1例肺曲霉菌合并血小板减少症患者的用药监护

目的探讨临床药师在肺曲霉病合并血小板减少症患者治疗中的作用。方法临床药师参与1例肺曲霉病合并血小板减少症患者的治疗,分别从抗细菌药物和抗真菌药物选择、药物不良反应等方面实施全程药学监护,提出药学建议并对患者进行用药教育。结果医师采纳临床药师建议,患者病情得到有效控制,23 d后出院。结论临床药师积极开展药学监护,协助医师完善用药方案,有助于临床合理用药,保障患者用药安全有效。     

1例原发性血小板减少症合并肺血栓栓塞患者出现药物性肝损伤药学监护

目的通过临床药师参与1例原发性血小板减少症、肺血栓栓塞、药物性肝损伤患者的治疗过程,讨论药学监护的重要性。方法临床药师协助医师对1例原发性血小板减少合并肺血栓栓塞患者进行抗凝药物的选择、剂量调整、保肝药物的选择,寻找可能导致肝损伤的药物,协助医师优化个体化治疗方案。结果患者经过治疗后,肝功能基本正常,抗凝安全有效。结论临床药师参与临床治疗中的药学监护,提高了治疗有效性,保障了患者的用药安全。     

1例化疗致发热性中性粒细胞减少儿童患者的药学监护

目的:探讨临床药师为化疗致发热性中性粒细胞减少患儿进行药学监护的作用.方法:结合发热性中性粒细胞减少患者抗菌药物应用指南,对用药方案进行探讨和分析.结果:临床药师重点对儿童抗菌药物品种的选择、给药方法及停药时机进行监护,协助医师调整升白细胞、血小板治疗方案.结论:通过临床药师对患儿实施药学监护,协同医师制定合理的给药方案,保证患者用药安全有效.     

1例吸入性重症肺炎合并癫痫患者的药学监护

目的探讨临床药师在吸入性重症肺炎合并癫痫患者药物治疗实践中发挥的作用。方法通过临床药师参与1例吸入性重症肺炎并癫痫患者的治疗过程,实施药学监护,关注患者用药方案的选用及出现不良反应的处置及分析等几个方面,协助医师为患者制定安全有效的治疗方案。结果治疗11 d后,患者一般情况明显好转,炎症指标恢复正常,肺部CT明显吸收,肝功能好转。结论通过临床药师实施药学监护,可以及时发现用药问题,提高患者用药的安全性、有效性,体现临床药师价值。     

1例哮喘急性发作伴抑郁症患者的药学监护

摘 要 目的：探讨临床药师对哮喘急性发作患者开展药学监护的方法与思路。方法：临床药师通过了解哮喘急性发作的治疗原则,分析治疗方案,参与1例哮喘急性发作伴抑郁症患者的治疗过程并实施药学监护,关注药物不良反应及治疗窗,协助临床医生制定适合患者的个体化用药方案。结果：临床药师通过对治疗全程的药学监护和医嘱干预,识别了药品不良反应的发生,优化了治疗方案,提高了药物治疗效果。结论：临床药师在临床治疗中应积极开展药学监护,协助医师制定个体化治疗方案,以利于提高患者用药的安全性和有效性。     

对1例带状疱疹继发血小板减少症患者的药学监护

目的：以1例带状疱疹继发性血小板减少症患者的药学监护过程为例,展现临床药学监护的工作方法,探讨药学监护在保证合理用药方面的价值。方法：临床药师通过科室查房、临床药学会诊等方式发现监护目标,全程参与药物治疗过程,分析药物治疗方案,协助调整和优化用药方案。结果：继发性血小板减少症与不合理使用抗病毒药相关,药师及时发布院内不合理用药警示：更昔洛韦不得用于带状疱疹的治疗。结论：临床药师开展药学监护有助于及时发现不合理用药导致的药物损伤,减少药物引发的不良事件,保证患者用药安全、有效、经济。     

临床药师对1例病毒性脑炎伴血小板减少患者的个体化药学监护

目的:探讨药师在临床治疗实践中发挥的作用。方法:通过临床药师对1例病毒性脑炎伴血小板减少的患者实施药学监护,关注患者用药方案中抗病毒治疗、疼痛治疗、抗菌药物选用和急性胃黏膜病变预防几个方面,协助医师为患者制订有效、个体化的治疗方案,为患者提供合理的药学监护措施。结果与结论:临床药师对患者实施药学监护可以提高患者用药的依从性、安全性、有效性,为患者节省医疗开支,为临床医师选药开阔思路。     

临床药师对1例合并机会性感染艾滋病患者的药学监护

目的：通过临床药师对合并机会性感染艾滋病患者实施药学监护的过程,探讨药师在临床治疗中发挥的作用。方法：针对具体病例,协助医师为患者制订有效的治疗方案;为患者建立药历,针对患者在用药期间所出现的药品不良反应而提出合理的药学监护措施及健康教育计划。结果：临床药师为患者实施药学监护可提高药物治疗水平,提高患者用药的安全性及有效性,改善其生活质量。结论：临床药师参与临床药物治疗实践,有利于提高临床药物治疗水平,使用药更加规范化。     

1例小儿重症肺炎抗感染治疗的药学监护实践

目的:探讨临床药师参与药物治疗方案的制定与药学监护的方法。方法:通过对1例重症肺炎患儿进行药学监护,了解临床药师参与药学临床实践的过程,协助医师为患儿提供个体化药物治疗方案。结果:临床药师的建议被临床医师采纳,患儿病情好转出院。结论:临床药师参与药物治疗,可提高疗效,确保患儿用药安全,使患儿受益。     

妊娠合并急性重症胰腺炎患者的药学服务分析

目的:分析妊娠合并急性胰腺炎患者的药学服务,探讨临床药师在药物治疗中的作用。方法:临床药师参与妊娠合并急性胰腺炎患者的药物治疗,与临床医师一起制订用药方案,监护用药过程。结果:临床药师参与急性胰腺炎的治疗方案,关注药物对妊娠的影响,提供药学监护。结论:临床药师参与临床急性胰腺炎的治疗,通过制订用药方案和药学监护,减少了药物对妊娠的影响,保证了胎儿的健康发育。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.