Literature analysis of ocular adverse drug reactions related to dupilumab / 中国药房

OBJECTIVE To analyze the clinical manifestation and characteristics of ocular adverse drug reaction （ADR） related to dupilumab， so as to provide reference for clinically safe drug use. METHODS Retrieved from CNKI， Wanfang data， VIP and PubMed databases， the case reports about ocular ADR caused by dupilumab were collected， and then analyzed statistically in terms of gender， age， primary disease， drug use， occurrence time of ADR， main clinical manifestations， treatment or outcome， etc. RESULTS A total of 20 pieces of literature were selected， involving 46 patients， among which there were 29 males and 17 females. Mainly patients were under 60 years old. The results of the association evaluation was given as follows： 13 were “very likely” and 33 were “likely”. All patients were treated with dupilumab for atopic dermatitis （AD） without off-label medication. The occurrence time of ADR was 2 weeks to 2 years after administration， mainly within 6 months after medication. All patients received dupilumab monotherapy except that 3 patients with hypertension and 1 patient with chronic obstructive pulmonary disease and human immunodeficiency virus received other drugs simultaneously. Twenty-eight patients had a history of allergic disease， and 11 patients had a history of eye disease. Ocular ADRs were mainly conjunctivitis and uveitis， and the clinical manifestations mainly included conjunctival congestion， swelling， eye secretions， etc. Ten patients developed severe ADR， including uveitis， severe conjunctivitis， and tear point stenosis； 45 patients were improved after symptomatic treatment. AD， serious initial symptoms of AD， allergic disease and underlying ocular diseases might be the high-risk factors of ocular ADR caused by dupilumab. CONCLUSIONS Whether the patient has the history of allergic diseases and basic eye diseases should be asked in detail before clinical use of dupilumab. When using the drug， attention should be paid to monitoring whether the patient has intraocular inflammation， be alert to the occurrence of new or serious ADR， and give timely symptomatic treatment to ensure the safety of drug use.

Analysis of 15 183 Cases of ADR Caused by Antineoplastic Drugs / 中国药房

OBJECTIVE: To investigate the characteristics and regularity of ADR induced by antineoplastic drugs and provide reference for safe drug use in clinic. METHODS: ADR reports induced by antineoplastic drugs reported by 108 hospitals during Jan. 2009-Dec. 2016 were collected from PLA ADR Monitoring Center. ADR reports were analyzed respectively in respects of types of ADR reports, patients ' gender and age, administration route, occurrence time, types of antineoplastic drug, the situation of patients suffering tumor, systems/organs involved in ADR, clinical manifestations, outcome, etc. RESULTS: Among 15 183 ADR reports, there were 462 cases of new ADR and 2 873 cases of severe ADR; there were 8 039 male (52. 95％) and 7 144 female (47. 05％). The proportion of severe ADR in female (20. 00％) was significantly higher than male (17. 96％), with statistical significance (P=0. 001). ADR was mainly induced by intravenous administration (90. 53％), and mainly occurred 2-＜7 d after medication (23. 00％). Top 3 drug categories in the list of ADR were platinum antineoplastic drugs (25. 63％), plant-derived antineoplastic drugs and its derivative (24. 42％) and anti-metabolism drugs (18. 50％). Male patients mainly suffered from lung cancer, colorectal cancer and gastric cancer; female patients mainly suffered from breast cancer, lung cancer and colorectal cancer. Systems/organs involved in ADR were gastrointestinal system, hematological system and systemic damage. Main clinical manifestations were nausea, vomiting, myelosuppression, skin rash and fever. Totally 92. 57％ of ADR cases were cured and recovered after treatment, and 5 cases died. CONCLUSIONS: Antineoplastic drugs have high incidence of ADR with serious damage. Clinic should strengthen the monitoring of key population and key drugs so as to reduce the occurrence of ADR.

