KANGGANRAN YAOXUE

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  • 2019 Volume 16 Issue 7
    Published: 25 July 2019
      
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  • Research Advances in Pharmacological Action of Matrine for Respiratory System Diseases
    ZHANG Ming-fa, SHEN Ya-qin
    2019, 16(7): 1105-1109. https://doi.org/10.13493/j.issn.1672-7878.2019.07-001
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    Matrine has the effects of anti-microbial, anti-oxidation, anti-inflammation, anti-anaphylaxis, and increasing immunoregulation, and antagonizing histamine- and acetylcholine-induced contraction of trachea. Matrine has also the effects of inhibiting proliferation and collagenation of pulmonary fibroblast. Thus matrine can antagonize asthma, acute lung injury, and pulmonary fibrosis. In clinic matrine has been tried on treatment of children asthma and pulmonary fibrosis. The literatures of pharmacological action of matrine on respiratory diseases were reviewed, and the research progress was analyzed.
  • Determination of Methyl Benzene Sulfonate and Ethyl Benzene Sulfonate in Raw Materials of Amlodipine Benzene Sulfonate by HPLC
    NIU Hui-min, LI Yun-li, WANG Chen, ZHAI Fen
    2019, 16(7): 1110-1114. https://doi.org/10.13493/j.issn.1672-7878.2019.07-002
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    Objective: To establish a HPLC method for the determination of genotoxic impurities such as methyl benzene sulfonate and ethyl benzene sulfonate in amlodipine besylate. Methods: A Welch Ultimate Plus-C18(II) column (250 mm×4.6 mm, 5 μm) was used as mobile phase with a gradient of triethylamine adding phosphate buffer (pH=3.0) and acetonitrile. The detection wavelength was 220 nm. The flow rate was 1.0 mL/min, and the column temperature was 30 ℃. They were quantitatively studied in the raw material of amlodipine besylate for the genotoxic impurities such as methyl benzene sulfonate and ethyl benzene sulfonate. Results: They could be effectively separated for the peaks of methyl benzenesulfonate, ethyl benzenesulfonate and amLodipine. The linear response range of methyl benzenesulfonate was between 0.102 9 and 1.633 9 μg/mL (r=0.999 8) and the average recovery was 103.6%. The linear response range of ethyl benzene sulfonate was between 0.1033 and 1.6561 μg/mL (r=0.999 8) and average recovery was 102.7%. A total of 6 batches of amLodipine besylate bulk drugs were tested, and methyl benzene sulfonate and ethyl benzene sulfonate were not detected. Conclusion: The separation results show that the method is specific, accurate and reproducible, and can be used to control the genotoxic impurities methyl benzene sulfonate and ethyl benzene sulfonate in amlodipine besylate.
  • Analysis on Related Factors of Proton Pump Inhibitors in Elderly Out-patients Based on Beers Criteria 2015 Edition
    FAN Hong-chun, TANG Hui, YIN Wei-qing, TANG Chen, Tang Ye-qiu
    2019, 16(7): 1115-1120. https://doi.org/10.13493/j.issn.1672-7878.2019.07-003
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    Objective: To analyze the related factors of proton pump inhibitor (PPIs) in outpatient elderly patients, and to provide a reference for rational use of drugs in clinic. Methods: According to the Beers standard of version 2015, combined with the prescription management measures, the rationality of proton pump inhibitor in 9929 outpatients aged≥65 years in 2016 was analyzed. Results: Among the 9 929 prescriptions of PPIs, the frequency of administration was omeprazole>rabeprazole>lansoprazole>pantoprazole>esomeprazole, and the potential inappropriate (PIM) was (1) 5 415 times (54.54%) in elderly patients with PIM; (2) 7 times (0.07%) associated with their own diseases or symptoms; (3) 13 cases (0.13%) were treated with non-anti-infective drugs that should be avoided in elderly patients; (4) 164 cases (1.65%) were treated with non-anti-infective drugs that should be avoided or reduced according to the renal function of elderly patients, and (5) 71 cases (0.71%) were treated with drugs with strong anticholinesterase. (6) 216 cases (2.18%) were treated with potentially interacting drugs other than the Beers standard. Conclusion: There is a certain proportion of PIM phenomena in the use of PPIs among elderly patients in outpatient service. Therefore, relevant departments of hospitals should learn from Beers standards applying it to do a good job in prescription comment and intervention, so as to reduce the medication risk of elderly patients.
