KANGGANRAN YAOXUE

Archive

  • 2023 Volume 20 Issue 6
    Published: 25 June 2023
      
  • Select all
    |
  • Research Progress in Pharmacological Effects and Clinical Use of Berberine against Helicobacter Pylori
    ZHANG Ming-fa, SHEN Ya-qin
    2023, 20(6): 559-564. https://doi.org/10.13493/j.issn.1672-7878.2023.06-001
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Berberine has a wide range of antimicrobial effects. It has a strong inhibitory effect on Helicobacter pylori (Hp) in vivo and in vitro in addition to cocci, viruses and fungi. Moreover, berberine mainly inhibits and kills Hp in the stable phase. When berberine is used in combination with anti-Hp drugs that mainly inhibit and kill Hp in the logarithmic growth phase, a synergistic bactericidal effect can be produced. This article summarizes the antibacterial effects of berberine on Hp in vivo and in vitro, in animals and humans, and the clinical practice of combination with other anti-Hp drugs, providing reference for the subsequent clinical development of berberine.
  • Research Progress in Novel Monoclonal Antibody Anti-tumor Drugs and Their Pharmaceutical Care*1
    XU Ying, HOU Huan, CHEN Rong
    2023, 20(6): 565-574. https://doi.org/10.13493/j.issn.1672-7878.2023.06-002
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Tumors pose serious threats to human life and health. Global medical experts are actively exploring novel anti-tumor drugs and have made remarkable achievements. Among them, novel monoclonal antibody anti-tumor drugs (hereinafter referred to as "McAb anti-tumor drugs") are the most representative drugs, and have the advantages of high specificity and definite therapeutic effect, showing obvious advantages and a broad prospect in the anti-tumor field. By reviewing relevant literature on new McAb anti-tumor drugs approved for marketing by the U.S. Food and Drug Administration (FDA) since 2018, we summarized their targets and mechanisms of actions, and described how clinical pharmacists carry out pharmaceutical care for patients in terms of efficacy, hypersensitivity and adverse drug reaction monitoring, providing reference for safer and more effective medications for tumor patients.
  • Research Progress in Prevention and Treatment of Oral Infectious Diseases with Probiotics
    YANG Liu
    2023, 20(6): 574-577. https://doi.org/10.13493/j.issn.1672-7878.2023.06-003
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Pathogenic bacteria are everywhere in daily life, and are roughly divided into two types: beneficial pathogenic bacteria such as probiotics, and harmful pathogenic bacteria which can cause harms to the human body and induce various diseases. The vast majority of diseases are caused by harmful pathogenic bacteria, which can be distributed in all parts of the human body, with fast spread speed and strong reproductive capacity. Some pathogenic bacteria can reduce the immunity of human body, making the body unable to resist other pathogenic bacteria and causing various diseases. This will bring pains to people and challenges to medical staff. At present, people are very worried about oral infectious diseases. Because people eat by mouth, once they get sick, their eating will be affected, and their basic living needs will not be met; they can only maintain their living needs by injecting glucose injections, etc., so it is very painful for them. Probiotics can be used to treat oral infectious diseases, which brings good news to patients with oral diseases. This article reviews the types of probiotics, the research progress and safety in the treatment of caries, periodontal disease, bad breath and oral candidiasis.
