对我市2011年上报江西省药品不良反应监测平台的2429例不良反应病例进行回顾性研究分析。结果药品不良反应涉及的药品以抗微生物药物最多;不同给药途径中以静脉给药引起的不良反应最多见。结论应高度重视不良反应监测与上报工作,加强合理用药、特别是抗微生物药物的合理用药教育,慎用静脉注射剂,减少和避免不良反应的发生。     

重庆市2010年至2011年基本药物不良反应分析

目的了解重庆市基本药物不良反应发生情况及特点,为临床合理用药提供依据。方法对重庆市2010年至2011年发生的基本药物不良反应报告进行回顾性分析。结果基本药物不良反应报告的上报主体是医生,来源主体是医疗机构;引起不良反应的药品以抗微生物药物最多;给药途径以注射剂静脉滴注最常见;药品不良反应累及器官系统以皮肤及其附件最多见。结论应加强合理用药宣传,提高药品不良反应监测水平及报告质量,保障患者用药安全。     

抗微生物药物不良反应报告分析

目的 分析福建省抗微生物药物不良反应的发生情况,为临床合理用药提供参考.方法 结合EXcel电子表格和手工筛选,按患者性别、年龄、药物类别、ADR临床表现类型、给药途径、处理结果等进行统计分析.结果 抗微生物药物静脉注射给药产生不良反应最多,不良反应主要表现为皮肤及其附件损害、全身性损害和胃肠道损害.结论 加强不良反应监测,促进抗微生物药物的合理应用,减少严重事件的重复发生,保障公众用药安全合理.     

药物不良反应与合理用药——抗微生物药物不良反应报告分析

目的分析福建省抗微生物药物不良反应的发生情况．为临床合理用药提供参考。方法结合EXcel电子表格和手工筛选，按患者性别、年龄、药物类别、ADR临床表现类型、给药途径、处理结果等进行统计分析。结果抗微生物药物静脉注射给药产生不良反应最多，不良反应主要表现为皮肤及其附件损害、全身性损害和胃肠道损害。结论加强不良反应监测，促进抗微生物药物的合理应用．减少严重事件的重复发生，保障公众用药安全合理。     

659例抗微生物药物不良反应报告回顾性分析

目的：了解我院抗微生物药不良反应的情况,为临床合理用药提供参考。方法：回顾性分析我院2004～2008年的抗微生物药物不良反应报告。结果：659例药品不良反应（ADR）报告中,以头孢菌素类药发生例数最多（35．51％）,其次为喹诺酮类（25．34％）和青霉素类（19．73％）;ADR的给药途径主要是静脉给药（88．01％）;涉及的系统器官主要为皮肤及附件（53．87％）。结论：抗微生物药不良反应的发生与药物类型、给药途径、用药频率等密切相关,应提高医护人员对ADR的警惕性和不良反应监测水平,加强对抗微生物药物不良反应的监测,预防和及时报告ADR,以保证用药安全性和合理性。     

769例儿童静脉给药致药物不良反应报告分析

目的：探讨儿童静脉用药发生药物不良反应（ADR）的特点,指导临床合理用药。方法：对我院2006～2008年收集到的769例静脉给药ADR报告,建立数据库并进行统计分析。结果：10岁以下儿童发生不良反应较多;药物中以抗微生物药物所致不良反应较多,ADR临床表现以皮肤损害为主。结论：应注意儿童ADR相关因素,重视合理用药,防止ADR的发生。     

1430例药品不良反应报告分析

目的探讨发生药物不良反应的因素,促进合理用药。方法根据2006年丽水市ADR监测中心收集的1430份报告表,按患者性别、年龄、引起ADR的药物、ADR临床表现类型、给药途径、处理结果等进行统计。结果药物不良反应的发生与患者年龄、药物种类、给药途径等有关,不良反应涉及的药品以抗微生物药最多,以静脉给药为主,不良反应累及的系统以皮肤及其附件的损害最多见。结论应加强药物的合理使用及监测,减少药物不良反应的发生。     

我院药物不良反应分析报告

目的：分析我院药物引起的不良反应（ADR）,为临床安全合理用药提供警示。方法：对105例药物不良反应报告进行分析评价。结果：抗微生物药的ADR发生率最高,有69例,占65.71%,其次为中药制剂20例,占19.05%。ADR可累及全身各系统,其临床表现以皮肤系统损害最为常见,有74例,占70.48%。结论：临床应加强抗微生物药、中药制剂等重点监测,尤应注意联合用药的配伍禁忌,重视药品的合理应用,避免和减少不良反应的发生,以保证患者用药安全。     

2009年玉溪市药品不良反应报告分析

目的 探讨药品不良反应发生的各种因素,促进临床合理用药.方法 对我市2009年收到的503份ADR报告进行回顾性统计分析.结果 引起药品不良反应的药物主要是抗微生物药,临床表现以皮肤损伤为主,以静脉滴注引起的不良反应最多.结论 应重视药品不良反应,科学合理用药,确保患者用药安全有效.     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Comparison of in vitro cell models in predicting in vivo brain entry of drugs

Although several in vitro models have been reported to predict the ability of drug candidates to cross the blood-brain barrier, their real in vivo relevance has rarely been evaluated. The present study demonstrates the in vivo relevance of simple unidirectional permeability coefficient (P(app)) determined in three in vitro cell models (BBMEC, Caco-2 and MDCKII-MDR1) for nine model drugs (alprenolol, atenolol, metoprolol, pindolol, entacapone, tolcapone, baclofen, midazolam and ondansetron) by using dual probe microdialysis in the rat brain and blood as an in vivo measure. There was a clear correlation between the P(app) and the unbound brain/blood ratios determined by in vivo microdialysis (BBMEC r=0.99, Caco-2 r=0.91 and MDCKII-MDR1 r=0.85). Despite of the substantial differences in the absolute in vitro P(app) values and regardless of the method used (side-by-side vs. filter insert system), the capability of the in vitro models to rank order drugs was similar. By this approach, thus, the additional value offered by the true endothelial cell model (BBMEC) remains obscure. The present results also highlight the need of both in vitro as well as in vivo methods in characterization of blood-brain barrier passage of new drug candidates.