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OBJECTIVE：To investigate the clini cal features of thrombocytopenia induced by antidepressants ，and to provide reference for the rational use of clinical drugs. METHODS ：Retrieved from CNKI ，Wanfang database ，VIP，PubMed and Web of Science，during Jan. 1st in 1985 to Aug. 31st in 2020，case reports about antidepressants-induced thrombocytopenia was collected and analyzed descriptively in terms of demographic characteristics ，medication，clinical manifestations ，treatment and outcome. RESULTS：A total of 17 literatures were retrieved ，and 19 patients were included ，involving 10 male and 9 female，aged from 5 to 95 years old ，with an average of （48±24）years old. Nine kinds of drugs were involved ，including 4 cases of escitalopram ，3 cases of citalopram ，3 cases of fluoxetine ，3 cases of mirtazapine ，2 cases of amitriptyline ，1 case of sertraline ，1 case of paroxetine，1 case of mianserin and 1 case of imipramine. There were 9 cases of single drug and 10 cases of drug combination. All 19 patients suffered from thrombocytopenia at 3 d-10 years after medication ，14 of them had hemorrhage tendency. Main clinical manifestations included mucocutaneous hemorrhage ，gingival bleeding ，black stool ，hematochezia，vaginal bleeding ，ocular hemorrhage，alveolar hemorrhage. No bleeding was found in 5 cases. After drug withdrawal/changing drugs and other symptomatic treatment， platelet count of 19 patients recovered to normal ， and bleeding symptoms disappeared. CONCLUSIONS ： Thrombocytopenia caused by antidepressants has no obvious clinical features and is not easy to be found ，but it may lead to severe； bleeding symptoms if it is not found in time. The changes of platelet count should be closely monitored in clinical application of such drugs to ensure the safety of drug use.
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The pathogenesis of tourette syndrome is not clear yet, and the clinical manifestations are diverse. With modern medi-cal treatment, adverse reactions occur frequently in clinics. Based on syndrome differentiation, TCM treatment can well control the clinical symptoms of children, and achieve better results without obvious adverse reactions. TCM treatment has unique advantages. In the paper, the etiology and pathogenesis, and the classification of the disease were discussed, so as to systematically explore TCM treatment of the disease and provide reference for TCM treatment of the disease.
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OBJECTIVE:To analyze the features of risperidone-induced leucocytopenia ADR.METHODS:Twenty-one ADR cases of risperidone-induced leucocytopenia reported by our hospital were collected and analyzed during 2004-2015.The characteris tics of risperidone-induced leucocytopenia were discussed.RESULTS:Among 21 patients,there were 10 male and 11 female.The age was from 15 to 72 years old.Nine cases of patients were 31-40 years old (42.9％).Most of the original disease was schizophre nia.Incubation period of leucocytopenia caused by risperidone was (28.6 ± 21.4) d.Patients had no discomfort complain when leucocytopenia occurred.The lowest white blood cells reported was(3.1 ± 0.5)× 109 L-1.The leucocytopenia were improved after reduc tion,drug withdrawal and symptomatic treatment.CONCLUSIONS:Patients usually have no body discomfort complain when risperidone-induced leucocytopenia appears.Doctors should moniter ADR regularly,identify it earlier and treat carefully.
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OBJECTIVE:To investigate the characteristics of central nervous system(CNS)ADR caused by olanzapine,and to provide reference for safe and rational drug use in clinic. METHODS:Thirty cases of CNS ADR caused by olanzapine reported by our hospital to national ADR monitoring center were collected during 2004-2015. General information of patients,drug therapy, ADR,treatment measures and outcomes were analyzed statistically. RESULTS:Among 30 cases of CNS ADR caused by olanzapine, the female was more than male(22/8);the age of patients mainly ranged 21-40 years old(10 cases,33.3%). The original disease was given priority to schizophrenia (18 cases,60.0%). When ADR occurred,average dose of olanzapine was (18.0 ± 7.0) mg/d. The daily dose of 20 mg accounted for the most of ADR(8 cases,26.7%). Main ADR was extrapyramidal syndrome(22 cases, 73.3%). When mostly reduced the drug dose,stopped olanzapine,switched to other antipsychotics,and actively adopted symp-tomatic support treatment,the symptoms were relieved or returned to normal. CONCLUSIONS:The extrapyramidal syndrome take up the majority of CNS ADR caused by olanzapine. ADR is also likely to happen even if the daily dose is small. CNS ADR are more likely to happen in women. At the beginning of the treatment within a month,close attention should be paid to ADR. It is sug-gested to grasp the indications strictly and observe ADR so as to ensure the safety of drug use.
