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In 2022, the American Gastroenterological Association(AGA)published an expert consensus on the AGA's clinical practice update on PPI prescription cancellation in the Journal of Gastroenterology.In view of the excessive and unreasonable use of proton pump inhibitors(PPIs), experts were organized to formulate a set of ten practical suggestions on how to guide outpatient patients to reduce and stop using PPI.Based on the current situation of PPI use in China and the needs of clinical practice, this paper interpreted the consensus from the perspective of pharmacists, so as to provide reference for further regulating the rational use of PPI and reducing the excessive use and adverse reactions of PPI.
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Objective To investigate the use of hepatoprotective drugs in China in recent years, and to put forward related suggestions. Methods The outpatient prescription data of hepatoprotective drugs were collected from 85 hospitals in 6 cities of China from 2015 to 2019, and a real-world data analysis was performed to analyze the payment method, issuing department, drug category, and use of hepatoprotective drugs. Results A total of 1 113 575 prescriptions were extracted, involving 38 hepatoprotective drugs such as compound glycyrrhizin, polyene phosphatidylcholine, and bicyclol. Hepatoprotective drugs were mainly in tertiary hospitals, and the highest number of prescriptions containing hepatoprotective drugs were observed in department of infectious diseases, department of gastroenterology, and department of tuberculosis. Anti-inflammatory hepatoprotective drugs accounted for the highest proportion of all prescriptions, mainly compound glycyrrhizin, polyene phosphatidylcholine, and bicyclol. Of all prescriptions, 253 429 (22.76%) had the combination of multiple hepatoprotective drugs, with the highest number of 6 drugs, among which polyene phosphatidylcholine combined with bicyclol accounted for the highest proportion. Conclusion There are large quantities of hepatoprotective drugs used by outpatients in China. At present, the hepatoprotective drugs are clinically applied rationally, but there are still some problems to be solved, such as the combination of drugs.
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OBJECTIVE：To compare the eff icacy and safety of rivaroxaban versus enoxaparin in the treatment of malignant tumor complicated with venous thromboembolism （VTE），and to provide evidence-based reference to the clinic. METHODS ： Retrieved from PubMed ，Embase，Cochrane Library ，Clinical Trials ，CNKI，CBM and VIP ，clinical trials or observational studies about rivaroxaban versus enoxaparin were collected during the inception to Apr. 2020. After literature screening and data extraction ， the quality of included literatures were evaluated by Newcastle Ottawa scale ；Stata 15.0 software was used to conduct Meta-analysis，sensitivity analysis and publication bias analysis. RESULTS ：A total of 5 observational clinical cohort studies were retrieved，including 4 retrospective cohort studies and one prospective cohort study. Totally 997 patients were included ，among which 625 patients received enoxaparin and 372 patients received rivaroxaban. Results of Meta-analysis showed that there was no statistical significance in recurrence rate of VTE at 3 months follow-up [RR ＝0.91，95％CI（0.50，1.66），P＝0.760] and 6 months follow-up [RR ＝0.53，95％CI（0.24，1.15），P＝0.106] as well as the incidence of massive hemorrhage at 3 months follow-up [RR ＝ 1.22 ，95％CI（0.66，2.25），P＝0.530] and 6 months follow-up [RR ＝1.30，95％CI（0.73，2.33），P＝0.368]. The results of sensitivity analysis showed that the results of above Meta-analysis were stable ；the results of publication bias analysis showed that there was less possibility of publication bias in this study. CONCLUSIONS ：Rivaroxaban is as effective and safe as enoxaparin in the treatment of malignant tumor with VTE.
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OBJECTIVE： To reduce ADEs due to potential drug interaction （short for drug interaction） by improving medical staffs’ recognition， and to provide reference for making clinical guidelines for chronic disease. METHODS： According to the Survey Reprots on Chinese Resident’s Nutrition and Chronic Disease and related literatures， nine common chronic diseases （hypertension， type 2 diabetes mellitus， dyslipidemia， depression， primary lung cancer， rheumatoid arthritis， ischemic stroke， chronic heart failure and chronic obstructive pulmonary disease） and latest corresponding clinical guidelines， developed by the Chinese Medical Association or National Health and Family Planning Commission were selected to evaluate the improvement of drug interaction in the guidelines. Retrieving Micromedex， Stockley’s Drug Interactions， Medscape， Adverse drug interactions： A Handbook for prescribers and drug instructions， centered on the clinical guidelines for hypertension， type 2 diabetes and dyslipidemia， which were most likely to coexist with other chronic diseases and had the highest incidence， the number of drug interactions （mild/medium and severe drug interaction） of drugs recommended by 3 chronic disease guidelines and 8 other guidelines were counted， and drugs with a large number of severe drug interactions were also counted. RESULTS： There was no guideline to discussing the interaction between recommended drugs for comorbidity. The number of mild/mediuem drug reactions recommended by clinical guidelines for hypertension， type 2 diabetes， dyslipidemia and other 8 disease were 759， 681 and 68， respectively； those of severe drug interaction were 262， 17 and 37， respectively. The drugs with a high number of severe drug interactions were digoxin （24）， aspirin （22）， diuretics （12 kinds of drugs， 14-17）. CONCLUSIONS： When patients suffer from multiple chronic diseases， clinical pharmacists should pay attention to drug interactions. Selected clinical guidelines for chronic diseases still need to be completed the content of drug interactions.
