某院135例药品不良反应报告的相关因素分析

目的:分析医院药品不良反应(ADR)发生的特点及规律,为临床安全用药提供参考。方法:收集2015年l—12月间医院上报国家药品不良反应监测中心的有效药物ADR报告,对其不良反应的相关因素进行分析,探讨其特点和一般规律。结果:2015年度上报的ADR报告135份,涉及不良反应的药品52种,抗感染药物居首位,其次为中成药制剂。结论:临床应加强ADR的监测工作,注意安全合理用药,以减少和避免ADR的重复发生。     

366例药品不良反应报告分析

目的:探讨某院药品不良反应(ADR)发生的特点、规律及影响因素,为临床合理用药、正确判断ADR及药品安全性评价提供参考。方法:对该院2013年收集到的366例有效ADR报告进行回顾性分析。结果:366例ADR报告中,涉及药品103种;≥50岁的患者发生ADR的比例最高(189例,占51.64%);静脉给药引发的ADR最多(334例,占91.25%);最易引发ADR的药物为抗感染药物(87例,占23.77%),其次为心血管药物(73例,占19.95%);ADR损害类型主要以心外血管系统损害为主(106例,占22.80%),其次为皮肤及其附件损害(100例,占21.50%)。结论:临床应重视和加强ADR监测工作,以规范临床合理用药,减少或避免ADR的发生,确保患者用药安全。     

80例药品不良反应报告分析

目的：了解我院药品不良反应（ADR）发生的特点及引发的相关因素,为临床合理用药提供依据,保障临床用药安全。方法：对我院2014年上报的80例ADR报告进行归纳和分析。结果：涉及药品共43种,抗菌药物引起的ADR居首位,共27例,占32.15%,其次为中成药和中枢系统用药,分别占25.00%及22.62%;给药途径以静脉注射为主,占98.75%;临床表现以皮肤及附件反应最为常见,占35.09%。结论：ADR的发生与多种因素有关,各相关单位应积极配合,加强ADR的监测工作,为临床合理用药提供参考,减少ADR。     

某院2014年387例药品不良反应报告分析

目的探讨医院药品不良反应(ADR)发生的特点及规律,为加强药品安全监测、指导临床合理用药提供参考。方法统计并分析医院2014年收集的387例有效ADR报告。结果 387例ADR报告中,涉及药品129种,60岁以上患者发生ADR比例最高(166例,占42.89%);静脉注射(包括静脉滴注)给药引发的ADR最多(330例,占85.27%);最易引起ADR的药物为抗肿瘤及其辅助用药(163例,占42.12%),其次为中药针剂(78例,占20.16%);ADR损害类型主要以消化系统为主(93例,占24.03%),其次为血液系统损害;新的、严重的ADR 166例,占42.89%。结论临床应重视和加强ADR监测,合理用药,减少或避免ADR的发生。     

2007年我院静脉注射药品不良反应报告分析

目的:分析我院2007年静脉注射药品不良反应(ADR)发生特点及相关因素,为临床合理用药提供参考。方法:对我院2007年共46例静脉注射药品ADR报告作分析。结果:ADR发生年龄分布60岁以上的老年人及10岁以下的儿童共占58.70%,抗感染药物引起的ADR占71.74%,均列首位;ADR临床表现以过敏反应列首位。结论:加强ADR监测工作,促进临床合理用药。     

我院372例药品不良反应分析

目的：了解医院药品不良反应（ADR）发生的特点,促进临床合理用药。方法：对我院2009～2011年372例药品不良反应报告进行统计分析。结果：372例ADR中,抗感染药物占37.63%,中药注射剂占14.52%;静脉滴注引发的ADR最多,占88.98%;以皮肤及其附件损害最多,占43.12%,其次为消化系统损害,占15.38%;ADR多发于0～10岁婴幼儿、儿童人群。结论：药物不良反应的发生与多种因素有关,应加强药物不良反应监测工作,促进临床合理用药,保证患者用药安全。     

