8例替加环素致低钙血症不良反应分析

目的 提高临床使用替加环素的安全性.方法 借助于某三甲医院2018年7月1日至2019年6月30日不良反应主动监测软件筛选使用替加环素发生低钙血症的患者,结合电子病历和药品不良反应判定标准对数据进行分析.结果 使用替加环素与发生低钙血症相关.结论 建议临床使用替加环素时,应加强对血钙的监测.     

犬无束缚静脉输注给药的实现

目的建立犬无束缚静脉给药方法。方法将犬无束缚静脉给药装置(背心,输液保护套管,套管连接构件,精密微量输液监控器)组装,然后将该装置与埋植好留置针的犬连接,建立完整的输液通路给药开始。结果成功建立了犬无束缚静脉给药方法。结论设计合理、动物穿着舒适的给药装置,是犬无束缚静脉给药成败的关键因素。     

膦甲酸钠注射液与4种大输液的配伍稳定性考察

目的:考察膦甲酸钠注射液与5%葡萄糖注射液、10%葡萄糖注射液、葡萄糖氯化钠注射液、氯化钠注射液的配伍稳定性。方法:采用紫外分光光度法测定膦甲酸钠注射液与4种大输液在室温下配伍后8h内不同时间的含量变化,并观察溶液外观性状及测定pH值与膦甲酸钠紫外吸收光谱的变化。结果:配伍液的含量、外观、pH值及紫外光谱均无明显变化。结论:膦甲酸钠注射液与4种大输液在常温下8h内可配伍使用。     

Localization of Thermogenesis Induced by Single Infusion of Ephedrine in Dog

The localization of the thermogenic effect of ephedrine (1 mg · kg^-1 infused intravenously over 10 min.) was studied in 6 fasted dogs anaesthetized with etorfin-acepromazin-N₂O. Three experiments were performed in each animal to determine the effect of ephedrine on a) splanchnic oxygen uptake, b) lower leg oxygen uptake and c) the work of the heart. In all experiments whole body oxygen uptake was monitored. Following ephedrine administration the following significant changes were seen as whole body oxygen uptake increased 16%, and splanchnic and lower leg oxygen uptakes increased respectively from 38.4 to 42.3 and from 7.3 to 12.1% of the whole body control oxygen uptake. The pressure-volume work of the heart more than doubled. Significant changes were also seen in mean arterial blood pressure, pulse rate, cardiac output, splanchnic blood flow, and haematocrit and haemoglobin concentration. Plasma glycerol and free fatty acid concentrations increased after ephedrine, and the effects were not elicited by circulating catecholamines.     

输液所致静脉炎的药物原因分析

目的 输液带来的静脉炎等问题是护理工作的难点,药物的渗透压、pH值、刺激性、毒性及输注速度是导致输液性静脉炎的重要原因.文献报道可致输液性静脉炎的药物有多种.     

输液所致静脉炎的药物原因分析

目的输液带来的静脉炎等问题是护理工作的难点,药物的渗透压、pH值、刺激性、毒性及输注速度是导致输液性静脉炎的重要原因。文献报道可致输液性静脉炎的药物有多种。     

Mechanisms of Pulmonary Edema Induced by an Organophosphorus Compound in Anesthetized Dogs

