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Epilepsy is a common neurological disease, and studies have shown that some epilepsy patients are combined with cognitive impairment. In clinical practice, it has been found that, in addition to the seizure itself, anti-seizure medications can also have a corresponding impact on the cognitive function of epilepsy patients. However, the effects of some drugs on the cognitive function of epilepsy patients are still inconclusive, and the mechanism of their influence on cognitive function in epilepsy patients is not elucidated. In recent years, some studies followed up the cognitive function of patients receiving anti-seizure medications therapy, and put forward guidance. This article focused on the research of commonly used drugs on cognitive function, the possible mechanism of drugs affecting cognitive function, the rational use of drugs in different groups of people and the prevention strategies of related cognitive dysfunction, hoping to improve emphasis on cognitive function in epilepsy patients and guide clinical practice.
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Polygona-polysaccharose is an important indicator to measure the quality of Polygonati Rhizoma. The polygona-polysaccharose has the effect of lowering blood sugar, regulating blood lipid, anti-fatigue, improving learning and memory ability. The Polygonati Rhizoma, as a Chinese herbal medicine with homology of medicine and food, has a good prospect and application value in the development of food and health products.
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Guizhi Shaoyao Zhimu Decoction combined with drugs taken internally or external therapy show the benefits for rheumatoid arthritis patients. It can control the clinical symptoms such as swelling and pain of the joints, reduce inflammatory indicators, and has less adverse reactions. Modern pharmacological researches show that it can regulate a variety of inflammatory signaling pathways to achieve anti-inflammatory and analgesic effects, induce apoptosis of synovial cells, resist bone damage, and regulate immunity with multiple treatment targets to rheumatoid arthritis.
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Linarin, as a natural coumponent belongs to flavonoid glycoside, is widely existed in herbal plants such as chrysanthemum indicum and Mongolian flower, which has a variety of pharmacological effects, such as anti-inflammation, anti-cancer, liver protection, analgesia, antipyretic, anti-oxidation, anti-apoptosis, sedation and sleep, neuroprotection, preventing and treating hypertension, treatingdiabetes, preventing and treating osteoporosis, whitening, skin care and sunscreen. It is difficult to dissolve in water and has poor oral efficacy, but when combined with different substances or combined (forming phospholipid complex), its bioavailability can be improved, so as to improve its pharmacological efficacy.
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Uremic pruritus is one of the skin complications that perplex patients with end-stage renal disease undergoing hemodialysis or peritoneal dialysis. Because the specific pathogenesis is not clear, there is no unified treatment plan in the world. In August 2021, the US Food and Drug Administration approved the use of difelikefalin (under the trade name Korsuva) for the treatment of moderate to severe pruritus associated with chronic kidney disease in adult patients undergoing hemodialysis. Studies have shown that difelikefalin can remarkably reduce the intensity of pruritus and improve sleep and pruritus-related quality of life. The recommended dose of difelikefalin is 0.5 μg/kg, and difelikefalin is well tolerated and has high safety. This paper reviews the pharmacological effects, pharmacokinetics, clinical efficacy and safety of difelikefalin.
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SUMMARY OBJECTIVE: To review the main physiological and pharmacological changes related to prematurity, to promote the evidence-based clinical practice. METHODS: This is a narrative review whose research was carried out in the ScienceDirect and Medline databases via PubMed, searching for articles in any language from January 2000 to February 2020. RESULTS: Premature newborns are born before completing the maturation process that prepares them for extrauterine life, which occurs especially in the last weeks of pregnancy. Therefore, they have their own characteristics in development. Several physiological peculiarities stand out, such as disturbances in glucose regulation, adrenal function, thermoregulation, immunity, in addition to changes in liver, renal and respiratory functions. Pharmacological aspects were also highlighted, involving pharmacokinetics and pharmacodynamics. CONCLUSIONS: Despite the recent advances in prematurity, it is still an area with many uncertainties, since several changes occur quickly and there are ethical issues that make studies difficult. Thus, it is clear that the therapeutic management of premature infants is still very much based on clinical practice.
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Humans , Female , Pregnancy , Infant, Newborn , Infant , Premature Birth , Infant, Premature, Diseases , Infant, Low Birth Weight , Infant, PrematureABSTRACT
As a collective noun of incense and medicine, fragrant medicine has long been integrated into Chinese culture. It is not only a symbol of the cultural exchange between China and foreign countries in the middle ancient times, but also plays a very important role in medicine and other fields. Among them, Borneol can not only be used for medicinal purposes, but also for incense and fumigation, as well as food, tea, wine and other applications. This paper intends to sort out the medicinal properties, effects and other applications of Borneol recorded in ancient books of traditional Chinese herbs in the past dynasties, focusing on summarizing its medicinal properties, meridians, effects, compatibility and application characteristics. In addition, modern pharmacological action was included as a supplement, in order to provide reference for the clinical use of Borneol in medicinal aspects.
