Strategies to assess the drug interaction potential in translational medicine

Translational medicine is the drug development phase in which preclinical and clinical applied research is conducted to aid dose and disease selection with great financial impact. Thus, during this phase, early discontinuation of a drug that will later fail due to drug interactions is a must for a proper resource allocation. It is not only important to identify a potential interaction, but also to be able to differentiate between detectable interactions and clinically relevant interactions. Due to the scientific advancement, the prediction of drug interactions during translational medicine has shifted from empirical/observational to rational based. These investigations are thus in line with the FDA's Critical Path Initiative and are facilitated by the availability of mature technologies and by current European and US guidelines for both in vitro and in vivo studies. Because drug interactions must be evaluated in a multidisciplinary fashion, even if these studies are contracted externally, pharmaceutical companies should be directly involved in the conduction of such studies to fully exploit their potential and to allow a better and faster interpretation of the results.     

Herbal medicine in the treatment of cancer

Many of the classes of phytochemicals in herbal medicine are finding therapeutic use. In particular, cancer patients are reported to benefit from treatment with herbal medicine and survivability in many cases is significantly enhanced. Recent studies showed the anti-oxidative and superoxide scavenging activities of individual active components of herbal medicine for their inhibitory activities on lipid peroxidation and anti-cancer properties. Individual herbal medicines show antipyretic, analgesic and anti-inflammatory and anti-cancer effects. In addition to sharing many therapeutic activities, herbal medicine is also used in nutrient supplement for anti-cancer and anti-inflammatory activity. Numerous in vitro studies of herbal medicine on different cell lines and in vivo study of herbal medicine have been reported. However, the mechanisms of actions remain unclear. This review aims to give an overview on the recent development of herbal medicine in the prevention and treatment of cancer. The report covers the possible mechanism of action of some of the herbal medicine. In addition, the common properties of herbal medicine are described. Finally, the study sheds lights on the pharmacological applications of herbal medicine in the treatment of cancer and its potential use as anti-cancer agents.     

急诊科药嘱相关隐患原因分析及对策

目的探讨急诊科药嘱相关问题及对策。方法对2013年下半年用药医嘱中的隐患进行分析,发现造成药嘱隐患的原因,寻找消除药嘱隐患的对策。结果隐患药嘱与医生对药物作用、用法、剂量不熟悉,药局人员缺乏责任心有着直接的关系。结论加强护理工作中的核对环节,对轮转医生加强培训,加强药局工作人员的责任心,对临床医护人员加强相关培训,可以减少药嘱相关隐患,从而减少用药错误。     

Herbal medicine course within pharmacy curriculum

Due to the growing use of herbs and dietary supplements by consumers, pharmacists now need a basic knowledge of this topic for their professional practices. To meet this need, an elective course on herbs and dietary supplements is being taught at the Massachusetts College of Pharmacy and Health Science. The objective of the course is to teach students basic phytopharmacology, counseling skills on herbal medicine, evidence- based resources, manufacturing practices, and dietary regulations. A review of over 50 herbs touches on clinical use, efficacy, safety, and drug interactions. This paper reviews the course curriculum, resources and exercises used throughout the course.     

Herbal medicine causing likely strychnine poisoning

'Maqianzi' (the dried ripe seed of Strychnos nux-vomica L.) contains 1.0-1.4% each of strychnine and brucine. After processing to reduce its toxicity, 'maqianzi' was used as a herbal remedy for rheumatism, musculoskeletal injuries and limb paralysis. A 42-year old woman with neck pain was prescribed 15 g of 'maqianzi' to be taken in two doses at 7 hours apart, although the recommended dose was 0.3-0.6 g. She was apparently well after drinking the first of two bowls of 'maqianzi' decoction. One hour after she drank the second bowl of herbal decoction, she suddenly developed tonic contractions of all her limb muscles and carpopedal spasm lasting 5 min, difficulty in breathing, chest discomfort and perioral numbness. The second bowl of decoction probably became more concentrated because of evaporation of water during continued boiling and contained a larger amount of 'maqianzi'. On arrival in the hospital 1 hour later, she complained of muscle pain and tiredness. She was found to have hyperventilation and weakness of four limbs, with muscle power of grade 5(-)/5. All her symptoms gradually subsided over the next few hours. This case illustrated that 'maqianzi' can cause strychnine poisoning even after processing, especially when the recommended dose is greatly exceeded. In any patient with 'unexplained' muscle spasms or convulsions, strychnine poisoning should be included in the differential diagnosis and they should be asked about the use of herbal medicines.     

