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OBJECTIVE To provide reference for pharmaceutical care of multidrug-resistant bacterial infection patients with tigecycline-induced hypofibrinogenemia and the safe use of tigecycline. METHODS Clinical pharmacists participated in a case of hypofibrinogenemia caused by tigecycline with multidrug-resistant bacterial infection， to determine the correlation of hypofibrinogenemia and tigecycline， and to analyze the risk factors and possible mechanisms of the occurrence of hypofibrinogenemia caused by tigecycline in combination with relevant literature. Clinical pharmacists recommended that physicians discontinued tigecycline and provided human fibrinogen and plasma for correction. RESULTS & CONCLUSIONS Tigecycline was associated with hypofibrinogenemia of the patient. The physician followed the advice of clinical pharmacists and the patient’s fibrinogen level returned to normal. The risk factors of hypofibrinogenemia induced by tigecycline included high dose， long course of treatment， and complication with renal dysfunction. Clinical pharmacists should timely advise physicians to stop taking the drug， and give human fibrinogen and blood product infusion for correction when necessary， so as to avoid the occurrence of serious life- threatening coagulation disorders and ensure the safety of tigecycline use.
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OBJECTIVE：To provide reference for the development and application of pharmacy popular-science video courseware. METHODS ：Combined with the problems existing in the medication of patients with chronic diseases at the present stage and the key points of medication management ，the theme ，content and form of this popular-science were determined ；the video shooting and production were completed ，and publicity and promotion were carried out. Questionnaire survey was conducted ， and the reception of pharmacy outpatient service in our hospital was counted ；the broadcasting effects of popular-science video were analyzed. RESULTS ：The theme of popular-science video courseware was determined to be self-medication management of patients with chronic diseases at home assisted by pharmacists. Combined with the “five moments ”of medication safety proposed by WHO ， the content included six units as knowing pharmacists ，understanding drugs ，taking drugs ，adding drugs ，checking drugs ，and discontinuing drugs. PPT video was used to explain the contents of each unit ，with an average duration of about 25 min. After the first unit was launched ，a total of 39 327 hits were received within two months. A total of 100 questionnaires were sent out ，97 questionnaires were collected （recovery rate of 97.0％）. Among them ，80（82.5％）thought it helpful to watch the video. Within two months after the broadcast of unit 1 video，the reception volume of pharmacy outpatient department of our hospital （1 160 person times ）increased by 104.2％ compared with the two months in the same period last year （568 person times ），and increased by 18.7％ compared with the two months before the broadcast （977 person times ）；99 patients came to the pharmacy outpatient department to consult because of watching the video ，and 55.6％ of the registered patients consulted the demonstration of video courseware and repeatedly mentioned related problems. CONCLUSIONS ：It is a beneficial exploration for pharmacists to develop popular-science video courseware with the theme of safe and rational drug use. It is the direction for future work to increase the scope of disease types ，target different groups of people or focus on different types of drugs and promot them in various forms.
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OBJECTIVE: To investigate the factors that influence the progression-free survival time (PFS) of patients with non-squamous cell carcinoma type non-small cell lung cancer (NSCLC) after first chemotherapy, and to provide reference for the formulation of clinical individual treatment regimen. METHODS: Clinical information of 84 patients with non-squamous cell carcinoma type NSCLC after first chemotherapy were selected from our hospital during Jan. 2012-Dec. 2014. The effects of patient's factors [gender, age, performance status (PS) score], disease factors [tumor staging, tumor marker (TM) level] and treatment factors (chemotherapy regimen and treatment course, chemotherapy efficacy) on PFS were analyzed retrospectively. RESULTS: All patients were followed up for 11. 933 months averagely (final follow-up time of Jun. 30th, 2017), and their median PFS was 4. 017 months. The median PFS of male was slightly shorter than that of female; the median PFS of patients aged more than 65 year-old was slightly shorter than that of patients aged below 65 year-old; the median PFS of patients with PS score of 0-1 was slightly longer than that of patients with PS score of 2-4, without statistical significance (P＞0. 05). The median PFS of Ⅱ -Ⅲ stage patients was significantly longer than that of Ⅳ stage patients; the median PFS of patients with at least one TM index was 10 times higher than the upper limit of the normal value was significantly shorter than that of patients with four TM indexes were all 10 times lower than the upper limit of the normal value; the median PFS of patients underwent 1-3 treatment courses was significantly shorter than that of patients underwent 4-6 treatment courses; the median PFS of patients with progressive disease efficacy was significantly shorter than that of patients with stable disease efficacy or above, with statistical significance (P＜0. 05). Among 84 patients, 81 patients selected PP regimen (pemetrexed disodium+platinum), and other patients chose non-PP regimen. Due to the large difference in the number of cases, the effect of the chemotherapy regimen on the patient' s PFS was not investigated. CONCLUSIONS: The disease factor and treatment factor of patients may be associated with PFS. Tumor staging, at least one TM index was 10 times higher than the upper limit of the normal value, the number of completed chemotherapy treatment course, chemotherapy efficacy are independent influential factors of PFS in patients with non-squamous cell carcinoma type NSCLC.
