KANGGANRAN YAOXUE

Archive

  • Select all
    |
  • Research Progress in the Antibacterial Effect of Active Ingredients of Lonicerae Japonicae Flos
    LIU Xin-yuan, SHENG De-qiao
    2023, 20(8): 783-789. https://doi.org/10.13493/j.issn.1672-7878.2023.08-001
    Abstract ( 644 ) Download PDF ( 39 )   Knowledge map   Save
    Lonicerae japonicae flos is a common traditional Chinese medicine with multiple pharmacological activities such as antiviral, antibacterial, anti-inflammatory and immune-enhancing activities. Presently, a variety of antibacterial active ingredients have been isolated from lonicerae japonicae flos, mainly including organic acids, flavonoids, triterpene saponins, and volatile oils. In-depth studies of the antibacterial effects and pharmacological mechanisms of some active ingredients have been performed. In this article, the types, antibacterial effects and pharmacological mechanisms of antibacterial active ingredients in lonicerae japonicae flos are reviewed, to provide a theoretical basis for the subsequent development of these active ingredients.
  • Research Progress in the Antibacterial Effect of Berberine on Escherichia Coli and Its Pharmacological Mechanism
    ZHANG Ming-fa, SHEN Ya-qin
    2023, 20(8): 789-794. https://doi.org/10.13493/j.issn.1672-7878.2023.08-002
    Abstract ( 247 ) Download PDF ( 26 )   Knowledge map   Save
    Berberine is a medicine with a wide range of pharmacological effects. It has strong pharmacological activity against bacteria, fungi and viruses. Clinically, it is mainly used for intestinal infections. Researchers have found that berberine has a strong antibacterial effect on Escherichia coli both in vivo and in vitro when they studied its pharmacological effect on Escherichia coli, and its mechanism is possibly related to the interference with the nucleic acid metabolism and glucose metabolism of bacteria; in addition, berberine can enhance the antibacterial effect of other antibacterial drugs by interfering with the efflux system of drug-resistant Escherichia coli. In this article, the antibacterial effect of berberine on Escherichia coli and its pharmacological mechanism are reviewed and analyzed, to provide a reference for further clinical studies on berberine.
  • Analysis of the Clinical Treatment of Patients with Urinary Tract Infection Complicated by Acute Ischemic Stroke Caused by Multidrug-Resistant Escherichia Coli under the Multidisciplinary Diagnosis and Treatment Mode*1
    HUANG Wei-bin, WU Hong-zhong, LUO Shen-ying, HUANG Yun-qing, HUANG Hai-tao
    2023, 20(8): 795-800. https://doi.org/10.13493/j.issn.1672-7878.2023.08-003
    Abstract ( 90 ) Download PDF ( 11 )   Knowledge map   Save
    Objective: To analyze the multidisciplinary diagnosis and treatment (MDT) process of one patient with urinary tract infection complicated by acute ischemic stroke caused by multidrug-resistant Escherichia coli, and provide reference for clinical pharmacists to participate in MDT practices in similar patients. Methods: The patient visited the hospital's emergency department due to "sudden chills, fever, soreness in the waist, and difficulty in urinating". The examination at admission showed that the patient had obvious indications of urinary tract infection, and the NIHSS score revealed the presence of acute ischemic stroke. Results: For the patient's urinary tract infection, levofloxacin was used clinically for empirical treatment. However, after several days of treatment, the infection indications had not improved and showed a trend of aggravation; in addition, the urine culture result revealed infection with Escherichia coli, which was resistant to levofloxacin, cefuroxime, cefoxitin and ceftazidime. On the 5th day after admission, a multidisciplinary consultation was implemented, and experts participating in the consultation unanimously believed that the patient was at the risk of worsening the infection to sepsis or even septic shock, so the anti-infective treatment regimen was adjusted to meropenem (0.5 g, q8h) + compound sulfamethoxazole (0.96 g, q12h); after 2 days of treatment, the infection indications had not improved and a multidisciplinary consultation was implemented again, and it was believed that the infection had progressed to septicopyemia. It was recommended that the anti-infective treatment regiment was adjusted to meropenem (2 g for the first dose, 1 g, q8h for maintenance treatment) + amikacin (0.3 g, q24h). One week later, the patient's infection indications improved obviously, so only meropenem (1 g, q12h) was given; another week later, the patient's infection indications disappeared basically, so all antibacterial drugs were discontinued, and the patient was discharged from the hospital. Conclusion: Clinical pharmacists can participate in the patient's MDT process with their professional expertise and provide more personalized support for patients' drug therapy, so as to ensure the treatment safety and effectiveness.
