Historical Evolution of "Formula" and "Preparation" of Zixue as One of Three Classic Antipyretic Preparations / 中国实验方剂学杂志

Zixue was first recorded in detail in Qianjin Yifang, and practitioners of later generations renamed it as Zixuesan and Zixuedan, which is the representative prescription of antipyretic preparations and has high clinical application and research value. At present, there have been many studies on the pharmacological effect and clinical application of Zixue, but the medical books of the past dynasties have slightly different records on Zixue, which has brought some difficulties to the reasonable clinical application and research of this prescription. In addition to the introduction of Zixuesan, which is different from the ancient recipe, the researchers have questions about which development method can reasonably inherit and develop the classical preparation. The authors intend to summarize the historical evolution of "formula" and "preparation" of Zixue, in order to clarify its historical context, which can provide a reference for the modern research and development of this formula, and provide a new ideas for the in-depth exploration of other classic preparations.

The problem of medicating women like the men: conceptual discussion of menstrual cycle-dependent psychopharmacology

While hormonal changes during the ovulatory cycles affect multiple body systems, medical management, including medication dosing remains largely uniform between the sexes. Little is known about sex-specific pharmacology in women. Although hormonal fluctuations of the normal menstruating process alters women's physiology and brain biochemistry, medication dosing does not consider such cyclical changes. Using schizophrenia as an example, this paper illustrates how a woman's clinical symptoms can change throughout the ovulatory cycle, leading to fluctuations in medication responses. Effects of sex steroids on the brain, clinical pharmacology are discussed. Effective medication dose may be different at different phases of the menstrual cycle. Further research is needed to better understand optimal treatment strategies in reproductive women; we present a potential clinical trial design for examining optimal medication dosing strategies for conditions that have menstruation related clinical fluctuations.

Augmented renal clearance

Adding to the complexity of caring for critically ill patients is the fact that many of them have a creatinine clearance that exceeds 130 mL/min/1.73 m². This phenomenon, termed augmented renal clearance (ARC), has only recently been widely recognized and its pathogenesis remains incompletely understood. However, ARC has been shown to result in increased dose requirements for drugs that are primarily eliminated by renal excretion, including many antimicrobial agents and enoxaparin. Recognition of ARC is hampered by the fact that the standard creatinine-based equations used to estimate renal function are not accurate in this clinical setting and the diagnosis is best established using both serum and urine creatinine measurements to calculate clearance. So a high index of clinical suspicion and awareness is usually required before this step is taken to confirm the diagnosis of ARC.

A randomized, open labeled study comparing the serum levels of cobalamin after three doses of 500 mcg vs. a single dose methylcobalamin of 1500 mcg in patients with peripheral neuropathy

BACKGROUND: Vitamin B12 deficiency has been associated with peripheral neuropathy, loss of sensation in the peripheral nerves, and weakness in the lower extremities. Methylcobalamin is the most effective analogue of vitamin B12 used to treat or prevent the complications associated with vitamin B12 deficiency. The current study aimed to compare the serum cobalamin levels after administration of two different regimes of methylcobalamin in peripheral neuropathy patients. METHODS: The present study was a prospective, randomized, comparative study. The study consisted of two parallel groups, group A (methylcobalamin 500 µg injection intramuscularly three times a week) and group B (methylcobalamin 1500 µg injection intramuscularly once a week). A control group of healthy volunteers was also included. RESULTS: A total of 24 patients (12 in each group) were included in the study. Five healthy volunteers were also included as a control in each group. At the end of treatment, serum cobalamin levels were significantly (P = 0.028) higher in group A (1892.08 ± 234.50) as compared with group B (1438.5 ± 460.32). The serum cobalamin levels in Group A healthy volunteers were also two times higher than that of group B (P = 0.056). Both the LANSS scale and DN4 questionnaire reported similar results at end of treatment. CONCLUSIONS: The 500 µg methylcobalamin thrice weekly regime is more effective in increasing the serum cobalamin levels as compared to the 1500 µg methylcobalamin once weekly regime.

How to Choose Drug Dosage for Human Experiments Based on Drug Dose Used on Animal Experiments: A Review.

