药事管理学学科建设的几点思考

基于高等学校共同的功能和特点，以及学科建设共同的本质要求，药事管理学学科建设应该明确学科归属和地位，应兼顾基础性、战略性、综合性和积累性等基本特点，并符合学科可持续发展的要求。     

Pharmaceutical care and its relationship to prescribing behaviour of general practitioners

Objective To study the correlation between pharmaceutical care and prescribing routines of general practitioners (GPs).Methods Cross-sectional study; 201 pharmacies, 408 general practices, The Netherlands, 2000/2001. The variation in prescribing behaviour was characterised using 20 validated prescribing indicators based on general practice guidelines. The general construct ‘adherence to guidelines’ served as the dependent variable and was formed by summing the scores of the prescribing indicators. Four possible determinants of the variation were determined on the basis of survey questions: the construct ‘the pharmacist’s attitude towards pharmaceutical care’, and three partial constructs derived from the pharmacist’s care-providing function: the care for the individual patient, the cooperation with general practitioners and the registration of the care provided. A multiple linear regression analysis was then performed.Main outcome measure The weighted score for the prescribing indicators.Results The weighted average score for the prescribing indicators was 65% (SD 3.7). The response rate to the survey was 71%. The pharmacist’s attitude to pharmaceutical care, as well as the degree to which the pharmacist provided care for the individual patient, the degree to which he cooperated with the general practitioner and the degree to which he registered the care provided were not correlated with the ‘adherence to guidelines’ by the general practitioner with whom the pharmacist frequently cooperated.Conclusion Variations between general practitioners in the quality of prescribing, as measured by their adherence to guidelines, were not correlated with pharmaceutical care by the pharmacist with whom they cooperated on a day-to-day basis.     

清咽灵口服液的急性毒理及药效学实验研究

目的 观察清咽灵口服液的急性毒性反应、抗炎作用、化痰作用、抑菌作用及免疫作用。方法①取小鼠４０只，禁食１２小时，以最大浓度相当于人临床用量的８０００倍，观察给药后７日内动物一般状态、毛色、体重、饮食等指标的变化。②观察清咽灵口服液对棉球、琼脂引起大鼠慢性炎症及二甲苯所致小鼠耳肿胀的影响。③采用气管段酚红法观察了清咽灵口服液化痰作用。④采用试管法观察了清咽灵口服液的体外抑菌作用。⑤用清咽灵口服液对２·４－二硝基氟苯所致小白鼠迟发型超敏反应影响。结果 小白鼠灌胃给药，最大耐受量为３５６４０ｇ生药／ｋｇ，相当于人临床用量的８０００倍门临床成人６０ｋｇ，用量２６７．３ｇ生药／日），其给药后动物一般状态良好，毛色正常，体重增加，饮食及活动未见异常。未发现明显毒性反应。药效学实验结果提示，清咽灵口服液对棉球、琼脂所致的大鼠慢性炎症有明显抑制作用；对二甲苯所致小鼠耳壳肿胀有明显抑制作用，可增加小鼠气管对酚红排泌量；在体外对金黄色葡萄球菌、乙型溶血性链球菌、肺炎球菌、白喉杆菌均有不同程度的抑制作用；对二硝基氟苯所致小鼠迟发型超敏反应无明显影响。结论 中药清咽灵口服液无急性毒性作用，有显著抑菌、抗肉芽增生、化痰作用。     

Distribution of pharmaceuticals ? a Norwegian logistic perspective

There is a general concern about rising costs of pharmaceutical expences. One political measure is a more efficient distribution system, which can take the form of new channels for retailing. In Norway mailorder pharmacy (MOP) has been brought to the agenda due to the recently proposed law regulating pharmacies (Apoteklov), market developments abroad, demand for selfmedication, the increase in OTCproducts and advances in information technology. Mailorder pharmacy involves direct delivery of medications through postal mail to patients or those responsible for dispensing medication. With reference to the USA, mailorder pharmacy has filled a niche in the market and several other countries are following. We are convinced that it is possible to maintain a high level of service quality in the sense of safety, councelling and compliance, and that there is a potential to develop a model for this distribution form in Norway. We believe that the actors in the Norwegian pharmaceutical market are better served in taking a more active role in this area and where possible initiating pilot projects in mailorder distribution. The pharmacists will continue to play an important role as a retail outlet and should, with their influence over patients, their knowledge and experience, contribute towards developing MOP to be a safe and complementary sales outlet. Developing such a solution demands the right balance between performance and quality on the one hand and efficiency on the other; two criteria, which we believe, do not contradict each other.     

Formation,bioavailability and organoleptic properties of an inclusion complex of femoxetine with β-cyclodextrin

Femoxetine, a new selective serotonin uptake inhibitor with antidepressant properties, possesses a very bitter taste which hinders the development of oral liquid formulations. The present study has shown that it is possible to improve the organoleptic properties by inclusion complexation of the drug with β-cyclodextrin. Phase solubility diagrams and UV-spectroscopic studies revealed the formation of 1 :1 and 1: 2 inclusion complexes, the strongest complex being obtained for femoxetine in free-base form. A microcrystalline inclusion complex was isolated and shown to have the stoichiometric composition of 1: 2 (femoxetine: β-cyclodextrin). In a single dose cross-over study in 5 volunteers, the bioavailability of the solid complex formulated as an aqueous suspension was found to be similar to that observed for a sugar-coated tablet of femoxetine hydrochloride.     

Prodrug research: futile or fertile?

The objective of this Commentary is to help clarify and illustrate what prodrugs are, what they are not, which benefits they can offer, and what their limits are. To this end, a number of criteria of classification and evaluation are presented. This is followed by a discussion of the pharmaceutical, pharmacokinetic and pharmacodynamic objectives of prodrug research. Recent examples (e.g. oseltamivir, bambuterol, capecitabine, clopidogrel and tirapazamine) are discussed in a biochemical perspective to illustrate these objectives and to demonstrate some of the therapeutic benefits afforded by successful prodrugs. Attention is also called to the fact that the in vitro and in vivo behavior of prodrug candidates may differ from that of the parent drug in ways that go beyond the original pharmaceutical, pharmacokinetic or pharmacodynamic objective being pursued. We conclude that prodrugs offer a viable strategy to disentangle pharmacodynamic and pharmacokinetic optimization.     

Application of oxidants to the spectrophotometric determination of amlodipine besylate in pharmaceutical formulations

Three new spectrophotometric methods for the determination of amlodipine besylate have been proposed. The first two methods, i.e. A and B, are based on the oxidation of the drug with Fe(III) and the estimation of Fe(II) produced after chelation with either 1,10-phenanthroline or 2,2'-bipyridyl at 500 and 515 nm, respectively. The Beer's law was obeyed in the concentration ranges of 2-10 and 4-14 microg ml(-1) with molar absorptivity of 2.9 x 10(4) and 2.7 x 10(4) l mol(-1) cm(-1) for methods A and B, respectively. The third procedure depends on the interaction of amlodipine besylate with ammonium heptamolybdate tetrahydrate, which resulted in the formation of molybdenum blue (lambda(max) 825 nm). The linear dynamic range and the molar absorptivity values were found to be 15-59 microg ml(-1) and 1.8 x 10(4) l mol(-1) cm(-1), respectively. The results of the proposed procedures were validated statistically and compared with those obtained by the reference method. The proposed methods were applied successfully to the determination of amlodipine besylate in commercial tablets.