The Toxicity and Attenuation Methods of Toxic Chinese Materia Medica for its Reasonable Application: A Review.

Over a millennia, traditional Chinese medicine (TCM) has been used to treat various diseases in China. In recent years, more and more Chinese materia medica (CMM) have been studied in scientific research projects, applied in clinical practice, and their extracts have even appeared in some health products. However, the toxicity of some CMM is often overlooked, including hepatotoxicity, nephrotoxicity, neurotoxicity, cardiotoxicity, etc. In this review, the toxic components and their toxicological mechanisms of some toxic CMM were listed according to the chemical structure classification of toxic components. Afterwards, the traditional methods (processing and compatibility) and modern methods (structural modification, biotransformation, etc.) of attenuation of CMM were discussed. Since ancient times, it has been said that "fight fire with fire, fight poison with poison," and toxic CMM are of great significance in the treatment of difficult and severe diseases. The rational application of toxic CMM and their components in clinical practice was also exemplified in this review. While the pharmacological effects of TCMs have been emphasized, the scientific attenuation and rational application of toxic components should be concerned. We hope this review can provide a reference for future related research.

Research progress on chromatic aberration and safety of Chinese materia medica injection / 中草药

As a unique innovative dosage form of China, traditional Chinese medicine injection (TCMI) has the characteristics of high bioavailability and rapid onset, therefore it plays an important role in the treatment of acute and severe diseases. However, more adverse reactions of TCMI have been reported along with its wide application in clinic and the increasing varieties. In the clinical application process, there are obvious color differences between the same kind of injection, which has attracted the attention of researchers whether this phenomenon is related to safety. The safety issue of TCMI has become more and more prominent, which greatly limits the application and development of TCMI. In this article, we summarized the reasons that influenced the chromatic aberration and safety of the TCMI, and analyzed the relationships between them. It is expected to provide some new ideas for exploring the reasons that affect the safety of TCMI and improving TCMI quality by technical improvement. This article provided a reference for rational application of TCMI in clinical practice.

[The Activities of Representatives of Companies-Manufacturers of Pharmaceuticals Related to Informing Specialists with Purpose of Efficient Application of Medications].

The article presents the role of representative of company-manufacturer of pharmaceuticals in informing health care specialists about medications according WHO documentation. The analysis of regulation of procedure and permitted modes of their interaction with specialists in the Russian Federation. Also, an opinion of medical specialists is presented concerning the role of representatives of pharmaceutical companies in the portion of informing about medications. The results of questionnaire survey of medical representatives from the position of their role and tasks are presented concerning information activity during interaction with specialists. The proposals are formulated concerning necessity of legislative regulation of activities of representatives of the companies-manufacturers of pharmaceuticals.

[The Rational Anti-Retroviral Therapy of HIV-Infected Patients: Opinion of Medical Specialists].

The article presents the results of questionnaire sociological survey of medical specialists professionally working in the area of medical and medicinal care of HIV-infected patients. The survey data demonstrated that in spite of active implementation of regulating documents in practice of medical and medicinal support of HIV-infected patients the specialists encounter difficulties in case of choosing medications and evaluation of medicinal therapy schemes, including from position of efficiency and safety of anti-retroviral medications. This is also confirmed by analysis of actual practice of prescriptions. The results of study predetermine necessity of development of informational organizational technologies for optimization of choice, prescription and application of medications on the basis of principles of rational application of medications and according to direction of public policy.

Analysis on Clinical Rational Application of Xueshuantong Injection in Gansu Provincial Hospital of Traditional Chinese Medicine / 中国中医药信息杂志

Objective To investigate the influence of TCM Xueshuantong Injection on the clinical benefit and risk factors; To promote rational medication. Methods HIS system of Gansu Province Hospital of Traditional Chinese Medicine was used, and the medical records and information of patients who used Xueshuantong Injection from August 1st,2015 to August 1st,2016 were selected,including patient information, medicine information, and medicine application information. SPSS19.0 software statistics was used for rational analysis on the clinical application of Xueshuantong;two-class Logistic regression analysis was used to look for adverse reactions related factors. Results Totally 1229 patients with 10 974 medical records were included in the study. Irrational use of medicine was mainly for inappropriate indications (accounted for 21.11%), time of unreasonable administration (accounted for 1.87%), and too large dosage (accounted for 0.9%). Regression analysis showed: 1. Patients with history of allergies to food, medicine, and other substances, increased the risk of adverse reactions 8.725 times after application of Xueshuantong Injection; 2. The medicine combination increased the risk of adverse reaction of Xueshuantong Injection 1.799 times; 3. Medicine combination with Xiaozhong Zhitong Mixture, Jianwei Xiaoshi Mixture, ossotide injection, cobamamide, dextran injection, polyene lipid phosphoryl acid choline injection, and glucosamine hydrochloride tablets, may have potential risk factors for adverse reaction of Xueshuantong Injection. Conclusion Clinical irrational medicine use factors of Xueshuantong Injection mainly manifest in the indications are not suitable, the dosage of the drug medicine is too large and the course of treatment is too long. Adverse reactions occur mainly in patients with allergic history,combination of medication and large dosage.

Evaluation and analysis of clinical application of apatinib / 中国药学杂志

OBJECTIVE: To evaluate retrospectively the clinical application of apatinib in a hospital. METHODS: The medical records including apatinib were collected during April 2015 to March 2016. Then, the rationality and safety of drug use were evaluated. RESULTS: The 84 patients used apatinib during this time, while 15.48% (15 patients) conformed to the approved indications. The major adverse reactions were gastrointestinal disorders, hypertension, skin disorders and myelosuppression. CONCLUSION: Irrational use of apatinib such as off-label use, inadequate usage and dosage exists in clinic. Clinicians should pay close attention to the rationality of apatinib, and clinical pharmacists can improve the safety and effectiveness of therapeutic drugs by taking this as the breakthrough point.

