Research progress in pharmacokinetics/pharmacodynamics and drug use of meropenem in special population / 中国药房

Meropenem is the first choice for the treatment of multi-drug-resistant bacterial infections， which has been widely used in clinical practice. However， the physiological and pathological characteristics of special populations have a significant impact on the pharmacokinetics/pharmacodynamics （PK/PD） parameters of meropenem， so it is necessary to develop individualized drug administration plan according to the characteristics of patients in clinical application. Therefore， this paper summarizes PK/PD characteristics and application of meropenem in special population， and recommends the dosage of meropenem as follows： 10-40 mg/kg， q8 h for children； 1 g， q8-12 h for elderly patients； 0.75 g， q8 h for the patients with renal insufficiency who received continuous veno-venous hemofiltration and continuous veno-venous hemodialysis； 1 g， q8 h prolonged infusion until 3 hours or 2 g， q8 h for patients with hyperrenal function； 1 g， q8 h after 2 g loading dose for patients with cirrhosis.

Analysis of Clinical Application of Warfarin in Our Hospital / 中国药房

OBJECTIVE:To investigate the clinical application of warfarin in inpatients of our hospital,and provide reference for standardized application in clinic. METHODS:Totally 267 inpatients records used warfarin in our hospital from Jan. 2013 to Jun. 2014 were investigated to retrospectively analyze the indications,dosage,international normalized ratio(INR)monitoring and bleeding complications of warfarin. RESULTS:Warfarin was mainly used for patients with deep vein thrombosis,cerebral infarc-tion,rheumatic heart disease and pulmonary embolism in our hospital;the dosage of inpatients was in the range of 0.625-6.875 mg with average daily dosage of (2.15 ± 0.72) mg;the INR lower than 1.8 accounted for 52.8%,the INR in the range of 1.8-3.0 (reaching the standard) accounted for 31.8% and INR higher than 3.0 accounted for 15.4%;incidence of adverse reactions was 5.6%,mainly subcutaneous blood spots (petechiae) and urine occult blood,and incidence of severe hemorrhage (intracerebral hemorrhage) was 0.7%. CONCLUSIONS:At present,the clinical application of warfarin is still deficient,and qualified rate of INR is still low. It's important to actively carry out medication intervention and clinical pharmaceutical care.

Analysis of the applications of antibacterial agents to outpatients in primary hospitals in Hefei City of Anhui Province / 中国基层医药

Objective To investigate the applications of antibacterial agents to outpatients in primary hos -pitals in Hefei City of Anhui Province,and to provide reference for rational use of antibacterial agents.Methods In 2011, fourty-five primary hospitals in Hefei City were selected randomly ,including urban community health service centers (Group A) and township hospitals(Group B),and thirty or fourty outpatient prescriptions were analyzed monthly . Results In Group A, the percentage and intensity of antimicrobial usage , the proportion of the combination and injectable formulation were ( 45.36 ±20.02 )%, ( 89.73 ±25.50 ) DDDs · ( 100 cases ) -1 · d-1 , 13.34%, 23.16%,respectively,and the data in Group B were (61.36 ±17.18)%,(108.46 ±32.27)DDDs· (100 cases) -1 · d-1,29.13%,46.39%,respectively,which the former were significantly lower than the latter.Conclusion In primary hospitals,the applications of antibacterial agents to outpatiants are not rataional ,including high percentages of usage and unreasonable selection of species ,and more supervision and training need to be given to the medical staff , especially in township hospitals .

Survey of awareness on essential drugs policy in community / 中国基层医药

Objective To evaluate the understanding and supporting degree of staff and patients in Hefei's primary medical institutions on the essential drugs policy.Methods The staff and outpatients were taken from 45 primary medical institutions in Hefei, and “ medical staff questionnaire” and “ patient questionnaire” were finished.Results Total understanding rates of medical staff and patients were 89.4％ and 59. 1％ ,respectively, total supporting rate was 90. 8％ and 93.9％, respectively. The supporting rate is affected by age, educational level, residence and other factors. Conclusion In order to meet the public demand for health and medicine, the essential drugs policy should be publicized and the elderly,urban and rural patients and the medical staff should be paid more affention.

Anti-hepatitis B virus activity and mechanisms of recombinant human serum albumin-interferon-alpha-2b fusion protein in vitro and in vivo.

AIMS: To evaluate the anti-hepatitis B virus (anti-HBV) effects and mechanisms of recombinant human serum albumin-interferon-alpha-2b fusion protein (rHSA-IFNalpha-2b) in vitro and in vivo. METHODS: The inhibiting effects on HBV replication were examined in the HepG2 2.2.15 cell line and in ducks, and the expressions of signal transducers and transactivator 1 (STAT1), IFN-stimulated gene factor 3 (ISGF3) and 2',5'-oligoadenylate synthetase 1 (OAS1) were investigated by the reverse transcription-polymerase chain reaction (RT-PCR) and Western blot analysis. RESULTS: In vitro,at concentrations from 0.075 to 1.2 nmol/l, rHSA-IFNalpha-2b inhibited the releases of extracellular hepatitis B surface antigen, hepatitis B e antigen and HBV DNA in a dose-dependent manner; rHSA- IFNalpha-2b also increased the levels of STAT1, ISGF3 and OAS1. In vivo, rHSA-IFNalpha-2b reduced the levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin and duck hepatitis B virus (DHBV) DNA in the sera of DHBV-infected ducks. CONCLUSIONS: We provide the first evidence that rHSA-IFNalpha-2b significantly inhibits HBV replication in HepG2 2.2.15 cells and in ducks, and that the antiviral effect of rHSA-IFNalpha-2b in vivo is more potent than that of IFNalpha-2b. The anti-HBV mechanism probably operates by triggering the JAK-STAT signaling pathway and increasing the expression of OAS1.

Research progress of the anti-hepatitis virus mechanism of interferon-alpha and long-acting form of interferons / 中国药理学通报

Interferon-alpha is one of the most important drugs against hepatitis virus,and it can inhibit the replication of virus by inducing the expression of 2'-5'-OAS,PKR,MxA through Jak-STAT pathway in hepatocytes.The effects are also concerned with other signal pathways,such as MAPK,IRS-1/PI3K-p70S6 kinase pathways and so on.In order to prolong the half life of interferon-alpha and enhance its effectiveness,many other long-lasting interferons are developed,such as pegylated interferon,recombinant human serum albumin-interferon,and liposome interferon,which maybe take the place of interferon-alpha.The research and development of more long-acting and efficient interferons are becoming a more and more important way to the anti-virus treatment of hepatitis.