中国儿童常用药品剂型使用现状分析

目的 分析目前中国儿科常用药品剂型使用现状。方法 收集中国8家不同省份三级甲等儿童医院的用药目录，筛选出儿童常见系统疾病用药品种目录，对收集到的药品剂型信息进行统计分析。结果 共收集到2 495种儿科常用药品品规，其中口服剂型1 162种（46.6%）、注射剂型1 072种（42.9%）、外用剂型225种（9.0%）及吸入剂型36种（1.4%）。口服剂型中最常用的为普通片剂和颗粒剂。注射剂型中中药注射液有9种品规，其中有5种说明书中未标明儿童用法用量。儿科专用药品剂型共有190个品规，最常见的剂型为颗粒剂、口服溶液剂和糖浆剂。结论 尽管中国儿科常用药品剂型对儿童的适宜性有一定的改善，但目前儿科专用药品较少，适宜学龄前及以下儿童的药品剂型仍然比较缺乏，还远远不能满足不同年龄儿童多样化的药品剂型需求。     

Triiodothyronine accelerates and enhances the antipsychotic effect of risperidone in acute schizophrenia

In acute psychotic schizophrenia patients we investigated if the combination of triiodothyronine (T3) plus risperidone was more effective when compared to risperidone monotherapy. Thirty-two in-patients meeting the DSM-IV-TR diagnostic criteria for schizophrenia and without thyroid disease received risperidone (flexibly adjusted dose for tolerability) and were randomized to additionally receive either T3 (25 μg daily; risperidone plus T3 group) or placebo (risperidone plus placebo group). Treatment lasted until meeting the response to treatment criteria defined as score of ≤3 on the Clinical Global Impression Severity and Improvement scales. Acute psychotic episode symptom severity was evaluated using the Brief Psychiatric Rating Scale (BPRS) at treatment initiation and at the final study assessment. Fourteen patients were randomized to receive risperidone plus T3 and eighteen to receive risperidone plus placebo. The time until treatment response was shorter in the risperidone plus T3 group relative to the risperidone plus placebo group (25.5 ± 4.4 days vs 32.2 ± 8.2 days, respectively; p = 0.001). Moreover, there was a greater reduction of BPRS-total score (p = 0.01) in the risperidone plus T3 group relative to the risperidone plus placebo group. Treatment with T3 was associated with shorter time to treatment response (β = −0.440, p = 0.022) and with greater improvement in BPRS score (β = 0.240, p = 0.053), independent of patients' gender, age, baseline BPRS score and mean risperidone dose. The study confirms that addition of T3 to risperidone was associated with accelerated and enhanced treatment response in acutely psychotic schizophrenic patients.     

Use and Non-Use of Medication by Sufferers of Selected Symptoms of Depression

Abstract

The overuse of drugs as a means of alleviating stress and anxiety is thought to be characteristic of modern American society. This article addresses the problem by asking the question: given the number of people suffering from certain common symptoms, what percentage will seek relief through the use of medication? Multiple standardization is used to assess the effects of race, sex, age, marital status, and SES on the proportions of people reporting each symptom and the proportions of those who took medications, both before and after standardization for subgroup differences. More than 40 percent of the nearly 4000 adults surveyed reported some problems of sleeplessness and enervation, but when only those who reported persistent problems are examined, very few resorted to medications. The authors conclude that the U.S. is not a “pill-popping” society as depicted by the popular press.     

高效液相色谱法测定人血浆中伏立康唑浓度

目的：建立一种简单高效的高效液相色谱（HPLC）法用来检测人体中伏立康唑的血药浓度，并应用于临床中伏立康唑用药监测，以促进其个体化用药。方法：色谱柱：Kromasil C₁₈（4.6 mm×150 mm，5 μm），柱温：35℃，流速：1.0 mL·min^-1，流动相：甲醇-水（60：40），检测波长：257 nm，内标：酮康唑。对该方法进行方法学验证。结果：该方法专属性良好，血浆中伏立康唑在0.1~20.0 μg·mL^-1范围内线性良好（r=0.999 6），定量下限为0.1 μg·mL^-1。高、中、低3个浓度提取回收率分别为（90.68±10.32）%、（92.82±8.26）%、（97.47±4.58）%；日内精密度RSD分别为5.87%、7.85%、4.10%；日间精密度RSD分别为5.64%、3.30%、2.74%。对某院20例（男12例，女8例）使用伏立康唑抗真菌治疗的患者运用该方法进行了监测，结果显示浓度范围在0.71~13.51 μg·mL^-1之间。结论：本方法专属性高，操作简便，结果准确，可用于临床上伏立康唑血药浓度的检测，从而促进其个体化用药的推广。     

Pro Re Nata Drug Use in Nursing Home Residents: A Systematic Review

Objectives

In addition to routinely administered long-term medication, complex drug regimens of nursing home residents often include as needed or pro re nata (PRN) medication. However, there has been no systematic evaluation of the frequency and concomitants of PRN medication in nursing homes. The main objective of this systematic review was to provide a current assessment of PRN drug use in nursing homes.

Medication‐related problems in patients referred to aged care and memory clinics at a tertiary care hospital

Aim: To investigate the prevalence of medication‐related problems (MRPs) in patients attending aged care and memory disorder clinics and explore the potential role of a clinical pharmacist to obtain medication histories and identify unresolved MRPs. Methods: The clinical pharmacist interviewed patients and reviewed their medication regimens in the outpatient clinics. Clinical significance of pharmacist‐identified MRPs was rated by an independent expert panel using validated criteria. Results: Forty‐six patients (mean age 82 years) were reviewed. They took a median of nine medications, of which three were not recorded in the medical record. One hundred and thirteen MRPs (median 2.0 per patient) were identified by the pharmacist. Independent review rated 35% of MRPs as high or extreme risk. Thirty‐seven (33%) MRPs related to medications not recorded in the medical record. Conclusions: Medication‐related problems were present for most patients. Involvement of a clinical pharmacist resulted in a more comprehensive medication history and identified unresolved MRPs.     

Placebo controlled evaluation of Xilei San,a herbal preparation in patients with intractable ulcerative proctitis

Background and Aim: Topical mesalamine or corticosteroid has shown efficacy in patients with ulcerative proctitis, but patients often become refractory to these interventions. Xilei San is a herbal preparation with evidence of anti‐inflammatory effects. We evaluated the efficacy of topical Xilei San in ulcerative proctitis patients. Methods: In a double blind setting, 30 patients with intractable ulcerative proctitis despite ≥ 4 weeks of topical mesalamine or corticosteroid were randomly assigned to True (n = 15) and placebo (n = 15). Patients in True received suppository Xilei San (0.1 g/dose per day of Xilei San), the other 15 received placebo suppository. The initial efficacy was evaluated on day 14. Primary endpoint of the trial was avoiding relapse during 180 days, relapse meant recurrence of active disease. Riley's index was applied for endoscopic and histological evaluations, while patients' quality of life was evaluated by an inflammatory bowel disease questionnaire. Results: On day 14, the number of patients who achieved remission, clinical activity index ≤ 4 in True was significantly higher versus placebo (P < 0.04). Likewise, at day 180, an 81.8% of patients in True were without relapse versus 16.7% in placebo (P < 0.001). Further, significant endoscopic (P < 0.01), histological (P < 0.02) and inflammatory bowel disease questionnaire (P < 0.04) improvements were observed in True, but not in placebo. Conclusions: This is the first controlled investigation showing significant clinical and endoscopic efficacy for Xilei San in patients with intractable ulcerative proctitis. Topical Xilei San was well tolerated, and was without safety concerns.