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OBJECTIVE:To evaluate the effectiveness of Corbrin capsules for respiratory systemdisease systematically,in or-der to provide evidence-based reference for clinical use. METHODS:Retrieved from CJFD,China Dissertation Database,Wanfang database,VIP,Cochrane Library,Medline and PubMed,randomized controlled trials(RCTs)about conventional treatment plan(trial group)vs. single treatment plan(control group)in the treatment of respiratory system disease. The quality of included studies were evaluated after extracting data and modifying according to Jadad scale and Cochrane bias risk assessment scale. Meta-analysis was performed by using RevMan 5.2 statistical software. RESULTS:A total of 17 RCTs were included,involving 1801 patients. The re-sults of Meta-analysis showed that response rate [RD=0.15,95%CI(0.10,0.19),P<0.001],FEV1[MD=0.21,95%CI(0.14,0.28), P<0.001],FVC [MD=0.26,95%CI(0.05,0.47),P<0.001] and FEV1/FEV [MD=5.60,95%CI(3.42,7.78),P<0.001] of trial group were significantly higher than those of control group,with statistical significance. CONCLUSIONS:Corbrin capsules have good therapeutic efficacy for respiratory system disease and effectively improve lung related indicators.
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Natural product resveratrol has antioxidation,cardiovascular protection and many other useful biological activities. In recent years,many researchers have paid more and more attention to it. However it cannot be used as candidate for the development of new drug due to its poor druggability. Novel resveratrol derivates with improved water solubility and highly potent biological activity could be obtained by chemical modifying of chemical structure of resveratrol. Researches have shown that resveratrol derivatives exhib?it many kinds of attractive activities,including antitumor,reducing blood fat,antiviral,anti-neurodegenerative diseases and so on, which makes them could be used as leads for the further developing of new drugs. This review discusses the development of novel resve?ratrol derivatives by chemical modification in recent years..
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OBJECTIVE:To provide reference for drug procurement and supply and rational use of lipid-regulating agents. METHODS:The epidemiological investigation was carried out among 159 506 cases from 74 hospitals in Beijing,Chengdu, Guangzhou,Hangzhou,Shanghai and Tianjin in 2013. The utilization of lipid-regulating agents was analyzed statistically in re-spects of purchase value,DDDs,DDC,actual average daily dose and sort ratio. RESULTS:The prevalence rate of hyperlipidemia was relatively high,accounting for 29.56% and showing a tendency of regional distribution and young age in all regions. The pa-tients with hypertension,diabetes and coronary heart disease had a higher incidence to suffer from hyperlipidemia. The use of atorv-astatin was in the first place,but it also had a higher DDC;while rosuvastatin hasd the advantage over aorvastatin in drug market. Simvastatin had a lower DDC and was more suitable for the patients with low income. The doses of lipid-regulating agents in other regions were lower than DDD except for those in Beijing and Tianjin. CONCLUSIONS:Statins dominate the lipid-regulating agents market. But new lipid-regulating agents and drug combination provide a new choice for clinical treatment.
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Objective To investigate the rationality and safety of dengzhanxixin injection used in elderly inpatients. Methods The clinical data of 986 inpatients including 620 males and 366 females were collected, and questionnaires containing age, sex, discharge diagnosis, symptoms, drug dosage, course of treatment, laboratory examination, adverse drug reaction and drug effect were analyzed. Results For the 986 cases, the average age was(74.3±7.5)years. The average dose of dengzhanxixin injection was (38.2±4.4) ml, once daily by intravenous drip, and the average period of treatment was (10.8±5.2) days. The adverse reaction rate was 0.81%. The levels of blood glucose and hemoglobin were decreased after treatment(t orμ=1226.5,2620.0, both P<0.05), but there were no statistical differences in the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine (CREA), blood urea nitrogen (BUN) and white blood cell count (WBC) before and after treatment (t or μ=122.5, 405.0, 513.5, 996.5, 956.5, all P>0.05). Conclusions It is safe to use dengzhanxixin injection according to the medication description for elderly inpatients.
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Objective:To analyze adverse drug reactions(ADRs)associated with proprietary Chinese medicine occurring in Beijing Hospital.Method:The ADRs associated with proprietary Chinese medicine between 2002 and 2006 were collected and the associated information was retrospectively analyzed.Result:a total of 179 ADRs were analyzed. Most of them occurring in women patients(76.1%)with hyperplasia of mammary glands who took Xiaojin pills and Xi- huang pills(22.1% & 12%).The herbal medicine injections were the other most associated ones.The clinical appearances of ADRs were rash and bodily manifestation of hypersensitiveness.Condusion:The investigation of Chinese medicine ADR plays a very important role in the modernization of Chinese medicine.
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OBJECTIVE: To discuss the characteristics and regular pattern of the adverse drug reactions(ADR) in our hospital.METHODS: A total of 314 ADR case reports collected by ADR monitoring center in our hospital during 2007 were analyzed statistically.RESULTS: 13 categories(178 kinds) of drugs and 338 cases were involved in the total 314 ADR case reports,mainly anti-infective agents(128 cases,38 kinds) and Chinese drugs preparation(51 cases,20 kinds).The ADR were manifested chiefly as lesions of skin and its appendants(134 cases) followed by gastro-intestinal lesion(56 cases).The patients showed a favorable turn and the death occurred in only 1 case.CONCLUSION: More attention should be paid to the monitoring of rational drug use to avoid or reduce the incidence of ADR.