KANGGANRAN YAOXUE

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  • Research Progress in Clinical Manifestations and Management of Adverse Drug Reactions Caused by Anti-tuberculosis Drugs*1
    YAO Lin, GU Bin-bin, ZHANG Jian-ping
    2023, 20(12): 1229-1234. https://doi.org/10.13493/j.issn.1672-7878.2023.12-001
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    Standardized anti-tuberculosis treatment is the key to the successful cure of tuberculosis. However, anti-tuberculosis treatment usually requires many drugs and has a long course of treatment; so adverse drug reactions are more common. The main clinical manifestations include liver damage, gastrointestinal reactions, ototoxicity and renal toxicity, allergic reactions, hematological damage, nervous system damage, etc. In this article, the clinical manifestations of adverse drug reactions caused by anti-tuberculosis drugs and management measures are reviewed and analyzed, so that clinicians can better understand and master the characteristics of adverse drug reactions of anti-tuberculosis drugs, thereby reducing or avoiding the occurrence of such adverse drug reactions.
  • Research Progress in Pharmacological Actions of Berberine against Pseudomonas, Monad, Bacillus and Other Bacilli
    ZHANG Ming-fa, SHEN Ya-qin
    2023, 20(12): 1235-1239. https://doi.org/10.13493/j.issn.1672-7878.2023.12-002
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    Berberine has a relatively broad-spectrum antibacterial effect, and its antibacterial spectra cover Salmonella, Shigella, Vibrio, Mycobacterium, Klebsiella, Helicobacter pylori, Escherichia coli, Pseudomonas, Monad and Bacillus, etc. In this article, the pharmacological actions of berberine against Pseudomonas, Monad, Bacillus and other bacilli that are little concerned previously are reviewed and analyzed, to provide theoretical support for the further clinical application and development of berberine in the future.
  • Analysis of Cases in Literature on Dysgeusia in Patients Caused By Terbinafine*1
    LI Yan, HANG Yong-fu, ZHU Jian-guo, QIAN Yu-lan
    2023, 20(12): 1240-1244. https://doi.org/10.13493/j.issn.1672-7878.2023.12-003
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    Objective: To analyze the clinical characteristics of dysgeusia in patients caused by terbinafine and provide reference for the clinical safe medication of terbinafine. Methods: The relevant documents and literatures from database establishment to September 2023 were searched from the domestic and foreign databases such as CNKI, Wanfang Database, Chongqing VIP, PubMed and Embase by using "terbinafine", "lamisil", "gustation/taste", "dysgeusia", "taste disorder", "ageusia" and "hypogusia" as keywords. The case data of patients included in the literature were collected to analyze the clinical characteristics of dysgeusia in patients caused by terbinafine. Results: A total of 259 articles were searched from the relevant databases, of which, 15 articles met the inclusion criteria, involving a total of 22 patients (6 males and 16 females); the Naranjo's assessment of 22 patients showed that there were 21 patients whose correlation between terbinafine and dysgeusia was "probable" (95.45%) and 1 patient whose correlation was "possible". Among the 22 patients, the onset time of dysgeusia was 1 day to 12 weeks after medication (median time: 8 weeks), and its clinical manifestations included complete loss of taste (14 patients, 63.64%) and partial loss of taste (8 patients, 36.36%); after management, 15 patients recovered completely, 4 patients did not recover completely, 2 patients did not recover, and 1 patient was unknown. Conclusion: Clinically, patients may develop dysgeusia during the use of terbinafine and some patients show irreversible symptoms. Therefore, patients shall receive propaganda and education about medication when using terbinafine in clinical settings, so that such adverse drug reactions can be fed back and managed as quickly as possible once occurring in patients.