  • Analysis of Diagnosis and Treatment and Pharmaceutical Care of One Patient with Clostridium Difficile Infection Caused by Cefazolin
    WEI Hong-qun, PING Xiao-li, WANG Yu, JIANG Zhong-cai
    2023, 20(8): 801-804. https://doi.org/10.13493/j.issn.1672-7878.2023.08-004
    Abstract ( 145 ) Download PDF ( 24 )   Knowledge map   Save
    Objective: To analyze the diagnosis, treatment and pharmaceutical care process of one patient with Clostridium difficile infection caused by cefazolin, and provide reference for the clinical medication safety of antibacterial drugs. Methods: The patient was admitted to the hospital for "lumbosacral pain, accompanied by numbness in both lower extremities for 3 years, and worsening for half a year". On the 6th day after admission, the patient received surgery, and cefazolin was used before and after surgery to prevent postoperative infection; on the 9th and 10th days, the patient developed the symptoms such as fever, diarrhea, and abdominal pain; so a clinical pharmacist was invited for consultation. The clinical pharmacist consulted relevant literature and gave pharmaceutical suggestions based on the patient's current symptoms, examination results, and medication history. Results: After analysis, the clinical pharmacist considered it to be antibiotic-associated diarrhea, and suggested the tests related to Clostridium difficile; on the 14th day, the Clostridium difficile test showed positive result, so the treatment with vancomycin (125 mg, q6h, orally) was recommended; after 2 weeks of treatment, the formed stool was produced and the abdominal pain disappeared. Conclusion: Clostridium difficile infection caused by cefazolin is relatively rare in clinical practice. Clinical pharmacists can suspect it is caused by cefazolin very quickly based on their pharmaceutical knowledge and believes that Clostridium difficile may be the pathogenic bacterium, achieving the purpose of early detection and early treatment and improving the quality of clinical diagnosis and treatment.
  • Literature Analysis of Serious Immune-related Adverse Events Caused by Tislelizumab in Patients
    SHI Jin-fang, JIANG Ling
    2023, 20(8): 805-809. https://doi.org/10.13493/j.issn.1672-7878.2023.08-005
    Abstract ( 228 ) Download PDF ( 18 )   Knowledge map   Save
    Objective: To analyze the clinical characteristics of serious immune-related adverse events (irAEs) such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) occurring in patients caused by tislelizumab (BGB-A317), and provide reference for the safe and rational use of BGB-A317. Methods: The case reports and literature related to SJS/TEN caused by BGB-A317 as of November 2022 were searched from domestic and foreign databases such as Embase, PubMed, CNKI, SinoMed using "tislelizumab", "Stevens-Johnson syndrome", "toxic epidermal necrolysis", "adverse drug reaction", "immune-related adverse events" and "case report" as the search terms, to analyze the clinical characteristics of SJS/TEN caused by BGB-A317. Results: Five high-quality case reports were searched from relevant databases, involving 5 medical cases, including 4 TEN cases and 1 SJS case; 5 patients (3 males and 2 females) were aged from 55 to 93 years, and the dosage and administration of BGB-A317 was "200 mg, q3w". The period from the first use of BGB-A317 to the onset of SJS/TEN was 54 to 127 days (median: 63 days). Among the 5 patients, the skin toxic reactions of SJS/TEN caused by BGB-A317 were manifested as mucosal involvement (all oral mucosa) and prodromal rash; among them, patients who developed SJS had mucosal involvement and prodromal rash; while 1 of the 4 patients who developed TEN had no skin toxic reaction and 3 of them developed prodromal rash, but only 1 patient had mucosal involvement. All of the 5 patients who developed SJS/TEN improved or recovered after symptomatic treatment. Conclusion: The irAEs such as SJS/TEN occurring in cancer patients during treatment with BGB-A317 shall be highly concerned; once manifestations such as mucosal involvement or prodromal rash have occurred, clinical investigation and diagnosis shall be performed actively to ensure the medication safety of patients.