药物转运体介导的中药及单体药物相互作用的研究进展

药物转运体在中药及单体成分的体内吸收、分布和排泄过程中发挥着重要的作用。中药及单体对药物转运体的功能和表达可产生诱导或抑制作用,从而影响这些转运体底物的体内处置过程。随着中药药动学的发展,基于转运体介导的中药及单体体内处置研究越来越受到重视。该文对药物转运体介导的中药及单体药动学的研究进行综述。     

2011 drug packaging review: too many dangers and too many patients overlooked

Every year, Prescrire's analysis of drug packaging confirms the importance of taking packaging into account in assessing a drug's harm-benefit balance. Safe, tried and true options are available, yet the quality of most of the drug packaging Prescrire examined in 2011 left much to be desired. Few of the packaging items examined help prevent medication errors and many actually increase the risks: misleading and confusing labelling, dosing devices that create a risk of overdose, bottles without a child-proof cap, and inadequate or dangerous patient information leaflets. Umbrella brands continue to expand and are a potential source of medication errors. Some patients are at greater risk: the patient leaflets for NSAIDs endanger pregnant women and their unborn babies; children are insufficiently protected by paediatric packaging and are at risk due to the lack of child-proof caps on too many bottles. The raft of regulatory measures taken by the French drug regulatory agency (Afssaps) in the aftermath of the Mediator disaster overlooked the importance of packaging. Until drug regulatory agencies tackle the vast issue of drug packaging, it is up to healthcare professionals to protect patients from harm.     

"A magnet for curious adolescents": the perceived dangers of an open drug scene

During the summer of 2004 the police closed Plata, an open drug scene in the midst of Oslo. The most important argument for the closure was that the drug scene made it easier for curious, city-dwelling adolescents to start using drugs. This research sought to assess this assumption. Ethnographic research methods including twenty 2-hr field observations and qualitative semi-structures interviews were employed. Interviews were conducted with 30 adolescents in the centre of Oslo, as well as with 10 former drug users, three police officers and three field workers. We were also given access to police statistics and authorised to do our own analysis of the material. The most important result was that adolescents seemed rather to avoid than to be attracted to this open drug scene in Oslo. Based on the presentation of qualitative data we suggest that this was due to the social definition of the drug scene. Because they experienced a great social distance between themselves and the regulars at the open drug scene, adolescents seemed to avoid Plata. Moreover, the scene was symbolically associated with heroin and injection as the route of administration, which had low prestige among the adolescents. Despite these findings, adolescents' recruitment to drug use was the key issue in the political debate following the closure. We point to the shared rhetorical interest among important institutional actors in framing the issue in this way. The argument was also embedded in widely shared public representations of adolescents and drug users as passive and irrational.     

基于转运体的中药毒性及药物相互作用研究进展

中药-药物的相互作用已成为药物毒性研究的热点。许多中药的活性成分或其提取物在体内的药效和毒性与转运体相关,转运体的表达或活性可明显影响中药在体内的药动学和生物活性。其中,基于转运体的马兜铃酸、雷公藤甲素等中药成分的肝、肾毒性的研究十分广泛,而中药对转运体的作用也会对其他药物的代谢产生影响从而发生药物的相互作用。主要基于转运体角度来概述中药毒性及对其他药物代谢的影响,对中药的毒性研究及临床上的合理用药具有指导意义。