  • Analysis on Related Factors of Clinical Medication of Antimicrobial Agents of Carbapenems in a Hospital
    ZHANG Jing
    2019, 16(7): 1121-1124. https://doi.org/10.13493/j.issn.1672-7878.2019.07-004
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    Objective: To analyze the related factors of clinical medication of antimicrobial agents of carbapenems and to provide a reference for clinical rational use. Methods: Clinical data of 98 in-patients treated with carbapenems from January to March 2019 were extracted. The basic situation, department distribution, defined daily dose system(DDDs), drug utilization index(DUI) and pathogenic examination results of the patients in the data were analyzed, and the rationality of medication was commented. Results: Among the 98 patients, the DDDs of imipenenci-statins for injection and biapenem for injection were 212.25 and 187.50, and the DUI were 0.63 and 0.57, respectively. The clinical departments using carbapenems most were respiratory department (40.82%) and intensive care unit (ICU) (25.51%). The total microbial testing rate was 91.84%, in which 35 cases (63.64%) were selected based on drug sensitivity results, and 28 cases (54.90%) were selected based on drug sensitivity results. Conclusion: The intervention management of carbapenems should be strengthened in the use of antibiotics to provide a reference for rational drug use in clinical practice and the formulation of fine management measures.
  • Analysis on Resistance to Anti-TB Drugs in AIDS Patients with Mycobac-terium TB Infection and Its Influence on Expression of T Cell Subsets*1
    LI Fang-hua, ZHAO Jing, XU Ping, SONG Hua-feng
    2019, 16(7): 1125-1127. https://doi.org/10.13493/j.issn.1672-7878.2019.07-005
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    Objective: To analyze the resistance to anti-tuberculosis drugs(TB) in AIDS Patients with Mycobacterium TB infection and its influence on expression of T cell subsets, and to provide a reference for clinical diagnosis and rational use of drugs. Methods: The data of 23 AIDS patients with Mycobacterium tuberculosis (MTB) infection treated from January 2014 to December 2018 were selected as the observation group, and the data of 30 healthy patients in the same period were selected as the healthy group. The levels of T lymphocyte subsets (CD3, CD4, CD8, CD4 and CD25) in peripheral blood of the two groups detected by flow cytometry were analyzed. Meanwhile, the anti-tuberculosis drug resistance rate and its effect on T cell subpopulation expression in patients infected with Mycobacterium tuberculosis were analyzed. Results: Compared with the healthy control group, there were significant differences in T lymphocyte levels (CD3, CD4, CD8, CD4 and CD25) in patients with Mycobacterium tuberculosis infection. In the sensitivity test of anti-tuberculosis drugs in 23 patients, the resistance rate of Mycobacterium tuberculosis to isoniazid was the highest (39.13%), while the resistance rate to Streptomycin, Rifampicin and Ethambutol were 30.04%, 26.09% and 8.70%, respectively. Conclusion: HIV patients with Mycobacterium tuberculosis (MTB) infection had a higher incidence of MTB resistance to first-line anti-TB drugs, and there were significant differences in the expression of T-lymphocyte subpopulations compared with the healthy group.