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OBJECTIVE:To investigate the role of clinical pharmacists in the therapy for acute exacerbation of chronic obstruc-tive pulmonary diseases (AECOPD) complicated with pulmonary infection. METHODS:Clinical pharmacists participated in the therapy for a case of acute exacerbation of AECOPD complicated with pulmonary infection. According to the patients’signs,assis-tant examination and disease condition,clinical pharmacists provided suggestions,i.e. Piperacillin sodium and sulbactam sodium for injection (4∶1) 5.0 g,ivgtt,q12 h,for anti-infective treatment;Bisacodyl enteric-coated tablet 5 mg,po,qd,for promoting defecation;Clostridium butyricum viable bacteria tablet 20 mg,po,tid,for regulating gastrointestinal flora;Pinaverium bromide tablet 50 mg,po,tid,for regulating gastrointestinal smooth muscle tension;Shexiang baoxin pills 22.5 mg,po,tid,instead of flu-id infusion for protecting heart,and isosorbide 5-mononitrate 20 mg,po,tid,for preventing angina pectoris;Cefminox capsule 100 mg,po,tid,for anti-infective treatment;fluconazol 0.4 g,ivgtt,qd,for antifungal treatment,and Bacillus licheniformis 500 mg,po, tid,for preventing alteration of intestinal flora. RESULTS:The physicians adopted clinical pharmacist’s suggestions. No ADR was found during treatment,and the patients transferred to ordinary ward after the disease condition had been controlled. CONCLU-SIONS:The participating of clinical pharmacists in pharmaceutical care can promote rational drug use in the clinic and guarantee the safety of drug use.
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OBJECTIVE:To investigate the effect of evaluation method on management of prescription. METHODS:A total of 24 000 prescriptions of 12 months were evaluated with both method 1 devised by our hospital and method 2 specified in ordinance of Management of prescription. The administration department intervened physicians’ prescription behaviors according to the evaluation results. The change of data in method 1 was compared with that in method 2. RESULTS: In method 1,the problems of usage and dosage increased a little while other irrational problems lessened largely. In method 2,the average amount of drug categories reduced a little while the other data increased a little. CONCLUSION: The effect of evaluation and intervention in method 1 are superior to those in method 2.
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OBJECTIVE:To prepare shenmai injection and establish its fingerprints,and to categorize the peaks in the fingerprints.METHODS:Shenmai injection was prepared from ophiopogonis tuber extracted by water and precipitated by ethanol and red ginseng extracted by ethanol and precipitated by water.The fingerprints of Shenmai injection was established by HPLC,and the relative retention time and peak area ratio of each common peak was determined.RESULTS:11peaks in fingerprints of Shenmai injection were noted.CONCLUSION:The method is suitable for the preparation and quality control of Shenmai injection.
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OBJECTIVE:A reversed-phase high performance liquid chromatography(RP-HPLC)method was established to study the pharmacokinetics of cetirizine hydrocloride tablet in 11 healthy male volunteers METHODS:Waters HPLC instrument was used with the Waters symmetry C18 steeless column(3 9mm?150mm,5?m) The mobile phase was composed of acetonitrile-0 02mol/L sodium hydrogen diphosphate-triethylamine(50∶50∶0 16,V/V),which contained 4 0mmol/L sodium dodecyl sulphate Flow rate was 1 0ml/min Detection wavelength was 229nm Propafenone was taken as internal standard A single 10mg oral dose of cetirizine hydrocloride tablet was given to 11 healthy male volunteers Cetirizine concentration was assayed in plasma RESULTS:The standard curve of cetirizine hydrocloride was linear in the range of 12 5～800ng/ml The minimum detection limitation was 5ng/ml The extraction recovery was more than 75% A two-compartment open pharmacokinetic model was adapted in cetirizine plasma concentration-time data analysis The main pharmacokinetic parameters were as follows:Cmax=(429 00?108 80)ng/ml,Tmax=(0 91?0 40)h,AUC0～36(calculated by trapezoid method)=(3 312 72?682 39)ng/(h?ml) CONCLUSION:The method was accurate,sensitive and reliable It is applicable to determine the concentration of cetirizine hydrocloride in human plasma;The main pharmaconetic parameters of the domestic cetirizine hydrocloride tablet were similar to those reported at home and abroad,so it could be extensively used in clinic
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OBJECTIVE:To establish a RP-HPLC method for the determination of chlorogenic acid in Qingyan granules.METHODS:Waters Breeze System was used with a Hypersil BDS C18 column(5?m,4.6mm?150mm).The mobile phase was composed of methanol and 0.4%(V/V)H3PO4 water solution(20∶80,V/V),flow rate:1.0ml/min;wavelength of UV detector:327nm,column temperature 20℃.RESULTS:The calibration curve of chlorogenic acid was linear within the range of (174～1 392)ng(r=0.9 999).The average recovery was 100.10%,RSD=1.60%(n=5).CONCLUSION:This method is simple,sensitive,as well as reliable,and is available to quality control.