Effect of immunochemotherapy administration sequence on efficacy and adverse reac-tions in patients with non-small cell lung cancer / 中国肿瘤临床

Objective:To explore the effect of chemotherapy administration sequence combined with programmed cell death protein-1(PD-1)monoclonal antibody on the efficacy and immune-related adverse events(irAEs)in patients with advanced non-small cell lung cancer(NSCLC).Methods:The clinical data of 110 patients with advanced NSCLC treated at The First Affiliated Hospital of Zhengzhou University between November 2019 and January 2022 were retrospectively collected.The factors influencing irAEs were analyzed by univariate and multivariate Logistic regression analyses,while those influencing curative effect were analyzed by Kaplan-Meier curve analysis,Log-rank test,and univariate and multivariate Cox regression analyses.Results:Treatment with PD-1 monoclonal antibody after 2 days of chemotherapy(sequential treatment group,n=36)significantly prolonged progression-free survival(PFS)compared with PD-1 monoclonal antibody admin-istration on the same day of chemotherapy(simultaneous treatment group,n=74)(17.2 months vs.11.3 months,respectively;P＜0.05).The disease control rate(DCR)was better in the sequential treatment group than in the simultaneous treatment group(94.4％vs.79.7％,re-spectively;P=0.045),while the objective response rate(ORR)did not differ significantly(69.4％vs.51.4％,respectively;P=0.072).The Cox re-gression analysis showed that cytokerat in 19 fragment(Cyfra21-1)and d-dimer(D-dimer)affected the efficacy of combination therapy(P＜0.05).The Logistic regression analysis showed that age and lactic dehydrogenase(LDH)influenced the occurrence of irAEs(P＜0.05),while the administration sequence did not significantly affect the occurrence of irAEs(P=0.130).Conclusions:Administration sequence influences the efficacy of combination therapy,and patients with advanced NSCLC who receive sequential therapy may experience better efficacy.Age and LDH are negatively correlated with the occurrence of irAEs.

Literature Analysis on Administration Sequence and Antibacterial Efficacy in the Combination Use of Am-broxol and Antibacterial Agents / 中国药师

This article reviewed the pharmacokinetic and pharmacodynamic characteristics of ambroxol and the interactions be-tween ambroxol and antibacterial agents. The use order of ambroxol and antiseptic drugs was analyzed and discussed. Ambroxol was a-ble to increase antibiotics concentration in bronchoalveolar lavage fluid (BALF) samples. Besides, ambroxol could destroy the struc-ture of bacterial biofilm(BF) in a dose-dependent manner,and high dose of ambroxol hydrochloride showed good safety. When ambr-oxol and antibacterial agents were in combination use,ambroxol should be administrated before antibacterial agents in order to enhance antibacterial efficacy,since ambroxol could increase the concentration of antibacterial agents in lung and help the antibacterial agents enter the bacterial BF. It was suggested that the label of ambroxol be further improved and revised as follows:①the administration se-quence of ambroxol and antibacterial agents should be stated;②the recommended doses of ambroxol for different indications should al-so be listed in the label;③ the clinical safety and efficacy of high dose of ambroxol should be stated.

Exploration of regulating infusion administration sequence by an intelligent prompt system in pharmacy intravenous admixture services / 中华医院管理杂志

Eight sub-databases of pharmacological information on rational use of medicines were designed and established. These sub-databases cover dosing frequency, therapeutic drug priority to auxiliary medication, infusion shelf-life after admixture, incompatibility of two continuous infusion in the vein infusion tube, chronopharmacology, drug interaction involved in administration sequence , venous irritative drugs and preventive medicine. Once the standing order delivery to PIVAS involves any of these sub-databases, the system will prompt in turn " Auxiliary" , " Time limit" , " Taboo" , " Chronopharmacology" , " Interaction" , " Irritative" and " Preventive (therapeutic)" , starting from therapeutic drug priority to auxiliary medication. Pharmacists would make a reasonable sequence of the corresponding infusion and label the administration sequence on the infusion tag according to the prompt.Compared to the circumstance prior to this system, the wards with the infusion sequence labeling and equipped with intelligent prompt increased from 2 to 43; the percentage of such inpatients increased from 0.50% to 66.33%; the percentage of medical orders increased from 0.72% to 78.94%. The time spent by pharmacists for the same workload reduced from 73.44 h per day to 1.94 h per day. The times of flushing infusion tube reduced from 34.42 to 1.49 per ward and per day. The cost of flushing infusion tubes reduced by a big margin. PIVAS has established a method of regulating infusion administration sequence by an intelligent prompt system, based on improved safety and effectiveness of medication.