Mechanisms of Pulmonary Edema Induced by an OrganophosphorusCompound in Anesthetized Dogs. LAINEE, P., ROBINEAU, P., GUNTIN,P., COQ, H., AND BENCHETRIT, G. (1991). Fundam. Appl. Toxtcol.17, 177-185. To determine the mechanism governing pulmonaryedema induced by an organophosphorus compound, 5-{2-diisopropylaminoethyl)-O-ethvlmethylphos-phonothiolate (VX), lung lymph flow and lymph-to-plasmaprotein concentration ratio were measured in six anesthetized,open-chest, mechanically ventilated beagle dogs before and afterintravenous injection of 6µg/kg of VX. Systemic and pulmonaryhemodynamic data (heart rate, aortic blood flow, and left atrial,systemic arterial, pulmonary arterial, and pulmonary capillarypressures) were continuously recorded. Arterial blood gasesand pH were measured every 30 min. Histological examinationsand lung water content measurements were also carried out. FollowingVX injection, lung lymph flow increased (from 109 ± 38to 179 ± 66 jil/min, p < 0.05) while lymph-to-plasmaprotein concentration ratio remained unchanged (from 0.64 ±0.14 to 0.62 ± 0.12, N.S.). Neither systemic nor pulmonaryhemodynamics were changed. Lung water content expressed as blood-freewet-to-dry weight ratio increased from 4.31 ± 0.23 to5.35 ± 0.26 (p < 0.05). Histological examinationsrevealed in many cases diffUse congestion of lungs and interstitialedema. These results suggest that VX injection induces an increasein pulmonary capillary permeability which may lead to a high-permeabilityedema.     

非拉尼特对犬冠状动脉结扎心肌缺血的影响

目的 观察非拉尼特对犬冠状动脉结扎造成心肌梗死模型的治疗作用. 方法 杂种犬30只随机分为5组,每组6只. 阳性对照组给予硝酸异山梨酯溶液,fl1、fl3和fl5组分别给予0.9%氯化钠溶液配制非拉尼特溶液1,3,5 mg.mL^-1,模型组给予等体积0.9%氯化钠溶液. 采用麻醉犬冠状动脉左前降支结扎造成心肌梗死模型. 结果 fl1、fl3和fl5组可显著降低犬冠脉结扎后心肌缺血的程度,缩小心肌缺血的范围; 定量组织学检测 结果 与心外膜电图测定 结果 一致,与模型组比较,非拉尼特可显著减小梗死范围. 非拉尼特显著降低犬冠脉结扎后血清乳酸、肌酸激酶及游离脂肪酸升高的程度; 显著降低全血三磷腺苷（ATP）降低的程度. 结论 非拉尼特能显著减轻犬心肌梗死时的心肌缺血程度和范围,减小梗死范围; 提示其可减轻心肌缺血时的细胞损害,对心肌细胞有保护作用.     

Pharmacokinetic Study of Cefotaxime (CTX) in Dogs

Cefotaxime (CTX) was injected either intravenously or intramuscularly in dogs, and its pharmacokinetics in plasma and urine were determined with the use of HPLC assay. Cephalothin (CET) was administered in a similar manner as a reference agent. While both CTX and CET rapidly disappeared from plasma after intravenous injection, the half-life of CET was approximately 2.5 times shorter than that of CTX. Both drugs were deacetylated, and desacetyl-CTX and desacetyl-CET appeared in plasma. Both drugs were rapidly excreted into urine either in unchanged or deacetylated form, the sum of which accounted for 77 % and 63 % of the CTX and CET dose, respectively. The ratio of the amount of unchanged drug over that of deacetylated drug in the urine was 1:1 for CTX and 1:2 for CET. When CTX and CET were intramuscularly injected, the plasma levels of CTX and CET reached a maximum 30 min and 15 min after injection, respectively, followed by a rapid decline. The pattern of urinary CTX excretion was similar after i.m. and i.v. injections. In contrast, the amount of desacetyl-CET in the urine was larger after i.m. than i.v. injections. CTX metabolites other than desacetyl-CTX (M₂ and M₃) that were also assayed by HPLC accounted for only 2–4 % of the dose of CTX in the urine, but were below detectable levels in this plasma.     