351例儿童药品不良反应报告的相关因素分析

目的:分析医院儿童患儿药品不良反应(ADR)的相关因素和发生的特点及规律,为患儿合理用药提供参考。方法:抽取医院2017年1—6月间上报国家药品不良反应监测系统的351例儿童ADR报告,分析儿童患儿引起ADR的相关因素和发生的特点及规律。结果:在351例儿童ADRs报告中,新的ADR 51例占14.53%,其中,新的严重的ADR报告2例占0.57%;给药途径中静脉滴注238例占67.81%;抗感染药物168例占47.86%,和营养、电解质、维生素类药物34例占9.69%;ADR累及全身各个系统,其中以皮肤及其附件损害241例占68.66%,主要表现为皮疹、瘙痒、皮肤潮红等症状;ADR发生率最高的年龄组为≤1岁111例占31.62%;大部分ADR经过相关处理后均较好的转归(痊愈12.54%、好转85.19%)。结论:应注意ADR发生的相关因素(给药途径和患儿性别、年龄等),以减少ADR的发生,保障儿童患儿临床用药的安全、合理。     

2010年六安市药品不良反应监测报告分析

目的了解我市各医院及药品生产、经营企业的药品不良反应(ADR)报告情况,探讨引起ADR的因素。方法对我市2010年上报国家药品不良反应监测平台的8614例ADR病例进行回顾性研究分析。结果抗感染药物引起的ADR 4686例占54.4%,中药制剂引起的ADR 1343例占15.6%。结论应加大ADR监测工作力度,最大限度的保障临床用药安全、合理、有效,尽量避免或减少ADR的发生。     

120例静脉输液不良反应报告分析

目的 通过对我院2011年1至12月收集的120例药物静脉输液不良反应汇总,了解药品不良反应(ADR)的特点,为临床合理用药提供依据.方法 采用病例回顾性研究的方法,总结不良反应发生状况.结果 120例静脉输液ADR报告中,女性患者发生ADR概率高,占59.2% ;涉及的药物中,抗微生物药物引发ADR居首位,占50.9%,其中头孢菌素类药物占50.6%.中药制剂其次,占36.7%;ADR涉及例次最多的系统/器官为皮肤及其附件,主要表现为皮疹、瘙痒等.结论 儿童和女性等特殊人群是ADR监测的重点,同时抗微生物药物、中药制剂是ADR监测的重点药物.临床医务工作人员应提高合理使用药物,尽量减少ADR发生.     

236例药品不良反应报告分析

目的:通过对药品不良反应(ADR)病例的分析,了解ADR发生的特点和规律,为临床合理用药提供依据。方法:收集2010年1月—2011年10月上报的236份ADR报告,从患者年龄、性别、药品种类、用药途径、涉及器官和(或)系统、临床表现和不良反应发生时间等方面进行分析。结果:236例报告涉及药品15类103种,其中抗菌药物引起的ADR居首位(80例,占33.9%),60岁以上的患者ADR发生例数最多(67例,占28.4%);其临床表现多为皮肤及其附件损害(92例,占40.0%),其次为神经系统损害(47例,占19.9%)、消化系统损害(33例,占14.0%)。静脉滴注引发137例(占58.1%),中药注射剂引发26例(占11.0%);严重ADR有5例,占2.1%。结论:ADR与多种因素有关,应加强临床用药监测和做好ADR相关知识宣传,避免或减少ADR的发生。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

基层医院护士在临床合理用药中的作用

目的充分利用护士在医师和患者间的特殊地位和作用,促进基层临床合理用药。方法从护士的工作性质出发,论述护士参与促进合理用药的方便和优势。结果通过实践,护士在促进合理用药中的作用得到有效发挥,基层合理用药环境得到极大改善。结论充分利用护士与医师和患者间的特殊桥梁作用,在基层医院促进合理用药,规范医师用药行为,防止药物滥用,引导患者安全用药,降低药源性疾病。