Pharmacokinetic interactions between the potential COVID-19 treatment drugs lopinavir/ritonavir and arbidol in rats / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has occasioned worldwide alarm. Globally, the number of reported confirmed cases has exceeded 84.3 million as of this writing (January 2, 2021). Since there are no targeted therapies for COVID-19, the current focus is the repurposing of drugs approved for other uses. In some clinical trials, antiviral drugs such as remdesivir (Grein et al., 2020), lopinavir/ritonavir (LPV/r) (Cao et al., 2020), chloroquine (Gao et al., 2020), hydroxychloroquine (Gautret et al., 2020), arbidol (Wang et al., 2020), and favipiravir (Cai et al., 2020b) have shown efficacy in COVID-19 patients. LPV/r combined with arbidol, which is the basic regimen in some regional hospitals in China including Zhejiiang Province, has shown antiviral effects in COVID-19 patients (Guo et al., 2020; Xu et al., 2020). A retrospective cohort study also reported that this combination therapy showed better efficacy than LPV/r alone for the treatment of COVID-19 patients (Deng et al., 2020).

Pharmaceutical care for severe and critically ill patients with COVID-19 / 浙江大学学报·医学版

Severe and critically ill patients with coronavirus disease 2019 (COVID-19) were usually with underlying diseases, which led to the problems of complicated drug use, potential drug-drug interactions and medication errors in special patients. Based on ( 6), and -19: , we summarized the experience in the use of antiviral drugs, corticosteroids, vascular active drugs, antibacterial, probiotics, nutrition support schemes in severe and critically ill COVID-19 patients. It is also suggested to focus on medication management for evaluation of drug efficacy and duration of treatment, prevention and treatment of adverse drug reactions, identification of potential drug-drug interactions, individualized medication monitoring based on biosafety protection, and medication administration for special patients.

Optional antiviral agents for the 2019 novel coronavirus and the liver injury / 中华临床感染病杂志

The most important treatment of anti 2019 novel coronavirus is antiviral and supportive treatment. Currently, the anti novel coronavirus drugs in clinical trials include broad-spectrum antiviral drugs (Alpha interferon and Ribavirin), hemagglutinin inhibitors (Arbidol), human immunodeficiency virus protease inhibitors (Lopinavir/Ritonavir and Darunavir/Cobicistat), nucleoside analogues (Favipiravir and Remdesivir) and antimalarial drug (chloroquine), however, some patients suffered from liver damage during the actual usage. This article reviews the research on liver damage associated with anti novel coronavirus drugs, aiming at promoting the rational, safe and effective use of anti novel coronavirus drugs.

Liver injury caused by antiviral agents for COVID-19 / 中华临床感染病杂志

Antiviral therapy is important for COVID-19. Currently, the anti-2019-nCoV drugs in clinical trials include broad-spectrum antiviral drugs (alpha interferon and ribavirin), hemagglutinin inhibitors (arbidol), human immunodeficiency virus protease inhibitors (lopinavir/ritonavir and darunavir/cobicistat), nucleoside analogues (favipiravir and remdesivir) and antimalarial drug (chloroquine); while liver damage may occur in some patients with the medication. This article reviews the research on liver damage associated with anti-2019-nCoV drugs, aiming at promoting the safe and effective antiviral therapy for COVID-19 patients.

Effects of puerarin on lipopolysaccharide-induced myocardial dysfunction in isolated rat hearts.

Myocardial dysfunction is a serious complication induced by sepsis. Puerarin is an oriental medicine that possesses therapeutic benefits for cardiovascular diseases. The aim of this study was to evaluate the anti-myocardial dysfunction effects of puerarin in isolated rat hearts induced by lipopolysaccharide- and compare the myocardial protective effects between the different concentrations of puerarin. Isolated hearts were attached to a Langendorff apparatus and perfused with lipopolysaccharide (LPS) and different concentrations of puerarin. The hemodynamic parameters of heart rate (HR), left ventricular end systolic pressure [LVESP], +dp/dtmax, and -dp/dtmax were recorded. The biochemical indexes of lactic dehydrogenase (LDH), tumor necrosis factor alpha (TNF-α), and creatine kinase (CK) in the coronary effluent were measured at 40, 90, and 120 min of perfusion. TNF-α in myocardial tissues was measured after perfusion was completed. As a result, puerarin (0.24 µmmol/L-0.48 µmmol/L) significantly increased LVESP, +dp/dtmax, -dp/dtmax, and HR in isolated rat hearts that were declined by LPS during perfusion periods. Puerarin could protect against increased LDH, CK, and TNF-α in coronary effluent of isolated rat hearts by LPS during perfusion periods. Treatment of 0.48 µmmol/L puerarin significantly decreased the TNF-α in coronary effluent of isolated rat hearts compared with the treatment of 0.12 and 0.24 µmmol/L puerarin, but the TNF-α values were not reverted to baseline levels. However, the difference of TNF-α in myocardial tissue in the three puerarin-combined groups was statistically significant. This study confirms that puerarin can improve LPS-induced contractile dysfunction in isolated heart and inhibit LPS-stimulated myocardial TNF-α production.

Guideline Formulation of the Off-label Use of Drugs Based on Evidences / 中国药房

OBJECTIVE:To explore an effective method to formulate management-related strategies for off-lable use of drugs by the evidence-based medicine. METHODS:The process of guideline formulation included seven procedures,i.g. establishment ofguideliesformulation workgroup;investigation and selection of the status quo on off-label drug use;identification of the clinical problems;retrieval and evaluation and comprehensing of evidence;applification of GRADE in evidence quality grading;formation of the recommendations consensus;peer review and result publication. And eventually guidelines were formed based on the steps. This study took off-label use of rheumatoid immunoprotective subjects as a case to explore. RESULTS & CONCLUSIONS:Based on the evidence evaluation system and above 7 steps,the methods and process of guideline formulation on off-label use of rheuma-toid immunoprotective subjects that integrated administration,law,clinical medicine,pharmacy subjects were made .The process of guideline formulation fully reflects multidisciplinary characteristics of the workgroup,the advanced nature of the process,the comprehensiveness of evidence ,the rigor of evidence quality grading,and the normalization of consensus. It provides reference in methodology for establishing a comprehensive evidence-based evaluation and management system of off-label use of drugs for all clinical specialist disease. Therefore,this scientific research results may promote the standardization and legalization of the off-label use of drugs management in China.