32例静脉滴注阿奇霉素致不良反应分析

目的通过对我院门诊32例静脉滴注阿奇霉素所致的不良反应报告进行分析,探讨阿奇霉素不良反应发生的规律和临床表现,提示临床注意监测其不良反应,避免严重后果。方法对32例门诊静脉滴注阿奇霉素的不良反应报告进行归类及分析。结果阿奇霉素的主要不良反应是胃肠道反应和过敏反应,此外还可引起过敏性休克、循环系统损害等较少见的、严重的不良反应。结论临床上合理使用本药能减少其不良反应的发生。     

精密过滤输液器用于降低刺五加注射剂不良反应发生率的研究

目的:探讨应用精密过滤输液器等方法降低刺五加注射剂不良反应发生率的效果。方法:将静脉输注刺五加注射剂的532例患者随机分为观察组和对照组,观察组使用一次性精密过滤输液器给药,对照组使用一次性普通输液器给药,比较两组患者不良反应发生情况。结果:观察组不良反应发生率(2.68%)显著低于对照组(7.75%),差异有统计学意义(P<0.05)。结论:临床使用一次性精密过滤输液器静脉输注刺五加注射剂能有效减少不良反应的发生。     

儿童患者静脉滴注莲必治注射液致急性肾损伤的危险因素分析

目的:探讨儿童患者使用莲必治注射液致急性肾损伤(AKI)的危险因素,为临床用药提供数据。方法:采用回顾性研究方法,收集2016年1月至2018年3月我院使用莲必治注射液的1876例儿童患者的病历资料,根据AKI诊断标准分为AKI组85例和非AKI组1791例,比较两组患儿的一般情况、原患疾病、合并用药、莲必治注射液用药情况等多种因素,分析发生AKI的危险因素。结果:我院使用莲必治注射液的患儿AKI发生率为4.53%(85/1876)。单因素方差分析显示,两组患儿在年龄、入住ICU比例、血清肌酐水平、内生肌酐清除率、合并用药(氨基糖苷类、阿昔洛韦、利巴韦林、血管升压药、安痛定)、日给药剂量和输液浓度方面比较差异有统计学意义(P均<0.05)。进一步Logistic回归分析显示,高输液浓度、高日给药剂量、低内生肌酐清除率、合并用药(氨基糖苷类、阿昔洛韦、利巴韦林)、年龄≤3岁和入住ICU是莲必治注射液致儿童患者发生AKI的独立危险因素(P均<0.05)。所有AKI患儿经停药等处理,转归较好,无继发尿毒症发生。结论:高输液浓度、高日给药剂量、低内生肌酐清除率、合并用药(氨基糖苷类、阿昔洛韦、利巴韦林)、年龄≤3岁和入住ICU是莲必治注射液致儿童患者发生AKI的独立危险因素,临床使用莲必治注射液应重点关注有独立危险因素的患者,以保证莲必治注射液临床安全用药。     

HPLC法检测输液盖及注射液中双酚A的含量

目的 建立检测输液盖及注射液中双酚A含量的高效液相色谱法.方法 采用二氯甲烷-甲醇萃取输液盖中双酚A单体,采用固相萃取柱(Cleanert PEP-SPE)富集注射液中迁移的双酚A,用HPLC法检测双酚A含量,色谱柱为ODS C18,柱温为室温,流动相为甲醇-水(3∶1),流速为0.8 mL·min-1,检测波长为280 nm.结果 双酚A在0.20～80.00μg·mL-1范围内线性关系良好(r=0.9999),高、中、低3个浓度回收率均大于98％,RSD小于2％,3批输液盖中双酚A单体的含量分别为3.96、3.38、4.25 μg·g-1.结论 所建立的方法简便、准确、重复性好,可用于输液盖及注射液中双酚A的检测.     