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RESUMO Objetivo: Investigar a efetividade da vancomicina contra Gram-positivos com concentração inibitória mínima de 1mg/L em pacientes pediátricos com base na razão entre área sob a curva e concentração inibitória mínima > 400. Métodos: População de 22 pacientes pediátricos (13 meninos) internados no centro de terapia intensiva pediátrica, com função renal preservada, que foram distribuídos em dois grupos (G1 < 7 anos e G2 ≥ 7 anos). Após a quarta dose de vancomicina (10 - 15mg/kg a cada 6 horas), duas amostras de sangue foram colhidas (terceira e quinta horas), seguidas da dosagem sérica por imunoensaios para investigação da farmacocinética e da cobertura do antimicrobiano. Resultados: Não se registrou diferença entre os grupos com relação à dose, ao nível de vale ou ainda na área sob a curva. A cobertura contra Gram-positivos com concentração inibitória mínima de 1mg/L ocorreu em apenas 46% dos pacientes em ambos os grupos. A farmacocinética se mostrou alterada nos dois grupos diante dos valores de referência, mas a diferença entre grupos foi registrada pelo aumento da depuração total corporal e pelo encurtamento da meia-vida biológica, mais pronunciados nos pacientes mais novos. Conclusão: A dose empírica mínima de 60mg/kg ao dia deve ser prescrita ao paciente pediátrico de unidade de terapia intensiva com função renal preservada. A utilização da razão entre área sob a curva e concentração inibitória mínima na avaliação da cobertura da vancomicina é recomendada para se atingir o desfecho desejado, uma vez que a farmacocinética está alterada nesses pacientes, podendo impactar na efetividade do antimicrobiano.
Abstract Objective: To investigate the vancomycin effectiveness against gram-positive pathogens with the minimum inhibitory concentration of 1mg/L in pediatric patients based on the area under the curve and the minimum inhibitory concentration ratio > 400. Methods: A population of 22 pediatric patients (13 boys) admitted to the pediatric intensive care unit with preserved renal function was stratified in two groups (G1 < 7 years and G2 ≥ 7 years). After the fourth dose administered of vancomycin (10 - 15mg/kg every 6 hours) was administered, two blood samples were collected (third and fifth hours), followed by serum measurement by immunoassays to investigate the pharmacokinetics and antimicrobial coverage. Results: There was no difference between the groups regarding dose, trough level or area under the curve. Coverage against gram-positive pathogens with a minimum inhibitory concentration of 1mg/L occurred in only 46% of patients in both groups. The pharmacokinetics in both groups were altered relative to the reference values, and the groups differed in regard to increased total body clearance and shortening of the biological half-life, which were more pronounced in younger patients. Conclusion: A minimum empirical dose of 60mg/kg per day should be prescribed for pediatric patients in intensive care units with preserved renal function. The use of the ratio between the area under the curve and minimum inhibitory concentration in the evaluation of vancomycin coverage is recommended to achieve the desired outcome, since the pharmacokinetics are altered in these patients, which may impact the effectiveness of the antimicrobial.
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Humans , Male , Infant , Child, Preschool , Child , Adolescent , Vancomycin/administration & dosage , Gram-Positive Bacterial Infections/drug therapy , Gram-Positive Bacteria/drug effects , Anti-Bacterial Agents/administration & dosage , Vancomycin/pharmacology , Vancomycin/pharmacokinetics , Intensive Care Units, Pediatric , Microbial Sensitivity Tests , Pilot Projects , Age Factors , Area Under Curve , Dose-Response Relationship, Drug , Half-LifeABSTRACT
The Polygonum hydropiper are dried whole grasses of Polygonum hydropiper L., which mainly contains the following chemical components, such asflavonoids, sesquiterpenoids, and volatile oils. The recent research of the pharmacological effects of Polygonum hydropiper showed that its effects include anti-oxidation, anti-inflammation, analgesic.
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Malt is a commonly used traditional Chinese medicine. Vitamin B exercises for invigorating the spleen and relieving depression of the liver. Polysaccharides have the effect of lowering blood glucose. Enzymes have the effect of digestion and accumulation. Alkaloids are related to terminating lactation, Soothing the Liver and induced abortion. Dietary fiber helps to strengthen spleen. In this paper, the chemical composition and clinical application of malt were reviewed in order to provide reference for the development and application of malt related preparations.