  • Analysis on Effect of Quality Control Circle Activities on Reducing Errors Rate of Clinical Medical Ordering and Dispensing Management*1
    WEI Ling, WANG Huan, WANG Le, SHEN Dongmei, SUN Jian
    2019, 16(7): 1128-1131. https://doi.org/10.13493/j.issn.1672-7878.2019.07-006
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    Objective: To explore the effect of quality control circle (QCC) activities on reducing the rate of errors in the management of medical ordering and discharging. Methods: 1 200 clinical orders implemented routine drug discharge management from June to October 2018 were selected as the control group, and the other 1 200 clinical orders implemented QCC activities from November 2018 to March 2019 were selected as the research group. The differences in the errors of dispensing, withdrawal, dispensing, complaint rate and incidence of medical disputes between the two groups were compared. Results: After the implementation of QCC activity, research group medication errors rate (0.17%) is lower than that of the control group (2.17%) (P<0.05); the return rate (0.25%) is lower than that of the control group (2.33%)(P<0.05), dispensing error rate (0.17%) is lower than that of the control group (2.08%)(P<0.05), patients' complaints (0.00%) are lower than that of the control group (3.17%) (P<0.05); the incidence of medical disputes (0.00%) is lower than that of the control group (2.67%) (P<0.05). Conclusion: The implementation of QCC activities in the management of dispensing drugs under clinical medical advice greatly reduces the rate of errors in dispensing drugs, drug withdrawal rate, dispensing errors rate, patient complain rate and medical dispute rate, ensuring the safety of patients' medication.
  • Analysis on Causes of Potential Inappropriate Medication in 559 Elderly Patients Hospitalized in Department of Cardiology
    ZHANG Yong-li
    2019, 16(7): 1132-1134. https://doi.org/10.13493/j.issn.1672-7878.2019.07-007
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    Objective: To analyze the causes of potential inappropriate medication in 559 elderly patients hospitalized in department of cardiology. Methods: A total of 953 geriatric inpatients admitted to the department of cardiology from July 2017 to April 2018 were selected to analyze the single factor of potential inappropriate medication and the reasons for inappropriate medication by retrospective analysis. Results: The potential inappropriate drug use in 953 patients was analyzed in retrospect. When the odds ratio (OR) was greater than 1, it means that inappropriate medication is more likely under the influence of influencing factors. When OR was less than 1, it means less inappropriate medication. At the same time, the causes of inappropriate drug use in elderly patients were also analyzed. When there were problems that could not be adapted to the drug use, such as the application of iodarone in hypertension, the effectiveness of cardiology treatment was reduced, and it was found that the effects of different drugs on different symptoms were statistically significant (P<0.05). Conclusion: There are potential inappropriate medication factors in elderly patients in cardiology department.According to the analysis of Beers standards, it can be concluded that there is a certain value, but it cannot replace the professional judgment. Therefore, for the potential drug use factors of elderly patients hospitalized in cardiology department, it is reasonable to choose drug treatment based on the patient's condition.
  • Influence of Changes in Internal Preparation and Finished Products Re-check Modes of PIVAS on Improving Mixing Speed and Accuracy
    CHEN Shan-shan, SONG Xiang-qing, LI Jin-lan, XIA Qiao, Pan Yong, WU Yi
    2019, 16(7): 1135-1138. https://doi.org/10.13493/j.issn.1672-7878.2019.07-008
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    Objective: To explore the influence of changes in internal preparation and finished products re-check modes of Pharmacy Intravenous Admixture Services(PIVAS) on improving mixing speed and accuracy. Methods: Before the change of mode, the mode of "classic confection-review" was adopted; after the change, the mode of "one supplement-match-review" was adopted. The personnel preparation capacity and the average difficulty of drug deployment were investigate before and after the change of the mode, as well as the prescription preparation and error registration record data of the two modes, and the influence of the two modes on improving the deployment speed and accuracy was compared. Results: There was no statistically significant difference between groups in pharmacists' preparation ability and the average difficulty of drug preparation before and after the change of mode (P>0.05). The average preparation speed was (2.04±0.02) bag/min after mode change, which was significantly higher than that before mode change (1.43±0.01) bag/min. After model change, the deployment error rate was 0.01‰ slightly lower than that before model change, but the difference was not statistically significant (P>0.05). Conclusion: Compared with the "classic confection-review" mode, the "one supplement-match-review" mode effectively improvd the mixing speed and accuracy.