The orthodontic tooth movement is a biological response to orthodontic force. The biological response is very strongly-related to local bone metabolism. There is a strong evidence in the literature that bone metabolism can be altered by drugs. There are various studies published in dental journals on administration of drugs for the purpose of affecting orthodontic tooth movement both for augmentation of anchorage and to increase the rate of tooth movement. Most of these studies are animal studies. The aim of this article is to give insight to how to convert drug dose from animal studies to human trails. Dose per kilogram of body weight for one species is not the same for another species, it has to be converted first based on body surface area (BSA)normalization method. BSA correlates well across several mammalian species with several parameters of biology, including oxygen utilization, caloric expenditure, basal metabolism, blood volume, circulating plasma proteins, and renal function.

The impact of VKORC1-1639 G>A polymorphism on the maintenance dose of oral anticoagulants for thromboembolic prophylaxis in North India: A pilot study.

BACKGROUND: The dose requirements for oral anticoagulants in thromboembolic events are influenced by promoter polymorphism in the VKORC1 gene. However, limited data are available on the influence of the polymorphism in various Indian populations. The present study aimed at determining the relationship between the VKORC1-1639 G>A genotypes and maintenance doses of oral anticoagulants for therapeutically stable INR values in patients taking Acitrom after valve replacement surgery. MATERIALS AND METHODS: Fifty patients from the northern Indian region were genotyped for VKORC1-1639 G>A by polymerase chain reaction and restriction fragment length polymorphism. Means of the weight-normalized daily Acitrom dose were calculated for every patient. RESULTS AND DISCUSSION: The VKORC1 1639G>A minor allele frequency in the study population (n = 50) was found to be 22%. The patients with a wild type genotype required the maximum drug dose as suggested for full functionality of the enzyme. Heterozygous patients were found to have an intermediate drug dose and the patients with a variant homozygous genotype had the minimum maintenance drug dose requirement. These findings are in concurrence with the effect of the promoter polymorphism on vitamin K epoxide reductase activity.1639G>A minor allele frequency in the study population (n = 50) was found to be 22%. The patients with a wild type genotype required the maximum drug dose as suggested for full functionality of the enzyme. Heterozygous patients were found to have an intermediate drug dose and the patients with a variant homozygous genotype had the minimum maintenance drug dose requirement. These findings are in concurrence with the effect of the promoter polymorphism on vitamin K epoxide reductase activity. CONCLUSION: The VKORC1-1639 G>A status can be indicative of establishing the therapeutic dose of oral anticoagulants in Indian patients.

Quantitative design of clinical scheme of combination drug therapy / 中国临床药理学与治疗学

Aim To show the performance of the weighted modification method in the clinicaldesign of combination drug therapy. Methods A scheme combined by Drug1, Drug2and Drug3 was used to treat infants with iron deficiency anemia for 2 wk in a hypo-thetical clinical trial. Thirty-six infants were randomly into 6 compound groups. Threedrugs in the scheme were divided into 6 dose levels, which were evenly distributed to the6 groups according to the weighted modification method. The increased Hb (?Hb) wasrecorded at 2, 3, 4 wk after the treatment (po ). The dose-effect data at 4 wk wereanalyzed by the method, and then the doses in scheme were modified by the analyticresult. The modified doses in the scheme would be further demonstrated. ResultsDrug1 and Drug2 were principal drugs, but Drug1 had larger contribution to the com-bined effect (△Hb) than Drug2. Drug3 had little effect. There was a strong synergismbetween Drug1 and Drug2 with the weighted coefficient (b1) = 2. 636 (P

Calcium -antagonistic effects of osthole on isolated rabbit aortic strips / 中国药理学通报

It was reported that Os-thole(Ost) was isolated from the fruits of Cnidium monnieri(L. ) Cusson, possessesanti - arrhythmic action and depressed the aortic pressure action in animal studies. Its calcium -antagonistic effects were studied on the isolated rabbit aortic strips.Ost shifted the dose response curves for NE, CaCl2 and KC1 nonparallelly to the right, and depressed their maximal response; pD2' value is 3. 16, 4. 28 and 4. 39 respectively. It produced neither ?- a-drenoceptic stimulating nor ? - adreno-ceptic blocking effects. At the concentration of 100 ?mol ? L-1, Ost significantly inhibited the intra cellular Ca2+ dependent component of NE - induced contraction of the aortic strips, however, it didn't in-hibit the extra cellular Ca2+ dependent component of NE - induced contraction of the aortic strips, These results indicated that Ost produced relaxation on vascular smooth muscle might result from its antagonistic effect to Ca2+ and mainly blocked calcium influx through PDC, and the mode of its anta -gonism is similar to that of verapamil.