  • Anti-infective Treatment and Pharmaceutical Care of One Patient with Multi-Site Nocardiosis
    HUANG Xiang
    2023, 20(6): 578-582. https://doi.org/10.13493/j.issn.1672-7878.2023.06-004
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the anti-infective treatment and pharmaceutical care process of one patient with multi-site nocardiosis, so as to provide reference for clinical pharmacists to participate in the drug treatment of such patients. Methods: One patient was initially treated in another hospital due to "pain in both lower limbs, fever, cough with chest tightness". After comprehensive clinical examination, the patient was determined to have bilateral lung infection and lower limb abscess. Nocardia cyriacigeorgica was found in the microbiological examination, and the drug susceptibility test results showed that the patient was resistant to compound sulfamethoxazole, but susceptible to linezolid, amikacin and imipenem. Later, the patient was transferred to our hospital due to poor treatment effect in that hospital. Results: After being transferred to our hospital, the patient received the combined anti-infective treatment with linezolid (600 mg, q12h, ivgtt) and imipenem-cilastatin sodium (2 g, q6h, ivgtt) and the pharmaceutical care. During this period, the patient developed thrombocytopenia, and clinical pharmacists recommended that the dose of linezolid was reduced to "400 mg, q12h". The patient had a history of nephrotic syndrome and developed renal hypofunction after admission, so it was recommended to reduce the dose of imipenem-cilastatin sodium to "1 g, q6h". Both recommendations were adopted clinically. After 2 weeks of treatment, the patient's pulmonary infection symptoms improved obviously, but the symptoms such as delirium, confusion, and general convulsions appeared very soon. The brain CT scan results showed multiple low-density lesions in the brain, which was suspected to be Nocardia infection spreading into the brain. After explaining the condition to the patient's family, the family decided to give up treatment. Conclusion: The patient is transferred to our hospital due to poor treatment of multi-site nocardiosis. With the cooperation of hospital doctors and clinical pharmacists, the condition improves for a time. However, nocardia may spread to and infect the brain, making it difficult for treatment with unpredictable prognosis, so the family has no choice but to give up treatment.
  • Analysis of Epidemiological Characteristics of New and Serious Adverse Drug Reaction Reports in a Hospital
    GUI Lai, ZHANG Gui-fen, WANG Jian, ZHU Ai-guo
    2023, 20(6): 583-588. https://doi.org/10.13493/j.issn.1672-7878.2023.06-005
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the epidemiological characteristics of new and serious adverse drug reactions (ADRs) in clinical patients in the hospital, so as to provide reference for patients' safe and rational drug use in the future. Methods: 696 ADR reports of Changshu No. 1 People's Hospital reported to National Center for ADR Monitoring, China from January 2021 to July 2022 were selected, and information such as patient gender, age, diseases, and organs (or systems) involved in ADRs, clinical manifestations, type of drugs involved, method of administration was collected to analyze the epidemiological characteristics of new and serious ADRs. Results: Among 696 ADR reports, there were 308 new and serious ADRs, of which 214 were new and general, 23 were new and serious, and 71 were serious; among 308 new and serious ADR reports, the top three reporting departments were Department of Critical Care Medicine (19 cases, 6.17%), Department of Neurology (17 cases, 5.52%), and Department of Orthopedics (17 cases, 5.52%). The patients involved were mainly 60 to less than 80 years old (157 cases, 50.97%) and 40 to less than 60 years old (78 cases, 25.32%), and the top three diseases they suffered from were gastric malignant tumors (21 cases, 6.82%), lung infections (19 cases, 6.17%) and bone fractures (18 cases, 5.84%); 308 new and serious ADR reports mainly involved anti-infective drugs (70 cases, 22.73% ), blood system drugs (35 cases, 11.36%) and cardiovascular system drugs (26 cases, 8.44%). The varieties of drugs involved were mainly tranexamic acid (14 cases, 4.55%) and levofloxacin (12 cases, 3.90%); the main organs (or systems) involved were skin and its appendages (114 cases), gastrointestinal and hepatobiliary system (90 cases), and systemic reaction (74 cases). Clinical manifestations that occurred more frequently included rash itching (47 cases), rash (38 cases), nausea (23 cases), chest tightness (20 cases), dizziness (19 cases). 308 patients with new and severe ADRs were treated, 220 cases (71.43%) were cured and 85 cases (27.60%) were improved. Conclusion: ADRs will inevitably occur in patients in the hospital during the medication process, and new or serious ADRs are more likely to occur. Among them, middle-aged and elderly people are most likely to have ADRs. Hospitals should supervise the clinical safety of medication and make unremitting efforts to ensure safe medication for patients.
