优化医疗机构药品不良反应监测与报告体系及其运作机制的探讨

完善医疗机构药品不良反应监测与报告体系及其运作机制。方法 :对我国当前医疗机构药品不良反应的现状进行分析。结果与结论 :我国医疗机构现有的药品不良反应报告和监测体系极不完善 ,必须进行优化。     

我院完善药品不良反应监测与报告体系的实践与体会

目的:为医疗机构建立并完善药品不良反应监测与报告体系提供借鉴。方法:解析我院药品不良反应监测与报告体系的结构与流程、各组成部分的作用以及确保其正常运行的措施。结果:通过建立并完善药品不良反应监测与报告体系,促进了医院相关工作的进步。结论:医疗机构完善药品不良反应监测与报告体系对保证合理用药意义重大。     

医疗机构药品不良反应监测工作现状的思考

目的 分析医疗机构药品不良反应监测工作现状及监测工作中存在的难点问题,为促进药品不良反应监测工作提供参考。方法 对哈尔滨市医疗机构药品不良反应监测工作现状进行综合分析。结果 及结论 医疗机构ADR监测体系建设、报告质量、报告时限、报告类型存在不足,应充分重视ADR监测工作,提高相关医务人员的监测水平和素质,完善医疗机构药品不良反应监测体系。     

瑞典医疗机构不良反应报告和监测研究

目的:探索研究瑞典医疗机构不良反应报告和监测的组织体系、法律依据、药物警戒系统特点,为我国开展医疗机构不良反应报告和监测工作提供参考.方法:根据瑞典药品管理局网站发布的法律法规文件、年度报告、工作信息,以及相关文献,对瑞典医疗机构药物警戒体系各要素进行分析.结果:瑞典在医疗机构报告和监测工作方面开展了诸多工作,建立了较...     

浅议加强基层药品不良反应监测体系建设的必要性

目的为加强基层药品不良反应监测体系建设提供参考。方法就目前基层药品不良反应监测体系建设中存在的问题及对药品不良反应监测工作产生的影响进行分析。结果与结论必须加强基层药品不良反应监测体系建设,逐步形成国家、省、市、县4级技术监测网络体系,完善药品生产、经营单位和医疗机构药品不良反应监测机构,才能有效保证药品不良反应监测工作深入开展。     

不可忽视县以下医院药品不良反应的监测工作

药物不良反应,是指药物在正常使用情况下出现的与用药目的无关的、对人体有害的反应.加强药物不良反应的监测工作,对保证广大人民群众用药安全有重要意义.我国新修订的<药品管理法>明确规定国家实行药品不良反应报告制度,发现可能与用药有关的严重不良反应必须及时报告,药品不良反应报告的主体是生产企业、药品经营企业和医疗机构.可见,开展药品不良反应的监测和报告工作,是医疗机构的一项法定工作任务,绝非可有可无.     

增加激励和约束机制,提高药品不良反应监测水平

近5年来,我国药品不良反应报告和监测工作不断加强,促进药品监管工作走上了可持续发展轨道.<药品不良反应报告和监测管理办法>明确了药品生产、经营企业、医疗机构的药品不良反应报告和监测职责,进一步完善了我国的药品不良反应报告和监测制度.在此基础上,各级药品监管部门牵头组织,建立了各级各类药品不良反应报告和监测工作机构,形成了药品不良反应报告和监测网络,药品不良反应报告和监测质量明显提高.笔者是基层药品不良反应监管人员,对此深有感触.但同时也感到,我们目前的药品不良反应报告和监测不论在质量上、数量上、应用上,同发达国家相比,与合理用药的需要相比,还有很大差距.     

黑龙江省垦区药品不良反应监测现状调查研究

目的初步探讨改善垦区药品不良反应监测工作现状的干预措施。方法采用文献研究、问卷调查的方法对垦区范围内医疗机构2010～2012年问药品不良反应监测数据进行统计分析。结果从中发现垦区在药品不良反应管理部门体制,对医务人员的业务培训,以及医疗机构药品不良反应监测部门建设等方面存在一些问题。结论垦区药品不良反应监测能力水平有待进一步提高,应进一步完善药品的不良反应监测管理部门,构建医疗机构药品不良反应监测体系,创新药品不良反应宣传培训方式。     

医疗机构如何做好药品不良反应监测工作

2011年5月4日,新修订的《药品不良反应报告和监测管理办法:》正式颁布.新《办法》对药品不良反应的报告主体之一的医疗机构的职责进行了明确规定.本文旨在结合新《办法》,探讨医疗机构在现今新的药品不良反应监测形式下如何做好监测工作.     

乡镇卫生院开展药品不良反应监测工作存在问题与对策

以本院为例,探讨乡镇医疗机构开展药品不良反应监测工作中遇到的困难,为加强乡镇医疗机构药品不良反应（ADR）监测体系建设提出对策。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.