阿比多尔治疗病毒性疾病的应用及评估

自2019年新型冠状病毒(SARS-CoV-2)疫情暴发以来,针对抗病毒药物的研究持续不断。阿比多尔是一个主要用于抗流感的广谱抗病毒药物,SARS-CoV-2体外细胞试验的成功使其被临床所关注,并开始在新型冠状病毒肺炎(COVID-19)的治疗中进行试用。但由于对阿比多尔的药理作用机制、临床应用评价、药学监护缺乏系统了解,使得其临床使用受到一定限制。本文结合国内外相关文献及资料,从阿比多尔基本信息、治疗病毒性疾病的药理学基础、治疗病毒性疾病的应用及评估、药学监护等方面进行归纳总结,为阿比多尔更加安全、有效地用于COVID-19的治疗提供参考。     

新型冠状病毒肺炎合并肿瘤患者使用抗病毒药物的药学监护策略

摘要：为探讨治疗新型冠状病毒肺炎(COVID-19)的抗病毒药物在肿瘤患者中应用的药学监护策略,临床药师查阅相关文献资料,深度分析《新型冠状病毒感染的肺炎诊疗方案(试行第七版)》中推荐的抗病毒药物与抗肿瘤药物之间的药品不良反应(ADR)和药动学相互作用,提出了在COVID-19合并肿瘤患者中合理使用抗病毒药物的建议,旨在确保特殊人群的用药安全。     

新型冠状病毒肺炎患者抗病毒治疗的药学监护：基于试行第七版诊疗方案

合并基础疾病的新型冠状病毒肺炎患者用药较多,为尽可能减少药物间的相互作用、提升药物治疗效果、减少患者药物不良反应发生率,本文对国家卫生健康委员会《新型冠状病毒肺炎诊疗方案(试行第七版)》纳入的抗病毒药物与其他治疗药物之间可能存在的药物相互作用进行阐述,并提供药学监护建议,以期为临床合理用药提供建议。     

新型冠状病毒肺炎抗病毒药物的治疗现状

目的:探究新型冠状病毒肺炎抗病毒药物的治疗现状。方法:2019年12月开始,新型冠状病毒(以下简称2019-nCoV)感染引起的新型冠状病毒肺炎(COVID-19)病例在国内陆续被发现,并呈暴发趋势;2020年3月3日,国家卫生健康委员会发布的《新型冠状病毒肺炎诊疗方案(试行第7版)》中,治疗COVID-19患者的抗病毒药物主要有干扰素-α2b、洛匹那韦/利托那韦、利巴韦林、磷酸氯喹和阿比多尔。结果与结论:通过检索相关文献并结合现有临床治疗证据,评价与分析了抗病毒药物的治疗现状和优缺点,以及药学监护。     

长期口服抗肿瘤靶向药物患者合并使用抗新型冠状病毒药物的药学监护

摘要：《新型冠状病毒肺炎诊疗方案（试行第七版）》延续第六版,推荐5种抗新型冠状病毒（SARS-CoV-2）的药物,同时强调药物毒性反应、相互作用的警示,关注特殊患者群抗病毒药物的选择。肿瘤患者是具有高感染率、高死亡率的特殊患者群,选择抗病毒药物应慎重,以期获得高效低毒的治疗效果。本文根据小分子口服肿瘤靶向药物的临床应用与毒性特点,结合肿瘤患者病理、生理特征,参考抗病毒药物临床及基础研究的相关文献数据,对长期口服靶向药物肿瘤患者的抗病毒药物选择进行了分析与探讨。以期为临床肿瘤患者抗病毒药物的选择提供参考。     

新型冠状病毒肺炎及常见合并症药物治疗与药学监护指引

2020年3月3日,国家卫生健康委员会发布《新型冠状病毒肺炎诊疗方案(试行第七版)》,提出抗病毒药物治疗方案、中医中药治疗方案及免疫治疗等。临床一线专业人员如何依据患者的病理、生理状况和药物的药理特性选择药物以及治疗中需要监测的指标,亟需明确和权威的学术支持。为此,中国药师协会治疗药物监测药师分会等11个学术团体联合编写了"新型冠状病毒肺炎及常见合并症药物治疗与药学监护指引",期望为一线医师、药师和护士提供参考。     

ACE2与新型冠状病毒肺炎的心肾损伤

由新型冠状病毒(Severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)感染引起的新型冠状病毒肺炎(Coronavirus disease 2019,COVID-19)不仅可以诱发典型的呼吸系统疾病,也能导致心肾系统等相关疾病。SARS-CoV-2的受体为血管紧张素转换酶2(Angiotensin-converting enzyme 2,ACE2)。本文通过阐述ACE2在心脏和肾脏中的作用,分析SARS-CoV-2感染引起患者心肾损伤的可能机制,为临床治疗COVID-19及研发抗SARS-CoV-2药物提供参考依据。     