Preparation and property of gelatin hydrogel loaded with AgSD-nanocrystal / 国际药学研究杂志

Objective To prepare a silver sulfadiazine(AgSD)-nanocrystal loaded hydrogel with gelatin as the main raw mate-rial,genipin as crosslinker,and test its physicochemical property and drug release characteristics. Methods AgSD-nanocrystal was prepared by ball milling,the particle size and polydispersity index were determined,the solubility was studied by an ultra perfor-mance liquid chromatography(UPLC)method and the microstructure was observed with transmission electron microscope(TEM);drug loaded gelatin hydrogel in different crosslinking degrees were prepared,the dissolution rate was studied in the same way as AgSD-nanocrystal and the possible dissolution mechanism was analyzed by fitting curves;the microstructure was observed by scanning elec-tron microscope(SEM). After 6 weeks,with the same method,all the above mentioned properties of drug loaded hydrogel and AgSD-nanocrystal suspension were determined repeatedly,and at the same time their stability was tested. Results After nanocrystalliza-tion,the polydispersity index of AgSD was 0.211,the mean particle size was about 267.8 nm,the dissolution rate greatly increased within 6 hours compared with that of AgSD bulk powder. There was a negative correlation between dissolution rate and crosslinking de-gree,and the nanoparticle gel's curve was higher than that of the bulk. In terms of stability,AgSD-nanocrystal in hydrogel was almost in the original state in SEM,while those in suspention had an increasing particle size and decreasing dissolution rate. Conclusion The stability and dissolution of the new drug loaded hydrogel are good,and its data can be used as reference for relevant study.

Gelatin hydrogel loaded with silver sulfadiazine nanocrystal:in vitro anti-bacterial activities and in vivo wound healing enhancing properties / 国际药学研究杂志

Objective To prepare a gelatin hydrogel crosslinked by genipin and loaded with silver sulfadiazine(AgSD) nanoparticles,and test its in vitro anti-bacterial activities and in vivo wound healing enhancing properties. Methods The suspension of AgSD nanoparticles and coarse powder,hydrogels loaded with AgSD nanoparticles and coarse powder were prepared,respectively, and blank gels were used as control. The diameters of inhibition zone of sensitive bacteria were measured;The biocompatibility to L929 cells was studied by MTT method and relative growth rates of the cells were determined. The minimum inhibitory concentration (MIC)and minimum bactericidal concentration(MBC)of 3 sensitive bacteria were tested;DeepⅡdegree scald co-aureus infection mice model was established and the healing index of treatment by drug-loaded hydrogel dressing was calculated within 3 weeks. The collagen deposition was studied after sirius red staining and pathological manifestations were observed after HE staining. Results Compared with AgSD coarse powder,the antibacterial property of AgSD nanoparticles obviously improved in inhibition zone and MIC, MBC experiments. Better biocompatibility and antibacterial property were revealed for AgSD nanoparticles gel group compared with AgSD cream group in MTT assay and inhibition zone studies;Healing index increased significantly since the second week in AgSD nanoparticles gel group compared with staph group,AgSD cream group and AgSD coarse powder gel group in wound-healing experi-ment(P<0.05). Compared with those control groups,nanocrystal gel group had more content of typeⅠcollagen and total collagen, and higher pathology scores(P<0.05). Conclusion AgSD nanocrystal loaded gelatin hydrogel has good antibacterial activity in vitro and high quality healing enhancing property in vivo.

Anti-radiation drugs for radiotherapy:research advances / 国际药学研究杂志

Anti-radiation drugs can prevent humans from radiation injury,reduce the clinical symptoms of radiation sickness and promote early recovery. With the wide application of radiotherapy in the treatment of malignant tumor patients ,anti-radiation drugs for radiotherapy have become more and more important. Tradiational anti-radiation drugs include free radical scavengers,super?oxide dismutase(SOD)and SOD mimetics,nitroxides,natural antioxidants and cytokines. These drugs have the common disadvantag?es of serious side effects,narrow therapeutic time window,poor stability and high cost. Therefore,it is particularly important and ur?gent to discover anti-radiation drugs which are highly efficient,lowly toxic,inexpensive and easy to use. In recent years,with the deepening understanding of cell signaling pathways,angiotensin converting enzyme inhibitors(ACEI)and apoptosis regulators have gradually become a hot spot for anti-radiation drugs research. This review summarizes the advantages and disadvantages as well as the future trends of anti-radiation drugs with proven or potential usefulness in radiotherapy.