  • Analysis of Pharmaceutical Care of Anti-Infective Treatment in Patients Undergoing Elective Heart Valve Surgery Complicated By Hospital-Acquired Infection
    JIA Jia-jia, SHI Feng-hao, SHEN Meng-li, YU Li
    2023, 20(12): 1245-1249. https://doi.org/10.13493/j.issn.1672-7878.2023.12-004
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    Objective: To analyze the pharmaceutical care process of anti-infective treatment in patients undergoing elective heart valve surgery complicated by hospital-acquired infection based on the bacterial resistance status and provide reference for anti-infective treatment in clinically similar patients. Methods and Results: The patient was admitted to the hospital due to "chest tightness after activity for 10 years and worsening in the past three months". The color Doppler ultrasonography of heart showed severe mitral stenosis combined with mild regurgitation and severe tricuspid regurgitation, so the patient was diagnosed with valvular heart disease and elective surgery was considered. On the 2nd and 15th days of admission, the patient experienced fever with abnormal infection indicators, and blood culture showed that Escherichia coli was detected. Based on the drug susceptibility test results, the clinical pharmacist recommended the use of piperacillin-tazobactam sodium and meropenem successively, and the patient improved. On the 43rd day of admission (after heart valve surgery), the patient's infection indicators became obviously abnormal again and septic shock occurred, so meropenem was empirically administered; later, the sputum culture was performed and klebsiella oxytoca was detected. The drug susceptibility test showed resistance to meropenem, and the test for drug resistance gene showed that Klebsiella pneumonia carbapenemase was positive, so the clinical pharmacist recommended the use of ceftazidime-avibactam sodium; 10 days later, the patient's indications of infection disappeared and the results of two consecutive sputum cultures were negative. Conclusion: Clinical pharmacists shall actively identify the pathogenic bacteria of infection and try to understand their drug resistance characteristics when carrying out pharmaceutical care of anti-infective treatment for infected patients, to ensure that patients receive effective anti-infective treatment.
  • Analysis of Clinical Characteristics of Three Patients with Serious Adverse Drug Reactions Caused By Clindamycin Phosphate*1
    WU Jing, XU Lu
    2023, 20(12): 1250-1252. https://doi.org/10.13493/j.issn.1672-7878.2023.12-005
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    Objective: To analyze the clinical characteristics of serious adverse drug reactions (ADRs) caused by clindamycin phosphate, and provide reference for the clinically safe medication of clindamycin phosphate. Methods: Three patients were administered clindamycin phosphate during hospitalization due to otitis media or bronchitis; during or shortly after the infusion of clindamycin phosphate, they developed symptoms of anaphylactic shock such as chills, systemic trembling and numbness, rapid increase in heart rate, rapid decrease in blood pressure, and the patients 1 and 3 even experienced loss of consciousness. Results: After the occurrence of ADRs, the patients clinically received symptomatic treatment with dexamethasone, promethazine, calcium gluconate injection, etc. in a rapid manner and their symptoms were relieved. Subsequently, the Naranjo's assessment scale was used to evaluate the correlation between clindamycin phosphate and ADRs, and the results for the patient 1 were "definitely related", for the patients 2 and 3 were "probably related". Conclusion: There is a risk of serious ADRs during the use of clindamycin phosphate, and ADRs monitoring shall be performed during clinical medication to ensure the medication safety for patients.
  • Analysis of Clinical Characteristics of Adverse Drug Reactions Related to Antibacterial Drugs in a Hospital
    WANG Si-lin
    2023, 20(12): 1253-1255. https://doi.org/10.13493/j.issn.1672-7878.2023.12-006
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    Objective: To analyze the clinical characteristics of adverse drug reactions (ADRs) related to antibacterial drugs in a hospital and provide reference for the safe medication of antibacterial drugs. Methods: The ADR reports related to antibacterial drugs for 80 patients reported by Xinfeng County People's Hospital from April 2021 to April 2022 were used as research data; the information such as patients' age and sex, the types and administration methods of antibacterial drugs, the occurrence time and clinical manifestations of ADRs was collected from the ARD reports, to analyze the clinical characteristics of ADRs related to antibacterial drugs. Results: In the ADR reports for 80 patients, the ages of most of patients were over 60 years (43 patients, 53.75%), and the number of males was slightly more than that of females (45 vs 35). In terms of the types of antibacterial drugs involved, the most type was cephalosporins (38 patients, 47.50%), followed by penicillins (20 patients, 25.00%) and carbapenems (17 patients, 21.25%); in terms of the method of administration for the antibacterial drugs involved, the main method was intravenous administration (64 patients, 80.00%), followed by oral administration (16 patients, 20.00%); in terms of the occurrence time of ADRs, most ADRs occurred within 10 minutes (including 10 minutes) after administration (45 patients, 56.25%), followed by more than 10 min to 24 hours after administration (16 patients, 20.00%), and more than 3 days to 5 days after administration (10 patients, 12.50%); In addition, the ARDs related to antibacterial drugs for 80 patients mainly involved the patients' skin and its appendages (42 patients, 52.50%), followed by the digestive system (14 patients, 17.50%). Conclusion: ADRs related to antibacterial drugs occurred in the hospital are more common in the middle-aged and elderly patients. The drugs involved are mainly cephalosporins and penicillins, especially for intravenous administration. When antibacterial drugs are used for clinical treatment, attention shall be paid to medication monitoring for patients to ensure the safe medication of patients.