抗病毒药物在新型冠状病毒肺炎治疗中的合理使用与药学监护

在抗击新型冠状病毒肺炎（COVID-19）疫情的关键时期,国家连续颁布了7版诊疗方案,每一新版诊疗方案对治疗药物都有补充、完善。α-干扰素、磷酸氯喹、阿比多尔、洛匹那韦/利托那韦、利巴韦林等抗病毒药物得到了临床专家的广泛认可与推荐。本文从药物不良反应、药物禁忌、药物相互作用、注意事项等多个方面对《新型冠状病毒肺炎诊疗方案（试行第七版）》涉及的抗病毒药物进行归纳与总结,对抗病毒药物的合理使用与药学监护提出建议,旨在为临床治疗药物选择提供参考,提高药物治疗效果。     

氯喹抗病毒作用证据基础和治疗新型冠状病毒肺炎的应用前景

摘要：从经典抗疟药到自身免疫疾病治疗用药,又在抗肿瘤方面有新发现,氯喹不断在新的临床试验中增加新适应证,展现老药新用的价值。最近多篇报道氯喹在体外研究和临床疗效观察中具有治疗新型冠状病毒肺炎(COVID-19)的潜力,并已纳入《新型冠状病毒感染的肺炎诊疗方案(试行第六版、第七版)》中。为了后续临床应用和抗病毒科学研究,本文就氯喹的抗病毒证据基础进行总结,从该药物的抗病毒机制、体内外抗病毒实验、临床试验、药动学、不良反应和药学监护等方面作全面概述,为临床一线工作者和科研人员提供参考。     

抗新型冠状病毒药物的研究进展

新型冠状病毒肺炎(Coronavirus disease 2019,COVID-19)具有很强的传染性和很高的致病率.目前,对于新型冠状病毒(Severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)尚没有特异性的抗病毒药物,临床上根据以往抗冠状病毒用药经验以...     

洛匹那韦/利托那韦抗新型冠状病毒治疗的可行性及临床评价

目的 评价洛匹那韦/利托那韦抗新型冠状病毒治疗的应用可行性、临床效果及安全性。方法 最近在中国暴发的新型冠状病毒肺炎(简称新冠肺炎)疫情,目前尚无针对性强的抗病毒药物,临床尝试"老药新用",以2003年严重急性呼吸综合征(SARS)和2012年中东呼吸综合征(MERS)疫情中使用的一线抗病毒药物洛匹那韦/利托那韦来抗新型冠状病毒治疗。分析该药的抗病毒药理作用、临床应用可行性,评价其临床应用效果和安全性。结果 洛匹那韦/利托那韦治疗冠状病毒感染性疾病有一定临床基础,可重建宿主的免疫功能,抗新型冠状病毒有一定疗效,但有较高的耐药屏障。结论 洛匹那韦/利托那韦用于抗新型冠状病毒治疗可行,临床疗效较好,但应用期间要加强药学监护,尤其是合并用药和特殊人群应用时,注重安全、合理用药。     

新型冠状病毒肺炎治疗药物研发现状

目的 探讨新型冠状病毒肺炎(简称新冠肺炎)治疗药物研发现状、成效和存在的问题,并提出改进建议。方法 以国家卫生健康委员会《新型冠状病毒肺炎诊疗方案》中药物治疗的演变为切入点,结合临床治疗现状,总结各种治疗新型冠状病毒感染药物的特点,分析新冠肺炎疫情暴发以来登记注册拟开展的药物临床试验研究情况及存在的问题。结果 对于新冠肺炎,目前尚无特效抗病毒治疗方法,国家卫生健康委员会《新型冠状病毒肺炎诊疗方案》中所推荐的药物治疗也是基于突发疫情条件下的试用建议,且需严格监控。针对新冠肺炎疫情下登记注册拟开展的药物临床试验项目整体上普遍存在立题依据、研究基础和研究条件不充分,缺乏必要的临床前试验数据和质量保证体系等问题。结论 针对新冠肺炎,药物选择都是基于既往的严重急性呼吸综合征(SARS)、中东呼吸综合征(MERS)或其他新型流感病毒的治疗经验,积极的对症支持治疗仍是治疗的关键。针对新型冠状病毒的新药研发应回归到认真做好基于药物作用靶点、作用机制的活性筛选的基础工作。     

Review of Emerging Pharmacotherapy for the Treatment of Coronavirus Disease 2019

The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has evolved into an emergent global pandemic. Coronavirus disease 2019 (COVID-19) can manifest on a spectrum of illness from mild disease to severe respiratory failure requiring intensive care unit admission. As the incidence continues to rise at a rapid pace, critical care teams are faced with challenging treatment decisions. There is currently no widely accepted standard of care in the pharmacologic management of patients with COVID-19. Urgent identification of potential treatment strategies is a priority. Therapies include novel agents available in clinical trials or through compassionate use, and other drugs, repurposed antiviral and immunomodulating therapies. Many have demonstrated in vitro or in vivo potential against other viruses that are similar to SARS-CoV-2. Critically ill patients with COVID-19 have additional considerations related to adjustments for organ impairment and renal replacement therapies, complex lists of concurrent medications, limitations with drug administration and compatibility, and unique toxicities that should be evaluated when utilizing these therapies. The purpose of this review is to summarize practical considerations for pharmacotherapy in patients with COVID-19, with the intent of serving as a resource for health care providers at the forefront of clinical care during this pandemic.     