  • Analysis of Epidemiological Characteristics of Adverse Drug Reactions Caused by Anti-infective Drugs in the Fever Clinic of a Hospital and Response Strategies
    LI Chuan-hui, NIU Fang-xin, ZHANG Fei-fei
    2023, 20(6): 589-593. https://doi.org/10.13493/j.issn.1672-7878.2023.06-006
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the epidemiological characteristics of adverse drug reactions (ADRs) caused by anti-infective drugs in the hospital fever clinic and propose corresponding response strategies, so as to provide reference for the safe use of anti-infective drugs in outpatient departments. Methods: 162 ADR reports caused by anti-infective drugs reported to National Center for ADR Monitoring, China from the Fever Clinic of the Second Affiliated Hospital of Nanyang Medical College from January 2021 to June 2022 were selected, and information such as patient age, gender, type and method of administration of related anti-infective drugs, occurrence time and organs (or systems) involved of ADRs was collected to analyze the epidemiological characteristics of ADRs caused by anti-infective drugs. Results: The sex distribution of 162 patients with ADRs caused by anti-infective drugs was relatively balanced (87 cases vs 75 cases), and their ages were mainly concentrated in elder than 60 years old (73 cases, 45.06%); the anti-infective drugs involved in 162 cases of ADRs were mainly antibacterial drugs (160 cases, 98.77%), of which the main categories were cephalosporins (44 cases, 27.16%), quinolones (38 cases, 23.46%), macrolides (34 cases, 20.99%) and penicillins (33 cases, 20.37%); the administration methods of anti-infective drugs involved in 162 cases of ADRs were mainly intravenous drip (115 cases, 70.99%), followed by oral administration (31 cases, 19.14%); 162 cases of ADRs mainly occurred more than 1 to 3 h after administration (70 cases, 43.21%), followed by more than 5 min to 1 h after administration (45 cases, 27.78%), and less than or equal to 5 min after administration (30 cases, 18.52%); the organs or systems involved in 162 cases of ADRs were mainly skin and its appendages (56 cases, 34.57%), gastrointestinal tract (41 cases, 25.31%) and nervous system (36 cases, 22.22%). Conclusion: ADRs caused by anti-infective drugs in the hospital fever clinic are mainly induced by intravenous antibacterial drugs, and are more common in the elderly. Focus on ADRs for the high-risk groups during clinical care and medication disclosure to ensure their medication safety.
  • Literature Case Analysis of Drug-induced Liver Injury Caused by Rivaroxaban*1
    WEI Zhong-na, LUO Yuan, XIE Zong-zheng, WANG Ning, WANG Shi-li, ZOU Tao
    2023, 20(6): 593-596. https://doi.org/10.13493/j.issn.1672-7878.2023.06-007
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the clinical characteristics of patients with drug-induced liver injury (DILI) caused by rivaroxaban using literature, so as to provide reference for the safe and rational use of rivaroxaban. Methods: With "rivaroxaban" and "liver injury" as search terms, relevant literature of DILI caused by rivaroxaban since its launch in 2008 till now was searched from domestic and foreign databases such as CNKI, Wanfang Database, Chongqing VIP, and PubMed Database. Information such as patient age, gender, disease, dosage of rivaroxaban, as well as DILI occurrence time, manifestation types and final outcomes was collected to analyze the epidemiological characteristics of DILI caused by rivaroxaban. Results: A total of 53 relevant articles were searched in domestic and foreign databases using corresponding key words, but after excluding irrelevant or duplicate articles, 19 articles were ultimately included, involving a total of 37 patients in a relatively balanced gender ratio, with the majority of patients aged above 60 and 80 years old (20 cases, 54.05%). The causal correlation evaluation between rivaroxaban and DILI showed that 10 cases (27.03%) were "highly likely", 20 cases (54.05%) were "very likely", and 7 cases (18.92%) were "possibly". DILI caused by rivaroxaban mainly occurred within 14 days after the medication (20 cases, 54.05%), mainly of a liver cell injury type (17 cases, 45.95%), followed by a mixed type (8 cases, 21.62%) and a cholestasis type (7 cases, 18.92%), with the main specific clinical manifestations of jaundice (17 cases, 45.95%) and nausea (13 cases, 35.14%). After symptomatic treatment, 35 cases (94.59%) were cured or improved, and the other 2 cases (5.41%) died. Conclusion: DILI caused by rivaroxaban mostly occurs in the middle-aged and elderly population. Although the majority of patients have good outcomes after symptomatic treatment, there are still deaths. Therefore, clinical attention and monitoring should be strengthened for patients at risk of DILI to ensure timely detection and treatment, and to ensure the medication safety for patients.