  • Case Analysis of One Patient with Decreased RBC and Hemoglobin and Discoloration of Radula Caused by Linezolid
    SUN Xiao-hui, WANG Ji-mei
    2023, 20(8): 810-813. https://doi.org/10.13493/j.issn.1672-7878.2023.08-006
    Abstract ( 229 ) Download PDF ( 24 )   Knowledge map   Save
    Objective: To analyze the clinical characteristics and treatment process of adverse drug reactions such as decrease in red blood cells (RBC) and hemoglobin and discoloration of radula caused by linezolid in patients, and provide reference for safe and rational use of linezolid clinically. Methods: The patient went to the hospital for treatment due to fever and knee joint pain. The past history showed that the patient had recently developed ulcers and pus on the inner thigh 10 cm away from the knee. The CT scan showed the presence of knee joint effusion, so it was considered to be a bone and joint infection. Linezolid was given for treatment; however, in the treatment process, the patient's RBC and hemoglobin levels decreased progressively, and his/her tongue coating turned yellow, and his/her teeth turned light brown. Results: Multidisciplinary expert consultation believed that the decrease in RBC and hemoglobin levels caused by linezolid could not be ruled out. The patient was discharged from the hospital on the same day and linezolid was discontinued; 1 week later, the patient came to the hospital for review, and his/her RBC and hemoglobin levels returned to 3.54×1012/L and 100 g/L; 2 weeks later, the patient's RBC and hemoglobin levels recovered to 4.22×1012/L and 121 g/L, and the color of tongue coating and teeth turned to normal. Conclusion: By reviewing the patient's disease course, it can be basically confirmed that the decrease in RBC and hemoglobin levels and the discoloration of radula are caused by linezolid, which suggests that sensitivity and identification ability of adverse drug reactions shall be strengthened during clinical medication to ensure the patient's medication safety.
  • Analysis of Use of Carbapenem Antibacterial Drugs in a Hospital in 2020*1
    SHEN Qian, ZHANG Lei
    2023, 20(8): 819-824. https://doi.org/10.13493/j.issn.1672-7878.2023.08-008
    Abstract ( 80 ) Download PDF ( 17 )   Knowledge map   Save
    Objective: To analyze the clinical use of carbapenem antibacterial drugs in the hospital, and provide reference for the standardized management and clinical rational use of carbapenem drugs. Methods: 221 hospitalized patients treated with carbapenem drugs at Jiangsu Shengze Hospital from January to December 2020 were selected as the research subjects. The information such as age, gender, diagnosis, department, type of medication, and treatment outcomes was collected to analyze the clinical use characteristics and medication evaluation of carbapenem drugs. Results: The main carbapenem drugs used in 221 patients were biapenem (137 cases, 61.99%) and meropenem (80 cases, 36.20%); in terms of department distribution, the patients were mainly from Respiratory Medicine Department (105 cases, 47.51%), followed by ICU (36 cases, 16.29%); in terms of diagnosis, the patients were mainly diagnosed as pulmonary infection (152 cases, 68.78%), followed by sepsis (16 cases, 7.23%) and urinary tract infection (12 cases, 5.43%); during the treatment process, 184 cases (83.26%) underwent microbiological tests, of which 76 cases also underwent susceptibility tests, while 46 cases were treated according to susceptibility test results; according to the treatment results, 142 out of 221 patients (64.25%) improved or recovered, but there were also many cases that did not improve (31 cases, 14.03%), and that spontaneously left the hospital (41 cases, 18.55%), and even 7 cases (3.17%) died; the medication evaluation of carbapenem drugs showed that 65 patients (29.41%) did not meet the medication indications, but the vast majority (more than 90.00%) of patients met the relevant requirements in terms of medication monitoring, approval and management. Conclusion: Most of carbapenem drugs used in the hospital are used by patients with pulmonary infection, sepsis, and urinary tract infection in Respiratory Medicine Department and ICU. The relevant monitoring, approval and management during the medication period basically comply with regulations, but there are still many unreasonable conditions for medication indications. In clinical practice, corresponding training should be strengthened to improve the level of rational medication.