  • Analysis of Prophylactic Use of Antibacterial Drugs During the Perioperative Period in Patients Undergoing Class I Incision Surgery in a Hospital*1
    WANG Ji-yun, WANG Dan, WU Wen-li, ZHANG Yan-jie, MA Jing, WANG Nan, JING Jing, LU Zhao-gang
    2023, 20(12): 1256-1261. https://doi.org/10.13493/j.issn.1672-7878.2023.12-007
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    Objective: To analyze the prophylactic use of antibacterial drugs during the perioperative period in patients undergoing Class I incision surgery in the hospital's Orthopedics Department and provide reference for the rational use of antibacterial drugs in patients undergoing surgery. Methods: A total of 4 603 patients who underwent Class I incision surgery in the Orthopedics Department of the hospital from January to December 2019 were chosen as research subjects, and the information such as the type of surgery, duration of surgery, selection of antibacterial drugs, timing of use and course of medication was collected to analyze the medication characteristics of antibacterial drugs during the perioperative period in patients undergoing Class I incision surgery. Results: The main type of surgery for 4 603 patients undergoing class I incision surgery was internal fixation (1 433 patients, 31.13%), followed by arthroscopic surgery (716 patients, 15.56%), joint replacement (712 patients, 15.47%), internal fixation removal (696 patients, 15.12%) and lumbar spine surgery (551 patients, 11.97%); in terms of the duration of surgery, 3 304 (71.78%) of which had a duration of no more than 2 hours, and 781 (16.97%) and 506 (10.99%) of which had a duration of more than 2-3 hours and more than 3 hours respectively. Among 4 603 patients, there were 2 867 cases with prophylactic use of antibacterial drugs during the perioperative period (62.29%), of which, the types of surgeries with the largest number of cases for prophylactic medication were internal fixation (1 335 patients, 46.56%) and joint replacement (712 patients, 24.83%). The most commonly used drugs were cefazolin (1 529 patients, 53.33%) and cefuroxime (1 080 patients, 37.67%); in terms of the timing of prophylactic medication of antibacterial drugs, most of them were given 0.5-1 hour before operation (2 758 patients, 96.20%), but there were still cases that were given after operation but not given before operation (10 patients, 0.35%); in terms of course of prophylactic medication, the course was less than 12 hours for most patients (2 105 patients, 73.42%), and the course was longer than 48 hours for 461 patients (16.67%). Conclusion: The prophylactic use rate of antibacterial drugs in patients undergoing Class I incision surgery in the hospital's Orthopedics Department is high, but there are a few patients with unreasonable use in terms of variety selection, timing of medication and course of medication. The hospital's administrative department shall strengthen the management and the propaganda and education of antibacterial drugs during the perioperative period to improve the clinical medication level of antibacterial drugs.
