High-Dose Daptomycin Is Well Tolerated via 2-Minute IV Push Administration

Background:The purpose of this study was to evaluate the safety of administering high-dose daptomycin (HDD; > 6 mg/kg actual body weight) as a 2-minute intravenous (IV) push (IVP) compared to traditional 30-minute IV piggyback (IVPB) infusion.Methods:Retrospective cohort study comparing patients receiving HDD as an IVP or IVPB infusion. The primary outcome was the proportion of patients with a documented infusion-related reaction (IRR) to daptomycin.Results:Three hundred patients were included in the final analysis, 200 patients received IVP, and 100 patients received IVPB representing a total of 1697 administrations. Median (IQR) daptomycin dose was IVP 700 mg (550-900) and IVPB 700 mg (600-900), with mg/kg doses of 8.2 (7.9-10) and 8.3 (8-10), respectively. After adjudication, IRR occurred in 1% of subjects in each treatment group.Conclusions:This study provides data in more than 1100 administrations of HDD administered via IVP. Infusion-related reactions were documented in 1% of patients regardless of infusion method, suggesting comparable safety to traditional infusion methods. This practice may be useful during fluid shortage and in the outpatient setting.     

药物诱发加重银屑病的研究进展

银屑病是遗传、免疫和环境因素共同作用的结果,药物作为外因之一可诱发健康人群患病或恶化病情,如β肾上腺能受体阻滞剂、锂盐、抗疟药、四环素类抗生素等.药物按其与银屑病相关程度不同,可分为明确相关,有确切证据;可能相关,缺乏确切证据;偶有报道,有争议.按其后果不同可分为诱发银屑病的药物和恶化银屑病的药物.近年来发现诱发和加重银屑病的药物种类逐渐增多,有的药物本身可用于银屑病的临床治疗.了解这些药物的致病概况及致病机制,不仅有利于预防银屑病复发,而且对临床治疗有重要的指导意义.     

包裹阿霉素的新型载药微泡制备及体外缓释实验研究

目的 将包裹阿霉素(ADM)的乳/羟基乙酸共聚物(PLGA)纳米缓释药物微球(ADM-NP)通过共价结合方式连接于带正电氨基脂质超声微泡(MB-NH2)表面,制备包裹ADM的新型载药微泡,并观察其基本理化特性、载药量、包封率、体外缓释特性及显影效果.方法 采用双乳化法,制备ADM-NP,并通过碳二亚胺法活化ADM-NP表面的羧基,在一定条件下,使ADM-NP以共价结合的方式,连接于MB-NH2表面.用光镜观察连接情况、微泡形态并检测其粒径大小.用高效液相色谱法(HPLC)检测其包封率及载药量,观察该新型载药微泡的体外缓释药特性以及对兔VX2肝癌的显像效果.结果 48 h后光镜观察,可见大量ADM-NP连接于MB-NH2表面,呈花环状,分布较为均匀,其平均最大径为(2.68±0.98)μm.该新型载药微泡的载药量为(8.71±0.46)％,包封率为(86.11±6.76)％.两组体外释药均符合Hignch方程,其结果无明显差异性(P＞0.05),48 h体外累积释药量达90％以上.经兔耳缘静脉注射该微泡后,兔肝实质明显持续增强,肝癌呈“快进快退”显像表现.结论 采用碳二亚胺法可将ADM-NP通过共价结合方式连接于MB-NH2表面,提高微泡载药量,延长药物的持续作用时间,并且在兔VX2肝癌肿瘤中显影效果好,为采用超声靶向爆破微泡进行药物定位释放技术提供了一种新型高效的载药微泡系统.     

A gas chromatographic method for the indirect determination of hydroxylamine in pharmaceutical preparations: conversion into nitrous oxide

A simple, sensitive, and selective headspace gas-chromatographic method has been developed for measuring hydroxylamine (HA) in a variety of sample matrices including pharmaceutical formulations. This procedure relies on converting HA into nitrous oxide (N₂O), which is a single-step reaction that is carried out directly in a heated headspace vial. The gaseous products are then analyzed by headspace capillary gas chromatography. Several detection strategies were evaluated and electron capture provided the best sensitivity (4 parts-per-billion (ppb)) while the mass selective and thermal conductivity values were higher (14 ppb and 1.4 parts-per-million (ppm), respectively). The method's linear dynamic range spans two to four decades with a run-to-run precision that was better than 5% R.S.D. (n=7). The reagent concentrations (oxidant, buffer) strongly impact the N₂O signal and the greatest response was obtained for solutions that contained equimolar amounts of reactants. HA was efficiently (98%) recovered from a sample matrix that contained only the active pharmaceutical ingredient (API) but the recovery was lower (83%) when excipients were present.     

2,6-Dichloroquinone chlorimide and 7,7,8,8-tetracyanoquinodimethane reagents for the spectrophotometric determination of salbutamol in pure and dosage forms

A simple, rapid and sensitive spectrophotometric method for the determination of sulbutamol in pure form and in different pharmaceutical preparations has been developed. The charge transfer (CT) reaction between salbutamol as electron donor and 2,6-dichloroquinone chlorimide (DCQ) and 7,7,8,8-tetracyanoquinodimethane (TCNQ) as a π-electron acceptor have been spectrophotometrically studied. The optimum experimental conditions for these CT reactions have been studied carefully. Beer's law is obeyed over the concentration range of 1.0–30.0 μg ml⁻¹ and 2.0–20.0 μg ml⁻¹ for salbutamol using DCQ and TCNQ, respectively. For more accurate results, Ringbom optimum concentration range is calculated and found to be 10.0 to 30.0 and 8.0 to 20 μg ml⁻¹ for salbutamol using DCQ and TCNQ, respectively. The Sandell sensitivity is found to be 0.011 and 0.010 g cm⁻² for salbutamol using DCQ and TCNQ, respectively, which indicate the high sensitivity of the proposed methods. Relative standard deviations (R.S.D.) of 0.27 to 0.68% and 0.20 to 1.40% (n=5) were obtained for five replicates of salbutamol using DCQ and TCNQ, respectively. The results obtained by the two reagents are comparable with those obtained by British pharmacopoeia assay for the determination of salbutamol in raw materials and in pharmaceutical preparations.     