Analysis on 7 417 ADR Reports Induced by Antineoplastic Drugs from 91 Hospitals / 中国药房

OBJECTIVE:To investigate characteristics and regularity of ADR induced by antineoplastic drugs and provide ref-erence for the safe drug use. METHODS:7 417 ADR reports induced by antineoplastic drugs from 91 hospitals from 2009 to 2013 were collected in the ADR monitoring center of PLA. According to the classification in national ADR monitoring cencer,Excel soft-ware was performed to statistically analyze the data. RESULTS:Among 7 417 ADR reports,1 475 were severe ADR(19.89%), 196 were the new and general ADR(2.64%),and 44 were new and severe ADR(0.59%);the elderly patients aged from 45-59 years accounted for the highest proportion (41.01%);intravenous administration was the main administration route causing ADR (88.96%);the incidence of antineoplastic drugs was higher in plant-derived drugs(26.55%),platinum drugs(24.86%)and an-ti-metabolism drugs (19.46%);ADR mostly manifested as lesions of digestive system (38.80%),blood system (16.53%) and general system(12.79%);43.60%ADR occurred within 12 hours after administration. CONCLUSIONS:Highly poisonous,nar-row-range security antineoplastic drugs could easily induce ADR. Risk prevention of antineoplastic drugs should be strengthened to undertake monitoring for high-risk patients and antineoplastic drugs,and severe ADR. More attention should be attached to the reac-tions after 12 h administration to reduce ADR incidence as much as possible.

Analysis of 572 Cases of Drug-induced Liver Injury Induced by Anti-infective Agents / 中国药房

OBJECTIVE:To investigate the condition and characteristics of drug-induced liver injury (DILI) of anti-infective agents and provide reference for the prevention and treatment of anti-infective agents related DILI. METHODS:Based on retrospective analysis,a total of 572 DILI reports of anti-infective agents were collected from PLA ADR monitoring center during 2009 to 2013, and then analyzed statistically in terms of patient’s age and gender,main diagonosis,categories of DILI-inducing drugs,type,route of administration,occurrence time,lab indicator,DILI types and clinical manifestations,the application of liver protective drugs,out-comes,etc. RESULTS:Among 572 DILI cases,there were 412 cases(72.03%)of male patients and 160 cases(27.97%)of female patients,and average age of the patients was(44.54±23.75)years old. ADRs were related to 57 kinds of anti-infective agents in 6 cat-egories. Rifampin was the most frequent in suspected drugs,followed by isoniazid,moxifloxacin,fluconazole,azithromycin,cefurox-ime, cefoperazone/sulbactam, levofloxacin, cefoxitin and voriconazole. Intravenous infusion was the main administration route (74.48%). The occurrence time of ADRs was mainly within two weeks (86.19%). Hepatocellular damage (93.33%) was the main type in 360 cases of ADR for evaluation of liver injury types. The majority of cases(82.17%)were cured or improved after drug with-drawal and symptomatic treatment. CONCLUSIONS:Cephalosporin,fluoroquinolones,antituberculosis and antifungal drugs might be the common agents which caused liver injury. Hepatocellular damage is the most frequent type. Most of patients have a favourable prognosis. Clinical medical staffs should strengthen the awareness of DILI caused by anti-infective agents and ehance the prevetion of it.

Analysis of 410 Cases of Clinical Pharmacist Consultations and Discussion of Working Mode / 中国药师

Objective:To understand the mode and effect of the consultations involved clinical pharmacists, and discuss the work-ing process and mode of the consultations. Methods:Based on the practical work and team discussion, the flow chart and consultation registration form for the clinical pharmacist consultations were established and applied. Totally 410 cases of clinica1 pharmacist consul-tations were retrospectively investigated from March 2009 to December 2012. Results:The consultation flow chart was strictly followed by the clinical pharmacists in our hospital, and the obvious effect was shown. The number of consultation was increased from 59 cases in 2009 to 122 cases in 2013. In all the consultation cases, 21 departments were involved, including the medical departments and the surgery departments. Among the cases,the adjustment in antibacterial drug treatment was the main requirements. Meanwhile, the a-doption rate of the clinical pharmacist suggestions was 95. 12%. Conclusion:Clinical pharmacists are playing an important role in clin-ical treatment. The consultation work can be regulated by the consultation flow chart and registration form with the improved adoption rate and consultation quality.