  • Optimization Analysis of Anti-infective Treatment Plans for Septic Shock Patients Caused by Escherichia coli Based on PK/PD Model and Mote Carlo Simulation*1
    WANG Ying, YAO Yin-hui, WANG Ling-di, HU Jun-hui, ZANG Ya-ru
    2023, 20(6): 597-600. https://doi.org/10.13493/j.issn.1672-7878.2023.06-008
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the optimization process of anti-infective treatment plans for septic shock patients caused by Escherichia coli based on pharmacokinetics (PK)/pharmacodynamics (PD) model and Mote Carlo simulation (MCS), so as to provide reference for constructing reasonable and effective treatment plans for clinical infection patients. Methods: One patient was admitted with unexplained fever and initially diagnosed with urinary tract infection and septic shock. After admission, the patient underwent relevant laboratory tests immediately, and the optimal anti-infective treatment plan was determined with PK/PD model and MCS based on microbial culture results and drug susceptibility tests. Results: On the third day of admission, Escherichia coli was detected in microbial culture, subsequent drug susceptibility tests showed that the patient was sensitive to meropenem and imipenem, but mediated by cefoperazone-sulbactam sodium. PK/PD model and MCS were used to analyze several proposed anti-infective treatment plans, and the results showed that the probability of target attainment (PTA) of both meropenem (1 g, q8h) and imipenem (0.5 g, q6h) was 100.00%, while the PTA of cefoperazone-sulbactam sodium (3 g, q12h) was 1.14%, and the PTA of cefoperazone-sulbactam sodium (3 g, q8h) was 7.65%. Finally, meropenem (1 g, q8h) was chosen for clinical treatment, and the infection indications of the patient basically disappeared after one week. Conclusion: The two tools of PK/PD model and MCS can effectively help clinical pharmacists predict the possible effects of anti-infective treatment plans, thereby better assisting doctors in formulating and optimizing treatment plans, and thus maximizing the treatment effect of patients.
  • Analysis of Clinical Medication of Rivaroxaban in Inpatients in a Hospital
    LU Yi, ZHANG Gui-fen, TANG Hui
    2023, 20(6): 601-607. https://doi.org/10.13493/j.issn.1672-7878.2023.06-009
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the clinical medication of rivaroxaban in inpatients in the hospital, so as to provide reference for its safe and rational use in clinical practice. Methods: 562 patients admitted to the hospital from September to November 2022 who used rivaroxaban were selected as the research objects. Information such as patient gender, age, department, disease, length of hospitalization, usage and dosage of rivaroxaban was collected to analyze the clinical use characteristics of rivaroxaban, and the rational drug use was evaluated based on the drug instructions and relevant guidelines of rivaroxaban. Results: 562 patients were generally in an equal gender ratio (304 cases vs 258 cases), with 464 patients greater than or equal to 60 years old (82.56%) being the main age group. In terms of department distribution, the patients were mainly concentrated in Ward II of Orthopedics Department (137 cases, 24.38%), Cardiology Department (135 cases, 24.02%), and Oncology Department (81 cases, 14.41%). 186 patients were selected for analysis, the results indicated that Cardiology Department mainly used the drug to treat non-valvular atrial fibrillation (71 cases, 38.17%), Oncology Department mainly used it to prevent venous embolism (51 cases, 27.42%), and Orthopedics Department mainly used rivaroxaban to prevent formation of venous embolism (39 cases, 20.97%). Among 186 patients, the usage and dosage of rivaroxaban were mainly "10 mg, oral/nasal, q24h" (99 cases, 53.23%) and "15 mg, oral/nasal, q24h" (42 cases, 22.58%). The results of rational drug use evaluation showed that 49 out of 186 patients had irrational use of rivaroxaban, with the main cause of unreasonable usage and dosage (37 cases, 75.51%). Conclusion: Rivaroxaban is widely used in hospital clinical practice, but there are still many irrational uses. Management and training of doctors should be strengthened in clinical practice to ensure the safe and rational medication.