  • Pharmaceutical Care for Clinical Medication of 1 Patient of Urinary Tract Infection Accompanied with Hypokalemia
    YUAN Lin-ya
    2019, 16(7): 1195-1197. https://doi.org/10.13493/j.issn.1672-7878.2019.07-030
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    Objective: To analyze the pharmaceutical care process of 1 patient of urinary tract infection accompanied with hypokalemia, and to explore the role of clinical pharmacists in clinical medication. Methods: Close attention was paid to the changes of patients' condition, participating in the adjustment of medication regimen to achieve individualized medication for patients. Results: The clinical pharmacists participated in the adjustment of clinical treatment regimens, and actively communicated with doctors and patients, which was beneficial to improving hospital medical treatment and service level. Conclusion: Clinical pharmacists should find out problems in time according to the actual conditions of patients, so as to better ensure the rationality, safety and effectiveness of patients' medication.
  • Efficacy of Notoginseng Powder Combined with ETV in CHB Patients with Liver Fibrosis and Its Influence on Liver Fibrosis and Hardness
    LI Xiao-hong, WANG Pei, ZHU Chuan-wu, LIU Yi'an, XU Jun-chi
    2019, 16(7): 1204-1207. https://doi.org/10.13493/j.issn.1672-7878.2019.07-034
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    Objective: To evaluate the efficacy of Notoginseng powder combined with entecavir (ETV) in chronic hepatitis B (CHB) patients with liver fibrosis and its influence on liver fibrosis and liver hardness improvement. Methods: The data of 106 cases of CHB fibrosis patients admitted from December 2015 to December 2017 were divided into treatment group and control group according to different treatment methods, with 54 cases in each group. Control group patients was given ETV antiviral treatment, and the treatment group patients on the base of the control group were additionally given with Notoginseng powder. The differences of the total effective rate were compared. and the changes of the measured values of liver fibrosis indexes and liver stiffness level before and after the treatment (adhesion protein, hyaluronic acid, layer type Ⅲ before collagen and collagen type Ⅳ) were also compared. Results: The total effective rate of the treatment group was higher than that of the control group at 6 months and 1 year (P<0.05). In two groups of patients before treatment the layer adhesion protein, hyaluronic acid, collagen and collagen type IV level before Ⅲ type value could be measured by comparing the differences between two groups but they had no statistical significance (P>0.05); after treatment, it was lower than that before treatment (P<0.05). In treatment group patients at 6 months and 1 year the hyaluronic acid and collagen level before Ⅲ type measured value was lower than that before treatment (P<0.05) significantly. The liver hardness levels of the patients in the treatment group were lower than those in the control group at 6 months and 1 year after treatment (P<0.05). Conclusion: The efficacy of Notoginseng powder and entecavir in treating patients with liver fibrosis was better than that of using entecavir alone, and they effectively improved the indexes of liver fibrosis and liver hardness.
  • Evaluation on Efficacy of Cefazolin Sodium Combined with Metronida-zole in Postoperative Incision Infection Patients with Uterine Fibroids
    FENG Yun
    2019, 16(7): 1208-1210. https://doi.org/10.13493/j.issn.1672-7878.2019.07-035
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    Objective: To evaluate the efficacy of cefazolin sodium combined with metronidazole in postoperative incision infection patients with uterine fibroids. Methods: 86 cases of laparoscopic myomectomy patients admitted from May 2016 to May 2019 were selected and divided into control group and observation group according to different treatment methods, with 43 cases in each group. Patients in the control group were treated with metronidazole alone 1 h before surgery, and patients in the observation group were treated with cefazolin sodium on the basis of the control group. The differences in the total effective rate, incidence of incision infection and incidence of adverse reactions were compared between the two groups. Results: The total effective rate (93.02%) of the observation group was significantly higher than that of the control group (72.09%) (P<0.05), and the incidence of incision infection (2.33%) was significantly lower than that of the control group (11.63%) (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: The combined use of cefazolin sodium and metronidazole to prevent postoperative incision infection in patients with uterine fibroids after laparoscopic excision was more effective than using metronidazole alone, which effectively reduced the occurrence of incision infection and had a higher safety.