Off-label and off-NCCN guidelines uses of antineoplastic drugs in China

To evaluate off-label and off-NCCN guidelines uses of antineoplastic drugs in a major Chinese hospital. Totally 1122 patients were selected from July to December 2011. Then, the off-label and off-NCCN guidelines uses of antineoplastic drugs were analyzed. In 798 of 1122 patients [71.12%], drugs were used for off-label. In 317 of 1122 patients [28.25%], the drugs were prescribed for off-label and off-NCCN guidelines. 2591 medical orders for 1122 patients, 1051/2591 [40.56%] medical orders were off-label; 445/2591[17.17%] medical orders were off-label and off-NCCN guidelines. In 445 off-label and off-NCCN medical orders, 399 [89.66%] were unapproved indications, 38 [8.54%] were unapproved drug concentration and 12 [2.70%] were unapproved route of administration. Percentage of off-label and off-NCCN guidelines drug uses in male was higher than that in female [21.92% vs. 11.39%, P<0.01]. Compared with other lines of treatment, percentage of off-label and off-NCCN guidelines drug uses in postoperative adjuvant was the smallest [P<0.01] and percentage in three or multi-line treatments was the highest [P<0.01]. The pancreatic cancer possessed the highest percentage [38.74%] of off-label and off-NCCN guidelines drug uses among all types of cancer [P<0.01]. Off-label uses of antineoplastic drugs are generally common in China hospitals based on NCCN guidelines. The fact suggests that anti-tumor treatment was relatively standard in China. Off-label and off-NCCN guidelines drug uses were mainly for individual treatment. Doctors should fully consider the adverse drug reaction, contraindication, cautions and increase the drug security monitoring. Uncorrected drug concentration should be avoided for drug risk

Protective activity of different concentration of tea polyphenols and its major compound EGCG against whole body irradiation-induced injury in mice / 中国中药杂志

<p><b>OBJECTIVE</b>To evaluate the different concentrate of tea polyphenols (TP) and its compound for irradiation-protection and investigate its mechanism.</p><p><b>METHOD</b>To evaluate the radioprotective activity, mice were exposed to whole body gamma irradiation. TP 80 and TP 50 (50, 10 mg x kg(-1)) and its major constituent epigallocatechin gallate (EGCG) (50, 10 mg x kg(-1)) were administered after irradiation to examine its inhibition against irradiation-induced injury.</p><p><b>RESULT</b>This study indicate that in comparison with non-irradiated controls, irradiation resulted in a significant reduction the spleen index (spleen weight/body weight 100), haematological parameters (RBC, WBC and PLT), activity of superoxide dismutase (SOD), and increase of malondialdehde (MDA) level in 28 days. Oral administration of TP (50 mg x kg(-1)) shown the best effect on reducing the irradiation-induced injury on mice studied, and showed a protective effect against irradiation-induced haematological parameters (RBC, WBC and PLT), the spleen index and MDA level significant reduction, and antioxidase activity (SOD) decrease.</p><p><b>CONCLUSION</b>The results suggest that TP 50 mg x kg(-1) and EGCG have in vivo antioxidant potential and radioprotective activity against whole body gamma irradiation in mice. It may be concluded that TP (50% EGCG) possess good irradiation-protective and antioxidant effect.</p>

Antidepressant effects of piperine and its neuroprotective mechanism in rats / 中西医结合学报

To study the antidepressant effects of piperine in chronic unpredictable mild stress (CUMS) rats and to explore the underlying mechanisms in the hypothalamic-pituitary-adrenal (HPA) axis.