  • Construction of a Hospital's Smart Pharmacy Service Mode and Analysis of Effect *1
    LIU Ling, TAO Song, LUO Xin-xin, LI Hai, XU Juan
    2023, 20(6): 611-615. https://doi.org/10.13493/j.issn.1672-7878.2023.06-0011
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To construct a smart pharmacy in the hospital through a fully automatic dispensing machine and a decision-making system for rational drug use, compare and analyze the effectiveness of the pharmacy before and after the implementation of the smart pharmacy, so as to provide reference for the exploration of domestic smart pharmacies. Methods: The Rowa Vmax 160 and Rowa Cmax fully automatic dispensing machines, MCDEX rational drug use decision-making system and Health Assistant were integrated into the hospital information system to construct the hospital's smart pharmacy, and waiting time of patients to take medicines and the prescription dispensing error before and after the implementation of the smart pharmacy were compared and analyzed. Results: After the implementation of the smart pharmacy, the average waiting time for patients to take medicines was shortened from 12 min to 5.6 min, and the patients' satisfaction for pharmacy services increased from 87.80% to 94.40%; the prescription dispensing error rate was decreased from 0.035 5% to 0.005 8%. Conclusion: The application of smart pharmacy service mode not only improves the work efficiency of outpatient pharmacies, shortens the waiting time of patients, but also reduces the dispensing error rate of dispensing pharmacists, thereby improving the overall pharmaceutical service level of pharmacies.
  • Analysis of Pathogenic Bacteria Distribution and Risk Factors of Elderly Primiparous Women Complicated by Puerperal Infection after Cesarean Section
    LIU Mei-xiang
    2023, 20(6): 616-620. https://doi.org/10.13493/j.issn.1672-7878.2023.06-0012
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To explore the pathogenic bacteria distribution and risk factors of elderly primiparous women complicated by puerperal infection after cesarean section in the hospital, so as to provide reference for the prevention and treatment of puerperal infection in such population. Methods: 352 elderly primiparous women who were admitted to Suichuan County Maternal and Child Health Hospital and underwent cesarean section from January 2018 to January 2023 were selected as the research objects, and they were divided into the infected group (n=29) and the uninfected group (n=323) according to the presence or absence of puerperal infection after surgery. Information of all parturients such as age, height, weight, education, complications, medication history, gestational age, operation time, postpartum hemorrhage, premature rupture of membranes, and laboratory test results was collected to analyze the pathogenic bacteria distribution and risk factors of them complicated by puerperal infection after surgery. Results: A total of 92 strains of pathogenic bacteria were detected in 29 samples of parturients complicated by puerperal infection, including 64 strains of Gram-negative bacteria (69.57%, mainly Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae), and 28 strains of Gram-positive bacteria (30.43%, mainly Streptococcus); the regression analysis results showed that the occurrence of puerperal infection in elderly primiparous women after cesarean section was related to prenatal hemoglobin level, presence of prenatal reproductive tract infection, operation time, postpartum hemorrhage or not, combined diabetes or not, and premature rupture of membranes or not (P<0.05); among them, prenatal hemoglobin level less than 60 g/L, presence of prenatal reproductive tract infection, operation time longer than or equal to 1.5 h, presence of postpartum hemorrhage, combined diabetes, and occurrence of premature rupture of membranes were independent risk factors for puerperal infection after surgery (P<0.05). Conclusion: Prenatal hemoglobin level, prenatal reproductive tract infection, operation time, postpartum hemorrhage, combined diabetes, and premature rupture of membranes are important influencing factors for puerperal infection in elderly parturient women after cesarean section. Clinical care and monitoring should be strengthened for parturients with high risk factors to avoid and reduce the occurrence of puerperal infection and ensure the health of mothers and babies.