Analysis on the Antibiotic Rational Application in Department of Gastrointestinal Surgery / 中华医院感染学杂志

OBJECTIVE To realize the circumstances of the antibiotic application during perioperational period and evaluate the rational application of antimicrobial agents in department of gastrointestinal Surgery in a hospital.METHODS Retrospective study for 210 patients in the department of gastrointestinal Surgery form Jan 2007 to Dec 2008 was carried out randomly.RESULTS The antibacterial agents were used in all patients during perioperation.The antibacterial agents used most frequently were Metronidazole and Cephalosporins,The combined use cases accounted for 90.5%.The average period of treatment was 7 days.The incidence of surgical site infection was 8.6%.Only 55.6% patient′s samples were examined and drug susceptibility test were detected.CONCLUSIONS The irrational applications of prophylactic antibiotitcs during the perioperative period are serious,such as the average time of using antibiotics was too long,unreasonable frequently sort changing and low rate for samples detecting.

Antibiotics Application in Perioperative Period:An Investigation / 中华医院感染学杂志

OBJECTIVE To analyze the prophylactic application of antibiotics during perioperative period in surgical department and provide the scientific basis for management and rational application of antibiotics.METHODS The rational use of antibiotics during perioperative period was evaluated based on antibiotics selection,usage,dosage,the first time of application,treatment course,and the percentage of antibiotic application for cleaning operation.RESULTS All of surgical operations were used antibiotics.As for the first time of application,the use rate of thirty minutes before operation was 4.1%,but nothing used before operation was 73.2%.The treatment period after operation within 3 days was 8.1%.Among all kinds of used antibiotics,the third generation of cephalosporin accounted for 49%,and quinolones for 25%.CONCLUSIONS There are still some problems about prophylactic application of antibiotics during perioperative period in surgical department in our hospital.It is necessary to standardize application of antibiotics during perioperative period.

Antibiotics Clinical Application Before and after Executive Intervention:An Analysis / 中华医院感染学杂志

OBJECTIVE To analyze the effectiveness and feasibility of executive intervention measures on antibiotics clinical use.METHODS To analyze statistically with the data from 748 inpatients in 2003(before intervention) and 1332 cases in 2006(after intervention),both were collected randomly.RESULTS The antibiotics use rate,the pathogenic test rate,the rate of use antibiotics for therapy,the rate of use antibiotics for prophylaxis in 2003 and in 2006 were following respectively:81.81% and 76.57%,11.11% and 47.05%,28.10% and 36.56%,71.89% and 63.43%,with significant difference.CONCLUSIONS The examination regulations of the antibiotics clinical application made up by the hospital is effective and feasible.The system that examination monthly,the results opening to the hospital staff and having relationship with the receipts of doctors is effective to normalize the behavior of clinical doctors to use antibiotics.But it still needs to improve education,and examination strictly.

Clinical Application of ?-Lactamase Inhibitor Antibiotics / 中华医院感染学杂志

OBJECTIVE To know of the application status of ?-lactamase inhibitor antibiotics in our hospital,promote the compliance of Guideline for application of antibiotics,and cut down the abusing or irrationally using of antibiotics.METHODS Retrospective cohort research was used to review the medical records of 1184 patients left our hospital.Based on the inspection results,to select following 98 inpatients to do prospective research and correct those problems found in the retrospective research.RESULTS There were 71 cases in the prospective research who had applied antibiotics,in which 23 cases had used ?-lactamase inhibitor antibiotics;20 cases with precautious application,18 cases underwent type Ⅰ operation and used antibiotics for 2 to 10 days;2 cases underwent type Ⅱ operation and used antibiotics for 5 to 6 days;2 cases underwent type Ⅲ operation;3 cases of internal medicine patients had been treated with ?-lactamase inhibitor antibiotics for 10 days,not selected by the type of bacteria and the result of drug sensitivity test,and no analysis records in the progress note.CONCLUSIONS In surgical departments,use antibiotics as preventive measurements even after clean operation which lack indications and choose over estimated level of ?-lactamase inhibitor antibiotics and combine medication for post-operation preventive medicine.When treating ordinary infections,Internal department had chose antibiotics which should be used for difficult diseases caused by resistant microbes.Most patients do not have undergone bacteria cultivation and drug sensitivity test before applying antibiotics.Therefore the management of antibiotics should be enhanced.

Survey of Bacterial Antibiotics Resistance and Antibiotics Application in Orthopedics Infection / 医学研究杂志

Objective The antibiotics resistance of common bacteria in orthopedics infection was investigated to guide rational application of antibiotics in treating infection disease.Methods Totally 500 secretions samples from orthopedic inpatients between June 2005 and June 2007 were cultured aerobically.The results of bacterial culture,antibiotics resistance of common bacteria and antibiotics application were analyzed.Results 43 kinds,248 strains of pathogenic bacteria were detected,and 52.8% of them were Gram-negative bacteria.The result of drug sensitive tests indicates that resistance of common antibiotics has been increasing.Conclusion Gram-negative bacilli dominate the pathogenic bacteria in orthopedics patients and it tends to increase;while incidence of infections by Gram-positive cocci is lower.Some pathogenic strains acquire higher resistance against those antibiotics which were effective in the past.Antibiotics application in clinical practice is far from rational,and the irrationality is characterized by high antibiotics use rate,high star point,prolonged postoperative medication,excessive drug combination etc.