Analysis of Utilization of Chinese Patent Medicines in our Hospital During 2001-2005 / 药物流行病学杂志

Objective:To analyze the utilization of Chinese patent medicines in our hospital,and evaluate the ra- tional use of drugs in clinic.Method:The data of annual consumption and total consumption of Chinese patent medicines in our hospital during 2001-2005 were calculated,and DDDs and daily average cost of Chinese patent medicines were calcu- lated with the pharmacoeconomic method.Result:The annual consumption of Chinese patent medicines showed an increas- ing trend in our hospital during 2001-2005.The consumption of agents for injection increased clearly in Chinese patent medicines.Especially,the rank ratio of sum and DDDs always were less than one.Conclusion:In our hospital,the use of Chinese patent medicines is rational on the whole,and Chinese patent medicines play an important part in the clinical use for their cheap and effective reasons.DDDS should be stressed and management of Chinese traditional medicines for injec- tion should be intensified.

Evaluation of Ration of Atomization Inhalation Given to Patients in Perioperative Period / 药物流行病学杂志

Objective:To assess the ration of atomization inhalation medicine which was given to the patients in the perioperative period to provide possible reference for the application of medicine in operations.Method:From the clinical pharmacy workstation combined with manual retrieval method,a research was done among some patients who had once received treatments in the four surgical wards of our hospital in order to assess the related index of the ration of atomization inhalation medicine given to the patients in the perioperative period.Result:Among the 186 patients,the proportion of the used atomization inhalation medicine ration ranged from 63.79%to 100.00%.The medicines used in the largest amount were Ambroxol Hydrochloride Injection,Sodium Chloride Injection and Etimicin Sulfate for Injection.The qualified proportion of the ration of the medicine applied to patients each single time was 56.59%.The proportions of single medicine and double medicine were 31.71%and 54.15%,respectively.Conclusion:The atomization inhalation medicine applied to the patients is basically rational in our hospital,but the overdose use of medicine in a single time and the irrational combined use of different medicines still exist.The clinicians and pharmacists need a close cooperation with each other,and analyze the process comprehensively in order to improve the atomization inhalation medicine's application.

Composition and Influential Factors of Hospitalization Expenses in Inguinal Hernia Inpatients Under the Single-disease Payment Standard of Medical Insurance / 药物流行病学杂志

Objective:To analyze the hospitalization expenses in inguinal hernia inpatients under the single-disease payment standard of medical insurance.Method:A retrospective study was performed to analyze the data of inguinal hernia patients who received inguinal herniorrhaphy in 2006.According to the regulations worked out by the Beijing Medical Insurance Affairs Administration,32 cases were selected and their medical costs were characterized.Result:The average hospitalization expense in inguinal hernia patients was 5722.37?2967.66 yuan,including surgery cost(45.6%) and drug cost(26.7%).The surgery cost level depended on the selection of various hernia prosthetic mesh and the drug cost depended on the selection of various anti-infective drugs.The hospitaliztion expenditures were lower in 18 cases than the payment permission in the medical insurance standard but higher in the other 14 cases.The sex composition,surgery cost, drug cost and laboratory cost showed a significant difference between the two groups(P

Analysis of Hospital Preparation Utilization in Our Hospital / 中国药房

OBJECTIVE:To evaluate the role and function of hospital preparations.METHODS:A retrospective analysis was conducted on the utilization of hospital preparations in our hospital from July 1,2005 to June 30,2006.RESULTS:A total of 158 kinds of hospital preparations were used in our hospital,with their sales value totaling RMB 10.025 3 million,representing 1.13% of total drug sales.The top 10 selling hospital preparations accounted for 72.2% of all hospital preparations in sales value.A difference was seen in use of hospital preparations by outpatient and inpatient departments.CONCLUSIONS:Hospital preparations are indispensable for routine diagnosis and medication despite their small proportion in sales value of total drugs.