Drugs Used in the Treatment of Multiple Sclerosis During COVID-19 Pandemic: A Critical Viewpoint

Since COVID-19 has emerged as a word public health problem, attention has been focused on how immune-suppressive drugs used for the treatment of autoimmune disorders influence the risk for SARS-CoV-2 infection and the development of acute respiratory distress syndrome (ARDS). Here, we discuss the disease-modifying agents approved for the treatment of multiple sclerosis (MS) within this context. Interferon (IFN)-β1a and -1b, which display antiviral activity, could be protective in the early stage of COVID-19 infection, although SARS-CoV-2 may have developed resistance to IFNs. However, in the hyperinflammation stage, IFNs may become detrimental by facilitating macrophage invasion in the lung and other organs. Glatiramer acetate and its analogues should not interfere with the development of COVID-19 and may be considered safe. Teriflunomide, a first-line oral drug used in the treatment of relapsing-remitting MS (RRMS), may display antiviral activity by depleting cellular nucleotides necessary for viral replication. The other first-line drug, dimethyl fumarate, may afford protection against SARS-CoV-2 by activating the Nrf-2 pathway and reinforcing the cellular defenses against oxidative stress. Concern has been raised regarding the use of second-line treatments for MS during the COVID-19 pandemic. However, this concern is not always justified. For example, fingolimod might be highly beneficial during the hyperinflammatory stage of COVID-19 for a number of mechanisms, including the reinforcement of the endothelial barrier. Caution is suggested for the use of natalizumab, cladribine, alemtuzumab, and ocrelizumab, although MS disease recurrence after discontinuation of these drugs may overcome a potential risk for COVID-19 infection.     

Baricitinib,a drug with potential effect to prevent SARS-COV-2 from entering target cells and control cytokine storm induced by COVID-19

In December 2019, a novel coronavirus pneumonia (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) suddenly broke out in China and rapidly spread all over the world. Recently, a cell surface protein, known as angiotensin-converting enzyme II (ACE2), has been identified to be involved in receptor-mediated endocytosis for SARS-CoV-2 entry to the cells. Many studies have reported the clinical characteristics of COVID-19: sudden deterioration of disease around 1–2 weeks after onset; much lower level of lymphocytes, especially natural killer (NK) cells in peripheral blood; extremely high pro-inflammatory cytokines and C reactive protein (CRP). About 15.7% of patients develop severe pneumonia, and cytokine storm is an important factor leading to rapid disease progression. Currently, there are no specific drugs for COVID-19 and the cytokine storm it causes. Baricitinib intracellularly inhibits the proinflammatory signal of several cytokines by suppressing Janus kinase (JAK) JAK1/JAK2. It has been demonstrated clinical benefits for the patients with rheumatoid arthritis (RA), active systemic lupus erythematosus and atopic dermatitis with good efficacy and safety records. Baricitinib is expected to interrupt the passage and intracellular assembly of SARS-CoV-2 into the target cells mediated by ACE2 receptor, and treat cytokine storm caused by COVID-19. Several clinical trials are currently investigating the drug, and one of which has been completed with encouraging results. In this paper, we will elaborate the role of cytokine storm mediated by JAK-STAT pathway in severe COVID-19, the possible mechanisms of baricitinib on reducing the viral entry into the target cells and cytokine storm, the key points of pharmaceutical care based on the latest research reports, clinical trials progress and drug instruction from the US FDA, so as to provide reference for the treatment of severe COVID-19.     

儿童新型冠状病毒肺炎药物治疗研究进展

新型冠状病毒(severe acute respiratory syndrome corona virus,SARS-CoV)-2感染在全球暴发,目前尚无明确有效的抗病毒药物治疗SARS-CoV-2感染.结合以往临床一线治疗新型冠状病毒肺炎(corona virus disease 2019,COVID-19)的经验,...     

新型冠状病毒肺炎合并基础疾病患者抗病毒药物使用的药学监护策略

新型冠状病毒肺炎（COVID-19）在全球暴发，已对人民的身体健康及生命安全造成了严重威胁。合并基础疾病患者易重症化，在抗病毒治疗过程中，存在加重原有疾病、发生药物相互作用及出现药物不良反应等风险，因此非常有必要结合各类基础疾病特点提供个体化的药学监护。本文综合分析COVID-19抗病毒药物在不同基础疾病中的用药风险，总结了合并用药的相互作用及可能的不良反应，为伴随心血管疾病、慢性阻塞性肺病、器官移植、艾滋病及细菌真菌感染的COVID-19患者制定了药学监护策略，旨在提高COVID-19患者治疗方案的安全、合理及有效性。     

法匹拉韦治疗新冠肺炎临床研究进展

新型冠状病毒肺炎(COVID-19)疫情在全球大流行,临床上迫切需要特异性抗病毒治疗药物.对已批准上市或正在临床开发的药物开展重定位研究是针对突发疫情快速寻找潜在治疗药物最为快速和高效的策略.法匹拉韦是一种广谱抗RNA病毒药物,在日本和中国已批准上市用于治疗流感,其作为抗新型冠状病毒感染的潜在药物,全球多个国家正在开展...