  • Impact of Drug Therapy Management on the Clinical Treatment of Patients with Chronic Calculus Cholecystitis*1
    LU Hui, XU Gang, XU Lu
    2023, 20(12): 1269-1272. https://doi.org/10.13493/j.issn.1672-7878.2023.12-010
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  • Analysis of Immunological Characteristics and Drug Resistance in Patients with Acquired Immunodeficiency Syndrome Combined with Mycobacterial Infection*1
    ZHU Yue-ping, HUANG Jin-long, XU Wei-lu, WANG Ying-ling, GU Sai-hong, YAN Yu-juan, WANG Yue, LIU Jin, QIAN Feng
    2023, 20(12): 1273-1277. https://doi.org/10.13493/j.issn.1672-7878.2023.12-011
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    Objective: To analyze the immunological characteristics of patients with acquired immunodeficiency syndrome (AIDS) combined with Mycobacterium tuberculosis (MTB) or non-tuberculous mycobacteria (NTM) infection and the characteristics of resistance to commonly used anti-tuberculosis drugs and provide reference for the clinical diagnosis and treatment of patients with AIDS combined with MTB or NTM infection. Methods: A total of 44 patients with AIDS combined with MTB infection (the AIDS/MTB infection group) and 44 patients with AIDS combined with NTM infection (the AIDS/NTB infection group) who were admitted to the Fifth People's Hospital of Suzhou from January 2017 to December 2022 were chosen as the research subjects. The information such as patients' age, sex, immunological test results, and drug susceptibility test results of MTB and NTB to commonly used anti-tuberculosis drugs was collected to analyze the immunological characteristics and drug resistance characteristics of patients with AIDS combined with MTB or NTM infection. Results: The patients in both the AIDS/MTB infection group and the AIDS/NTB infection group were mainly males (93.18% vs 97.73%), and their ages were mainly in the range of 30 to less than 50 years (56.82% vs 59.09%), but upon comparation, there was no statistically significant difference in the sex and age distribution of patients between the two groups (P>0.05); the T-SPOT test results of patients in the AIDS/NTB infection group was negative, while the T-SPOT test results of patients in the AIDS/MTB infection group showed high positive rate; the absolute value of CD4+T cells in the AIDS/MTB infection group was significantly higher than that in the AIDS/NTB infection group (108.4±76.7 vs 36.5±22.1, P<0.05); the main pathogenic bacteria detected in the AIDS/NTB infection group were Mycobacterium avium and Mycobacterium kansasii, whose resistance rates to streptomycin, isoniazid, rifampicin, ethambutol, para-aminosalicylic acid and amikacin were greater than 50.00% (much higher than the resistance rates of MTB to them), but resistance rate to prothionamide was low (less than 5.00%). Conclusion: Patients with AIDS combined with MTB or NTM infection are more likely to occur in men aged 30 to less than 50 years. The T-SPOT test and the CD4+T cell levels can better differentiate MTB infection from NTM infection; in addition, the pathogenic bacteria of NTM infection are highly resistant to most anti-tuberculosis drugs. Other sensitive antibacterial drugs shall be used as much as possible to ensure the therapeutic effect on patients.
  • Study on Correlation between Quality of Life and Severity of Menopausal Symptoms in Patients with Breast Cancer
    LI Li-qi, WU Jun-qiang, HUANG Hu, HE Jing
    2023, 20(12): 1278-1283. https://doi.org/10.13493/j.issn.1672-7878.2023.12-012
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    Objective: To explore the correlation between quality of life and severity of menopausal symptoms in patients with breast cancer and provide reference for targeted psychological treatment of different patients with breast cancer. Methods: A total of 178 patients with breast cancer admitted to the Affiliated Hospital of Jiangnan University from October 2021 to December 2022 were selected as the research subjects. The Kupperman index was used to judge the severity of the patients' menopausal symptoms, and the Hospital Anxiety and Depression Scale (HADS) and Functional Assessment of Cancer Therapy (FACT) G/B were used to assess the psychological status and quality of life of patients, to analyze and evaluate the correlation between quality of life and severity of menopausal symptoms in patients with breast cancer. Results: According to the Kupperman index, among 178 patients with breast cancer, 72 patients had no menopausal symptoms (asymptomatic group), 38 patients had mild menopausal symptoms (mild symptom group), 54 patients had moderate menopausal symptoms (moderate symptom group) and 14 patients had severe menopausal symptoms (severe symptom group). Whether the endocrine therapy was received will affect the severity of menopausal symptoms in patients with breast cancer (P<0.01), among which, the incidence of severe menopausal symptoms in patients receiving endocrine therapy was higher (15.38% vs 3.54%, P<0.05); HADS scoring results showed that the severer the menopausal symptoms were, the more obvious the tendency of anxiety and depression (P<0.01); the FACT scoring results showed that the milder the patients' menopausal symptoms were, the better their overall quality of life and breast cancer symptoms (P<0.01), and the better the patients' physical well-being, emotional well-being and functional well-being, etc. (P<0.05). Conclusion: The severity of menopausal symptoms in patients with breast cancer indeed affects their psychological status and quality of life, and the severity of menopausal symptoms may be related to whether they receive endocrine therapy. Therefore, clinically, the menopausal symptoms of patients with breast cancer shall be controlled and improved as much as possible, so that they can obtain better quality of life.