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OBJECTIVE:To investigate the characteristics of serious ADR in psychiatric hospital,and to provide reference for effective and safe use of drugs in the clinic. METHODS:114 cases of serious ADR in our hospital from 2004 to 2015 were ana-lyzed retrospectively in terms of general information,primary disease,route of administration,dosage form,drug types,organs or systems involved in ADR and clinical manifestations,top 5 ADR-inducing drugs and main clinical manifestations,etc. RESULTS:Of 114 serious ADR cases,the number of female was more than that of male(71/43). Patients aged 21-30 years old took up the greatest proprotion(35 cases,30.70%). The main involved primary disease was schizophrenia(54 cases,47.37%). Oral adminis-tration-induced ADR was most common(103 cases,90.35%). The main involved drugs were antipsychotics,occupying the great-est proportion(75 cases,65.79%). Digestive system involved was the most common(53 cases,42.74%), Olanzapine tablets had the highest incidence of serious ADR (23 cases,18.55%),the main clinical manifestation were both abnormal liver function. There were 8 cases of new serious ADR (7.02%). Most of the ADR can be cured after drug withdrawal or countermeasures,no death case was found. CONCLUSIONS:Psychiatric drugs can induce serious ADR as treat psychiatric disease,among which the in-cidence of ADR induced by Olanzapine tablets is the highest and mainly manifestes digestive system symptoms. It is suggested to strengthen serious ADR monitoring to promote the safe use of drugs.
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OBJECTIVE:To provide reference for the training of clinical pharmacists in specialized hospitals. METHODS:Based on the characteristics of psychiatric patients,diseases and drugs ,we have discussed from the related links of the trained per-sons,the training targets,the training modes ,the training courses and so on .We have quantified the work of the trained pharma-cists to finish the training period. RESULTS:The cultivation of psychiatric clinical pharmacists take young pharmacists of high com-prehensive quality as the trained persons. They should study in the department of special clinical characteristics,be trained by the teaching team of physicians and pharmacists. After training they can better complete drug cases writing,drug education and other quantitative work. CONCLUSIONS:It shows that the training mode is in accordance with the characteristics of the state psychiatric hospital. This training mode is worth promoting.
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AIM: To observe the levels of triglyceridemia(TG),uricemia(UA),glycemia(GLU),the activity of 3-glyceraldehyde phosphate dehydrogenase(GAPDH) in blood and the gene expression in the liver in the animal model of hypertriglyceridemia,hyperuricemia and hyperglycemia.METHODS: SD rats were randomly divided into three groups,control group,fructose group,fructose and fenofibrate treated group.Rats in control group were fed with standard chow.Rats in fructose group were fed with high fructose diet.Rats in fructose and fenofibrate group were fed with high fructose diet,and treated with fenofibrate 100 mg?kg-1?d-1 by intragastric administration at the same time.Rats in control group and fructose group were given distilled water by intragastric administration.The levels of TG,UA and GLU were detected.Improved method was used to measure the activity of GAPDH.Quanti Gene technology was applied to determine the transcriptional level of GAPDH mRNA.RESULTS: During 7-28 d,the level of TG in fructose group was significantly and persistently high.During 14-28 d,the level of UA was higher.The level of GLU higher than that in control group was only observed at 28th day.The GAPDH activity change in blood and the expression in liver were significantly lower than that in norma1 during 7-28 d.Fenofibrate had the effect on reducing TG only at 7th day and reduced the level of GLU significantly at 28th day.Fenofibrate also increased the GAPDH activity in blood and the expression in liver at 7th day.CONCLUSION: ① The level of TG is significantly and persistently high in the early days by feeding with excessive fructose.The levels of UA and GLU are higher with the time cause of the model development.② The significantly higher level of TG,UA and GLU may be correlated with the reduction of the GAPDH activity in blood and the expression in liver.③ Fenofibrate has the effect of reducing the TG level only in the condition of hypertriglyceridemia,but not in the condition of accompanying hyperuricemia and hyperglycemia.④ The mechanism of reducing the TG level by fenofibrate may be correlated with the increase in GAPDH activity in blood and the expression in liver.