  • Analysis of Clinical Use of Sacubitril Valsartan Sodium in Patients with Chronic Heart Failure in a Hospital
    MA Min-ya, PING Hui, CHEN Yi, JIN Yu
    2023, 20(8): 825-829. https://doi.org/10.13493/j.issn.1672-7878.2023.08-009
    Abstract ( 87 ) Download PDF ( 12 )   Knowledge map   Save
    Objective: To analyze the clinical use of sacubitril valsartan sodium in patients with chronic heart failure (CHF) in the hospital, and provide reference for the safe and rational use of sacubitril valsartan sodium in clinical practice. Methods: By using the hospital information system, 190 CHF patients treated with sacubitril valsartan sodium in Cardiovascular Medicine Department of Changshu No. 2 People's Hospital from January to December 2020 were selected as the research subjects. The information such as left ventricular ejection fraction (LVEF), past medication history, and information on usage and dosage, treatment course, efficacy, and adverse drug reactions of sacubitril valsartan sodium was collected to analyze the clinical use of Sacubitril Valsartan Sodium in patients. Results: 190 CHF patients all met the indications for use of Sacubitril Valsartan Sodium. Among them, 183 patients had LVEF less than or equal to 40% before treatment, while the remaining 7 patients had LVEF more than 40% before treatment but had CHF symptoms that needed to be controlled; the initial regimen of sacubitril valsartan sodium was mainly "25mg, q12h" (88 cases, 46.32%) and "50mg, q12h" (97 cases, 51.05%), with only 5 cases of "100mg, q12h", while the maintenance treatment regimen was mainly "50mg, q12h" (83 cases, 43.68%) and "25mg, q12h" (62 cases, 32.63%), with a total of 123 patients (64.74%) not adjusting the treatment regimen; among 190 patients, 101 (53.16%) had previously been taking angiotensin converting enzyme inhibitors or vascular receptor blockers, but 8 patients who used angiotensin converting enzyme inhibitors had a drug conversion interval of less than 36 hours when changing the treatment regimen; in terms of medication course, 68 cases (35.79%) had a treatment course greater than 1 year, and 17 cases (8.95%) had a treatment course greater than 6 months to 1 year; during the treatment process, 22 patients (11.58%) achieved the target dose treatment target, with 2 patients receiving a maintenance regimen of "200mg, q12h" and the remaining 20 patients receiving the highest tolerated dose maintenance; among 85 patients with a treatment course more than 6 months, there were 49 cases that sacubitril valsartan sodium was significantly effective, 26 cases that the medicine was effective, and 10 cases that the medicine was basically ineffective; 28 (14.74%) out of 190 patients experienced adverse drug reactions during the medication process, including 22 cases of hypotension, 4 cases of renal function damage, and 2 cases of hyperkalemia. However, all patients improved after treatment. Conclusion: The hospital generally has reasonable clinical management of indications and medication conversion for sacubitril valsartan sodiume, but there is still a lack of compliance with target doses, which is an important indicator affecting the medication efficacy of patients. In clinical practice, management in the whole treatment course of patients should be strengthened to ensure the medication safety and effectiveness of patients.
  • Pharmacovigilance Evaluation of Zileuton Based on FAERS*1
    LAN Dong-mei, GUO Lin, NI Hao-tian
    2023, 20(8): 843-847. https://doi.org/10.13493/j.issn.1672-7878.2023.08-013
    Abstract ( 75 ) Download PDF ( 20 )   Knowledge map   Save
    Objective: To analyze and evaluate the clinical medication risks of zileuton based on the US FDA adverse event reporting system (FAERS), and provide reference for the clinical medication safety of zileuton. Methods: With the OpenVigil tool, adverse events related to zileuton reported from January 1, 2004 to September 30, 2022 were retrieved from the Open-FDA database of FAERS, and the characteristics and risks of adverse events related to zileuton were analyzed using the reporting odds ratio method and Beyesian confidence propagation neural network method. Results: A total of 215 adverse event reports related to zileuton were discovered in the Open-FDA database, of which 158 were females (73.49%), including a total of 58 cases (26.98%) of serious adverse events such as hospitalization or severe hospitalization and disability of patients; 215 reports involved a total of 26 signals, mapped to 8 SOC, with the main SOC of "respiratory, thoracic, and mediastinal diseases" (87 cases, 40.66%), "skin and subcutaneous tissue diseases" (43 cases, 20.00%), and "abnormal laboratory indicators" (46 cases, 21.40%, all related to liver function damage); the signal intensity detection showed that there were 13 strong warning signals (including 5 related to liver function damage and 4 related to respiratory function abnormalities), and 11 moderate warning signals. Conclusion: Based on FAERS data, the main risks of zileuton are liver function damage and respiratory system abnormalities. Monitoring should be strengthened during clinical treatment to ensure the medication safety of patients.