Heinz Body Hemolytic Anemia Induced by DQ-2511, a New Anti-ulcer Drug, in Dogs

DQ-2511, a new anti-ulcer drug, was administered to beagle dogsfor 4 weeks to investigate the mechanism whereby this drug inducedhemolytic anemia and its reversibility in comparison with ß-acetylphenylhydrazine.Hemolytic anemia accompanied by an increase in the number ofcells containing Heinz bodies that was preceded by a markeddecrease in blood-reduced glutathione concentration was observedin dogs receiving 600 mg/kg of DQ-2511, but only a slight increasein the methemoglobin level was noted.ß-Acetylphenylhydrazine,however, caused hemolytic anemia accompanied by marked increasesin both Heinz body-containing cells and methemoglobin concentration,but the blood-reduced glutathione concentration was not decreasedconsistently with the formation of Heinz bodies. Hemolytic anemiadisappeared after a 4-week recovery period in the dogs thatreceived DQ-2511. These results suggest that decreases in reducedglutathione in erythrocytes play an important role in the anemiaand Heinz body formation induced by DQ-2511, but not by ß-acetylphenylhydrazine.     

静滴盐酸昂丹司琼注射液诱发哮喘发作1例

1临床资料 患者男性,50岁,主因“结肠癌术后1月余”,为行第1次化疗于2007年11月26日收入我科。完善相关检查后于11月28日给予静脉化疗,化疗方案采用FOLFOX4方案（氟尿嘧啶＋亚叶酸钙＋奥沙利铂）。化疗开始前先给予盐酸昂丹司琼注射液（齐鲁制药有限公司,批号7020031EH）8mg＋生理盐水100mL静滴,以预防化疗胃肠道反应。此前患者未输注其他药物,无任何不适症状,静注约10rain后患者突发胸闷、憋喘、呼吸急促、口唇紫绀、不能平卧。     

儿童急性白血病化疗使用阿米福汀致低钙抽搐

目的探究儿童白血病化疗期间使用阿米福汀导致低钙的发生率,并提出预防低钙抽搐的方法。方法将218例患儿根据阿米福汀使用时间进行分组,并对各组发生率进行对比分析。结果使用阿米福汀导致低钙血症的比例为21.10%,对低钙抽搐患儿给予10%糖酸钙治疗后症状基本缓解,且血钙恢复正常。连续使用阿米福汀至少5 d的患儿出现低钙抽搐症状的发生率更高。结论儿童患者使用阿米福汀导致低钙抽搐的发生率增高,低钙抽搐使用糖酸钙治疗有效。     

Pharmacokinetic and Metabolic Disposition of p-Chloro-m-xylenol (PCMX) in Dogs

The pharmacokinetic and metabolic profile of p-chloro-m-xylenol (PCMX) was studied in healthy mongrel dogs after intravenous and oral administration of single doses of 200 and 2000 mg of PCMX, respectively. Calculation of pharmacokinetic parameters was based on compartmental and noncompartmental methods. The mean pharmacokinetic parameters of elimination half-life and mean residence time were 1.84 and 1.69 hr, respectively. The apparent volume of distribution at steady state was estimated to be 22.4 liters, and the plasma clearance was 14.6 liters/hr. The bioavailability of PCMX was 21%, indicating low absorption for this drug. PCMX's metabolite data show that a presystemic elimination process (first-pass effect) is also occurring. PCMX plasma concentrations after intravenous administration of 500-, 200-, and 100-mg doses were found to be proportional to the dose given, demonstrating that the pharmacokinetic profile of PCMX is linear over the dose range studied. Biotransformation studies showed that urinary excretion was not the major route for rapid elimination of unchanged PCMX and almost all material excreted in urine was associated with the conjugated species (glucuronides and sulfates). Statistical significant differences were not found (P > 0.05) between the percentages excreted in urine of PCMX and its conjugated metabolites after intravenous and oral administration. The percentages excreted in urine after iv and oral doses of unchanged PCMX were, respectively, 0.45 and 0.37; total conjugates, 46.3 and 43.3; sulfates, 38.1 and 33.2; and glucuronides, 8.2 and 10.2.     