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ABSTRACT Objective Analyze the microbiological effectiveness, based on the pharmacokinetics/pharmacodynamics correlation of vancomycin in pediatric patients, and to propose dose adjustment. Methods This is an observational, cross-sectional study, conducted in a pediatric hospital, over a 1-year period (2016 to 2017). Children of both sexes, aged 2 to 12 years, were included in the study; burn children, and children in renal replacement therapy were excluded. For the pharmacokinetic analysis, two samples of 2mL of whole blood were collected, respecting the 2-hour interval between each withdrawal. Results Ten pediatric patients with median age of 5.5 years and interquartile range (IQR) of 3.2-9.0 years, median weight of 21kg (IQR: 15.5-24.0kg) and median height of 112.5cm (IQR: 95-133cm), were included. Only one child achieved trough concentrations between 10µg/mL and 15µg/mL. Conclusion The empirical use of vancomycin in the children studied did not achieve the therapeutic pharmacokinetic/pharmacodynamic target for minimum inhibitory concentration of 1µg/mL.
RESUMO Objetivo Analisar a efetividade microbiológica considerando a correlação farmacocinética/farmacodinâmica de vancomicina em crianças e propor uma estimativa de ajuste na dose. Métodos Trata-se de um estudo observacional, transversal, realizado em hospital pediátrico, no período de 1 ano (2016 a 2017). Foram incluídas crianças de 2 a 12 anos de ambos os sexos, tendo sido excluídas crianças queimadas ou submetidas à terapia renal substitutiva. Para análise farmacocinética, foram coletadas duas amostras de 2mL de sangue total, respeitando o intervalo de 2 horas entre cada coleta. Resultados Foram incluídos dez pacientes pediátricos com idade de 5,5 anos (mediana) e intervalo interquartil (IQ) de 3,2-9,0 anos, peso de 21kg (mediana; IQ: 15,5-24,0kg) e altura de 112,5cm (mediana; IQ: 95-133cm). Apenas uma criança alcançou concentrações mínimas entre 10µg/mL e 15µg/mL. Conclusão A utilização empírica de vancomicina na população de crianças não alcançou o alvo farmacocinético/farmacodinâmico terapêutico para concentração inibitória mínima de 1μg/mL.
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Humans , Male , Female , Child, Preschool , Child , Vancomycin/pharmacokinetics , Anti-Bacterial Agents/pharmacokinetics , Time Factors , Vancomycin/administration & dosage , Microbial Sensitivity Tests , Cross-Sectional Studies , Drug Monitoring/methods , Dose-Response Relationship, Drug , Anti-Bacterial Agents/administration & dosageABSTRACT
The dried root of Ranunculaceae Aconitum perennial herb of North Aconitum, is commonly used. It has the function of cardiac stimulation, anti-inflammatory and analgesic, anti-tumor and immune regulation. However, its toxicity lower the safety and applicaiton. The pharmacological and toxicological effects were discussed in this paper, in order to provide reference for the intoxication diagnosis and clinical safety.
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The rhizome of Trillium Trillium tschonoskii Maxim. coming from liliaceous has the functions of tranquilizing and tranquilizing blood and detoxifying and detoxifying, which is used to treat the diseases of hypertension, neurasthenia, dizziness, headache, injury, trauma and hemorrhage. This paper summarized the pharmacological studies. We found that Trillium tschonoskii Maxim can be used for anti-cancer, anti-inflammatory analgesic, immune regulation, liver protection, improvement of cerebral ischemia, heart function, anti-oxidation, anti-aging effect, the pharmacological effects on the central nervous system and so on. This paper provides a reference for the research development and clinical application of Trillium tschonoskii Maxim.
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This paper summarizes the pharmacological action and the application value of Paris Polyphylla, analyzes the current situation of its resource and provides a number of solutions to the resource shortage problem:introduction and domestication;variety development by selection;improvement of cultivation techniques;secondary metabolite with its endophyte;medicinal composition reproduce after fermentation;alternative medicinal composition search and so on.All these solutions above are able to mitigate the problem of Paris Polyphylla′s resource shortage.
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Musk ketone(3-methyl cyclopentadecanolide) is the main active ingredient of the artificial musk,it has multiple pharmacological effects,including anti-dementia,cerebral ischemia,anti-inflammatory effects and so on.This article outlines the main pharmacological effects of musk ketone on brain diseases in the recent years, aim to further research, investigation and utilization deeply of it.
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The plant resources, distribution, extraction, pharmacological effects and its application in medicine of flavonoids procyanidins were reviewed based on the literature, in order to provide the basis for further application and comprehensive development.
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This paper reviewed the mechanism of Chinese herbal bathing for knee osteoarthritis. It has been found that Chinese herbal bathing worked mainly through improving bone circulation, inhibiting inflammation and promoting the progress of chondrocytes restore.In addition, the autophagy was related to the degeneration and apoptosis of chondrocytes. This paper help to provide ideas and direction for the treatment of knee osteoarthritis with Chinese herb bathing therapy.