Economic Benifits of Hospital Pharmaceutical Services after Cancelling the Hospital Drug Price Addition / 中国药房

OBJECTIVE: To discuss the economic benefits of pharmaceutical care after hospital drug price addition has been cancelled. METHODS: To analyze the way to create economic benefits from hospital pharmaceutical services in China by drawing experiences from developed countries. RESULTS & CONCLUSIONS: Canceling of hospital drug price addition is conducive to the increase of the status of pharmacists. Medical institutions can profit from extending pharmaceutical services.

Analysis of Drug Utilization by 98 Cases of Renal Transplant Inpatients During 2005 / 药物流行病学杂志

Objective:To analyze the situation of immunosuppressants utilization of renal transplantation inpa- tients in our hospital.Method:The records and relevant data of 98 case of renal transplant inpatients during 2005 were col- lected,and analyzed according to drug cost and defined daily dose(DDDs)ranking.Result:The average age was(42.50?10.56)a,the average drug cost was(18745.36?7603.86)yuan,the average inmunosuppressant cost was 13456.58 yuan,and all the drug utilization indicators(DUI)were≤1.Conclusion:The analysis shows that the inmunosuppressant utilization rate was high and the inmunosuppressant utilization by renal transplant inpatients was basically rational.

Usage of Cephalosporins in Our Hospital During 2003-2007 / 中华医院感染学杂志

OBJECTIVE To learn the situation of cephalosporins used in our hospital,and offer the scientific guidline base for their clinical use.METHODS Statistics methods were used to analyze dosage,sales volume and DDDS of cephalosporins during 2003-2007.RESULTS The usage of the first generation cephalosporins was reduced year by year,but the third generation of compoands cephalosporins and their oxef cephalosporins occupied the main places.The DDDs of cefoperazone/tazobactam usage ranked second for three years(2005-2007),and at the same period their DDDs consumption got top.CONCLUSIONS The situation of the usage of cephalosporins in our hospital is reasonable basically,but more attention should be payed to the usage of the third cephalosporins and their compounds and oxefs.

Pharmacoeconomic Evaluation of Individual Antimicrobial Therapeutic Schemes in Appendectomy Patients / 中华医院感染学杂志

OBJECTIVE To analyze the antimicrobial therapeutic schemes in appendectomy inpatients so as to(evaluate) the economic impact factors of each project.METHODS Totally 286 medical cases of appendectomy inpatients were chosen and analyzed from 2003 to 2005.The antimicrobial agent costs of each scheme were evaluated by(using) cost minimization analysis of pharmacoeconomic method.RESULTS There were 24 kinds of antimicrobial therapeutic schemes used by 286 cases.The commonest schemes were nitrodazoles + ?-lactams and nitrodazoles + ?-lactams + aminoglycosides(or clindamycin). The drug costs were 1671.46 and 1977.13 yuan(RMB)(individually) in combination of two or three kinds of antimicrobial agents.Choosing metronidazole instead of ornidazole could reduce drug fee significantly,which was also observed in choosing ceftazidime instead of other ?-lactams.CONCLUSIONS The antimicrobial drug utilization in our hospital is rational as a whole.Considering of economic factors,using metronidazole and ceftazidime(administering clindamycin if necessary) may be better than other schemes for prventing wound infection.

Analysis on Blood Concentration Monitoring of Vancomycin and Clinical Administration Behavior / 中国药房

OBJECTIVE:To analyze the blood drug monitoring results of vancomycin and clinical administration behavior and then to provide a clinical reference for its rational utilization. METHODS:We retrospectively collected the blood drug monitoring results of vancomycin and drugrelated information from July 2007 to October 2008 in our hospital. These data were from the electronic clinical pharmacy workstation and initial written case history. RESULTS:Among the 76 cases,non-clinical significant results due to doctor’s irregular manipulation in collecting blood sample accounted for 32.89%. In renal failure group,the rate of peak concentration above the effective blood concentration range was 44.46% . Every patient was averagely administered 21.85 kinds of drugs mainly by intravenous injection during vancomycin application. Clinical response rate of vancomycin was 65.00%. CONCLUSION:During the blood concentration monitoring of vancomycin,we should take clinical need into consideration,collect blood samples rightly,consider the factors such as special pathophysiologic status of patients,drug combination,and adjust the dosage timely.