乳酸左氧氟沙星胃漂浮缓释片的制备及体外评价

目的 制备乳酸左氧氟沙星胃漂浮缓释片,考察其漂浮性和体外释放行为.方法 以湿法制粒压片法制备乳酸左氧氟沙星胃漂浮缓释片,分别考察处方中各辅料对制剂漂浮性和体外释放行为的影响.结果 处方中羟丙基甲基纤维素（hypromellose cellulose,HPMC）黏度规格、用量及十八醇、碳酸氢钠用量对制剂的漂浮性或体外释放行为均有影响,处方中HPMC K100M用量为l00mg/片、十八醇用量为40mg/片、碳酸氢钠用量为40mg/片时其漂浮性能和释放行为较好.结论 本制剂具有良好的胃漂浮和缓释效果,且工艺稳定性好.     

461例中药制剂不良反应报告分析

目的 分析本地区中药制剂不良反应(ADR)总体发生情况、规律及特点,加深对中药ADR的认识,促进中药合理应用.方法 采用回顾性研究方法,从江门市药品ADR监测中心数据库筛选2012年江门市各单位上报的中药制剂ADR报告表进行分类统计、分析.结果 共筛选出中药制剂ADR报告461例,涉及108个中药制剂品种.老年(≥60岁)ADR发生率较高(36.23％);女性患者ADR发生率明显高于男性.中药注射剂品种导致ADR 372例次,占总例数的80.69％.注射剂是导致中药ADR的主要剂型且绝大多数采用静脉滴注给药方式;其次是不同剂型的口服制剂,占17.57％.累及的器官/系统主要为皮肤及其附件,其次为全身性损害、消化系统和循环系统等.轻度ADR 284例次,占61.60％,绝大多数转归治愈.结论;应加强对中药制剂ADR的监测,临床应减少或避免中药注射剂的使用,特别是在老年人群中的使用,应加强中药制剂用药安全的监管.     

Synthesis and biological activities of neurokinin pseudopeptide analogues containing a reduced peptide bond

A series of pseudopeptides, analogues of neurokinin selective agonists, in which a peptide bond was replaced by a (CH₂NH) bond were synthesized. The biological activities of these compounds were determined on selective pharmacological preparations: the dog carotid artery for NK-1, the rabbit pulmonary artery devoid of endothelium for the NK-2 and the rat portal vein for the NK-3 receptors. The results reported in this study indicate that insertion of a pseudopeptide bond in various positions of these selective agonists resulted in a great decrease in potency compared to the parent compounds. Furthermore, the selectivity of agonists is maintained by the use of a methylene amino group in position 9–10 (Sar) for the NK-1 or in position 7–8 (MePhe) for the NK-3 selective compound. The selectivity is greatly diminished for the NK-2 analogues.     

毛果芸香碱透明质酸钠缓释滴眼剂在兔眼房水中的药代动力学研究

目的探讨0.5%毛果芸香碱透明质酸钠缓释滴眼剂滴眼后眼部的药代动力学特征,评价其相对生物利用度.方法选择健康白兔100 只,随机分为10个实验组和10个对照组,每组5只兔(10只眼).各实验组兔双眼结膜囊内均滴入0.5%毛果芸香碱透明质酸钠缓释滴眼剂50 μl,各对照组兔双眼亦滴入1%毛果芸香碱滴眼液50 μl.分别于给药后5、10、20、30、40、60、90、120、150及180 min抽取房水并对其定量分析.用二氯甲烷提取房水中的药物,采用反相高效液相色谱法(HPLC)测定房水中的药物浓度.药代动力学参数采用3p87药代动力学计算软件计算机拟合求得.结果采用反相HPLC法可以将毛果芸香碱与其它杂质很好分离,最低检测浓度为0.025 μg/ml.毛果芸香碱在房水中的回收率平均为98.2%.实验组和对照组给药后药物房水达峰时间分别为10 min和20 min, 达峰浓度分别为4.46 μg/ml和2.25 μg/ml, 药物消除半衰期分别为31.83 min和22.98 min.实验组药物的房水浓度-时间曲线下面积(AUC0～180)是对照组的1.75倍.实验组房水药物达峰浓度是对照组的1.98倍(P<0.05).结论 0.5%毛果芸香碱透明质酸钠缓释滴眼剂与1%毛果芸香碱滴眼液比较,达峰时间提前,达峰浓度增高,消除半衰期延长,提示其相对生物利用度提高,作用时间延长.     

关于西医应用抗癌中成药的几点建议

中医用西药,西医用中药在我国已是普遍现象。在肿瘤临床工作中。抗癌中成药主要为西医所用也已成为现实,这表现了医务人员采用多种治疗手段的广阔思路,也反映了患者力求多种治疗手段早日康复的渴望。但在许多国家法律中,中西医各自的治疗手段有着严格界定,中医只能用针灸、中药,连注射器、血压计也不能用;而西医则只能用西医方法治疗,用中药属违法。在中国,中医、西医、中西医结合医学并存,目前对彼此用药尚无严格规定,只要用之得当,并无厚非。这种“中国特色”,为医生采用多种方法治疗而提高疗效是有益的。