肌氨肽苷和门冬氨酸钾镁联合使用致迟发型过敏反应1例

1例56岁男性行冠状动脉搭桥手术后患者．因心前区疼痛24小时入院,连续6天静脉滴注5％的葡萄糖250ml,肌氨肽苷20ml．门冬氨酸钾镁2g,1次／日．未观察到不良反应。患者于第7天滴注同组液体．从输液开始后约30min．自觉双上肢疼痛,继之出现寒颤、头痛,测血压160／100mmHg．立即停止输该液体。给予吸氧．苯海拉明肌注．并用250ml生理盐水注射液建立静脉通道．地塞米松入壶。15min后患者肢体疼痛、寒颤、头痛等症状逐渐缓解,但体温上升至39℃,给予赖氨匹林肌注．体温降至正常。15小时后．患者再次出现寒颤,伴胸闷,体温上升至39.2℃,血压160／100mmHg．呼吸困难,口唇发绀,两肺呼吸音粗,未闻及湿啰音。给予心电监护．血氧饱和度90～95％。给予面罩吸氧,氨茶碱静点．赖氨匹林肌注．症状较前减轻。密切观察1天后．未再有胸闷气短发作。     

Bumetanide Induced Increase of Renal Blood Flow in Conscious Dogs and its Relation to Local Renal Hormones (PGE,Kallikrein and Renin)

Abstract Bumetanide (0.25 mg/kg intravenously) increases renal blood flow (RBF) for 40–60 min. in conscious dogs with chronically implanted flow probes. The time of maximum increase in RBF (10–15 min. after administration) proceeds maximum diuresis (20–30 min. after administration). A several fold increase in urinary PGE-output occurs during the first 20 min. after bumetanide administration. Urinary PGE excretion is not increased during the later course of the increase in RBF. Urinary kallikrein excretion increases and this is highly correlated with the diuretic volume. Plasma renin activity (PRA) increases initially concomitantly with the increase in renal blood flow. Indomethacin treatment (5 mg/kg orally) lowers RBF and urinary PGE excretion. Bumetanide in indomethacin pretreated dogs does not modify RBF or urinary PGE output. The diuretic effect of bumetanide is reduced as is also the urinary kallikrein excretion, while the initial increase of PRA is absent. The results support the conclusion that the increase of RBF and PRA after bumetanide administration is dependent on an increased prostaglandin/kinin activity.     

Changes Produced in the Male Genital Organs of Rabbits and Dogs by 2,6-cis-Diphenylhexamethylcyclo-tetrasiloxane (KABI 1774)

Abstract: The drug. 2,6-cis-diphenylhexamethylcyclotetrasiloxane, was administered daily per os to rabbits (2 mg/kg body weight in soybean oil) for 2, 5, 10, 15, 20, 25, and 30 days, and to dogs (10 mg/kg and 250 mg/kg) for 40 days. Light and electron microscope studies were made on the testis, epididymis and accessory genital glands. In rabbits, cell death was seen in the epididymis, especially in the middle caput after 2, 5 and 10 days. Longer treatment also caused marked atrophy of the epididymal duct epithelium, and some atrophy of the accessory genital glands. After 15 days, spermatozoa no longer showed the morphological maturation changes that normally take place in the caput epididymidis, and the fine structure of the epididymal epithelium suggested a return to prepuberal conditions. After 20 days, spermatozoa in the the cauda epididymidis were dead. The seminiferous tubules showed arrested spermatogenesis followed by degeneration of all spermatids and many spermatocytes between 15 and 25 days. Some ultrastructural changes of the Leydig cell cytoplasm occurred after 10 days, before spermatogenesis was disturbed. In dogs, the effect on the seminiferous epithelium varied from arrested spermatogenesis to complete degeneration of most germ cells. The interstitial cells showed atrophy, shrinkage of the nucleus, and marked loss of the specialized cytoplasmic ultrastructure. The epididymis showed some cell death and very marked epithelial atrophy. The prostate gland showed marked epithelial atrophy, with a few areas also displaying epithelial metaplasia. These observations are compatible with the concept that the cyclotetrasiloxane compound has an antigonadotropic action, but an additional direct antiandrogenic effect on the epididymis may also be involved.