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Analisar as evidências científicas relacionadas ao tempo de administração endovenosa do Meropenem na prática clínica. Trata-se de uma revisão integrativa de literatura, retrospectiva, de natureza descritiva, com abordagem quantitativa com destaque para a produção científica de estudos clínicos randomizados, revisão sistemática e meta-análise. As bases de dados utilizadas foram Cochrane e Pubmed. A seleção da amostra foi realizada por dois pesquisadores independentes, utilizou-se instrumento adaptado para verificar o nível de evidência, grau de recomendação e classificação pela escala de Jadad. Foram selecionados 12 artigos referentes à administração endovenosa de forma contínua e intermitente do Meropenem. Dos quais nove eram ensaio clínico randomizado, dois eram ensaio clínico randomizado controlado e um meta-análise, destes 11 apresentavam nível II de evidência científica. A maioria dos estudos comparou a infusão rápida, em 30 minutos e/ou 3 horas, seguidos de estudos com administração rápida e/ou 30 minutos em infusão contínua. Os resultados dos estudos apontam que na infusão intermitente, com tempo de administração rápida, o pico da concentração plasmática não é suficiente para garantir eficácia do Meropenem. Já, para os estudos que abordaram a infusão intermitente clássica com tempo ≥ 3 horas demonstram que a técnica mantém melhor concentração inibitória mínima, devido à infusão ser prolongada.
This study aims to analyze the scientific evidence regarding the intravenous administration time of Meropenem in clinical practice. This is an integrative, retrospective, descriptive literature review, with a quantitative approach and emphasis on the scientific work of randomized clinical trials, with systematic review and meta-analysis. The databases used were Cochrane and PubMed. The samples were selected by two independent researchers, and an adapted instrument was used to verify the evidence level, recommendation grade and classification against the Jadad scale. A total of 12 articles related to the intravenous administration of continuous and intermittent Meropenem were selected. Nine of which were randomized studies, two were randomized controlled trials and one was a meta-analysis. From the total studies, 11 presented level II scientific evidence. Most studies compared rapid infusion, 30 minutes and/or 3 hour infusions, followed by rapid administration and/or 30 minute studies in continuous infusion. The results of the studies show that intermittent infusion with rapid time management presented peak plasma concentration that is not sufficient to guarantee the effectiveness of Meropenem. However, studies that addressed the classic intermittent infusion time ≥ 3 hours showed that the technology provides a better minimum inhibitory concentration due to the extended infusion time.
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Pharmacologic Actions , Drug-Related Side Effects and Adverse Reactions , Anti-Bacterial AgentsABSTRACT
Oxymatrine is the main effective monomer of Radix Sophorae flavescentis( Kushen) , which has a variety of pharma-cological actions and valuable clinical applications. Recently, there are many reports about molecular mechanisms of oxymatrine pharmacological actions, giving highly attention to the anti-in-flammatory, anti-fibrosis and antineoplastic effects. These effects are achieved through resisting of oxidation and free radical, anti- <br> virus, and affecting the secretion of inflammatory factor and ap-optosis and so on. This article summarizes the reports on the mo-lecular mechanism of the protection on liver, cardiovascular sys-tem, endocrine system and nervous system, hoping to provide theoretical basis for the practical application.
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Os objetivos principais do tratamento da tuberculose são curar o paciente e minimizar a possibilidade de transmissão do bacilo para indivíduos saudáveis. Reações adversas ou interações das drogas antituberculose entre si e com outros fármacos podem causar modificação ou descontinuação da terapêutica. Revisamos sucintamente o novo tratamento farmacológico da tuberculose introduzido pelo Ministério da Saúde do Brasil em 2009 e mostramos os mecanismos gerais de ação, absorção, metabolização e excreção dos medicamentos utilizados no esquema básico. Descrevemos as reações adversas e as interações (com medicamentos, alimentos e antiácidos) assim como a abordagem mais adequada para situações especiais, como gravidez, amamentação, insuficiência hepática e renal. Também descrevemos os mecanismos pelos quais as interações das drogas antituberculose do esquema básico podem causar hepatite medicamentosa e as possíveis alternativas nessa situação.
The main objectives of tuberculosis therapy are to cure the patients and to minimize the possibility of transmission of the bacillus to healthy subjects. Adverse effects of antituberculosis drugs or drug interactions (among antituberculosis drugs or between antituberculosis drugs and other drugs) can make it necessary to modify or discontinue treatment. We briefly review the new guidelines for the pharmacological treatment of tuberculosis, introduced by the Brazilian National Ministry of Health in 2009, and describe the general mechanism of action, absorption, metabolization, and excretion of the first-line drugs used in the basic regimen. We describe adverse drug reactions and interactions (with other drugs, food, and antacids), as well as the most appropriate approach to special situations, such as pregnancy, breastfeeding, liver failure, and kidney failure. We also describe the mechanisms by which the interactions among the antituberculosis drugs used in the basic regimen can cause druginduced hepatitis, and we discuss the alternatives in this situation.