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    15 August 2020, Volume 17 Issue 8 Previous Issue    Next Issue

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    Effect of Qingre Sanjie Capsules on Model of Bacterial Respiratory Tract Infections
    SUN Jing, GAO Yingjie, GUO Shanshan, ZHAO Ronghua, SONG Taifa, LI Linmei, YAO Rongmei, CUI Xiaolan, LI Xiaolu, SHI Yujing
    2020, 17(8): 449-454. 
    DOI: 10.19803/j.1672-8629.2020.08.01

    Abstract ( 462 )   PDF (1423KB) ( 189 )  
    Objective To study the effect of Qingre Sanjie capsules on the animal model of bacterial respiratory tract infections in order to provide reference for clinical application. Methods Laboratory animals were randomly divided into 7 groups according to body weight: normal group, model group, amoxicillin capsule group, andrographolide dropping pill group and 3 different-dose groups of Qingre Sanjie capsules. Four animal models were established, including three models of pneumonia caused by staphylococcus aureus, beta hemolytic streptococcus and streptococcus pneumoniae infection in mice and one acute pharyngitis model induced by beta hemolytic streptococcus in rats. The lung index, lung index inhibition rate, mouse mortality, the average survival time, pharyngeal lesion scores of rats and pathological examination were used to evaluate the efficacy of Qingre Sanjie capsules against respiratory bacterial infections. Results Qingre Sanjie capsules at the three doses could significantly reduce the mortality, prolong the average survival time, alleviate the pharyngeal lesions of mice infected with beta-hemolytic streptococcus, and reduce the lung index of mice infected with streptococcus pneumonia. Conclusion All the three doses of Qingre Sanjie capsules could effectively alleviate the symptoms of acute pharyngitis caused by beta-hemolytic streptococcus. They also have significant antibacterial effect in vivo.
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    Mutagenic Risk Evaluation of Monanthone with Emodin Type
    WEN Hairuo, WANG Yanan, YANG Ying, ZHAO Tingting, MA Shuangcheng, WANG Qi
    2020, 17(8): 455-460. 
    DOI: 10.19803/j.1672-8629.2020.08.02

    Abstract ( 249 )   PDF (1326KB) ( 157 )  
    Objective To evaluate the gene mutations caused by the potential genotoxicity of monanthone with emodin type by means of the miniAmes test and in vitro Pig-a gene mutation test. Methods The miniAmes test involved the control group (DMSO), monanthone with emodin type (0.6, 1.1, 2.3, 4.5, 9 μg/well), and positive group. Salmonella typhimurium TA97, TA98, TA100, TA102, TA1535, TA1537 bacterial reverse mutation assay based on 6-well plate culture was carried out in E. coli WP2 uvrA under the conditions of -S9 and S9, respectively. The number of mutant colonies was counted after 48 h. The In vitro Pig-a gene mutation test involved L5178Y cells that were used as the system, and metabolic conditions without S9: control group (1% DMSO), positive agent (EMS 500 μg/mL), and monanthone with emodin type (0.2 μg/mL,0.39 μg/mL,0.78 μg/mL,1.56 μg/mL).After the test object was treated for 4 h, the test substance and culture were removed. After 24 h, the cells were counted and expressed for 8 days. The cell density during the expression period was maintained at 1×106~2×106 cells/mL. After the expression was terminated, antibody incubation flow detection was performed. Metabolic conditions with S9: control group (1% DMSO), positive agent (B(a)P 5 μg/mL), and monoterpene ketone (0.2 μg/mL,0.39 μg/mL,0.78 μg/mL,1.56 μg/mL). After the test object was treated for 4 h, the test material was removed and cultured, and counted 24 hours later for 8 days. The cell density during the expression period was 1×106~2×106 cells/mL. After the expression was over, the antibody incubation flow assay was performed. Results In the Ames test, the number of colonies of TA97 and TA1537 reverting mutants induced by monanthone with emodin type increased compared with the negative control group under the metabolic activation conditions without S9. Upon metabolic activation with S9, the number of colonies of TA1537 reverting mutants induced by monanthone with emodin type increased compared with the negative control group. The rate of increase was more than two or three times that of the negative control group, and there was dose-related change in the above results. In vitro Pig-a gene mutation test showed that under metabolic activation conditions without S9, the concentration of monanthone with emodin type exceeded 0.78 μg/mL, and the mutation frequency of Pig-a gene was significantly different from that of the vehicle control group (P <0.01) with a dose correlation. Conclusion Under the conditions described in this study, monanthone with emodin type has the risk of gene mutation.
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    Tentative Study of Risk Factors of Hematological Toxicity Induced by Azathioprine
    LIN Yanfang, SU Songsen, ZHOU Hong, CAI Lili, HONG Lei, LIN Zhiqiang
    2020, 17(8): 461-464. 
    DOI: 10.19803/j.1672-8629.2020.08.03

    Abstract ( 256 )   PDF (1208KB) ( 104 )  
    Objective To explore the risk factors of hematological toxicity induced by azathioprine drugs via a logistic model and ROC curve. Methods Related information about patients was collected from the HIS system of our hospital, and SPSS 22.0 software was used for statistical analysis. Results A total of 70 patients with rheumatism were included, 28 of whom suffered from hematological toxicity. Logistic analysis showed statistically significant differences in BMI, NRS 2002, prealbumin, and NUDT15 polymorphism. Further multivariate logistic model analysis showed that the NRS2002 score was an independent risk factor for hematological toxicity. An ROC curve was constructed with NRS2002, and patients were more likely to suffer from hematological toxicity when NRS2002 exceeded 3 points. Conclusion The risk of haematological toxicity in azathioprine-treated patients can be predicted by the NRS2002 score so that drug safety can be ensured by providing dietary guidance.
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    Limitations of the Safety Assessment in Premarketing Clinical Trials of Drugs and Suggestions for Improvement
    LI Xinxu, TANG Zhimin, ZHOU Jun, WANG Jun
    2020, 17(8): 465-470. 
    DOI: 10.19803/j.1672-8629.2020.08.04

    Abstract ( 835 )   PDF (1268KB) ( 718 )  
    Objective To offer recommendations for sponsors on how to assess the safety of premarketing drugs more comprehensively, in more depth and scientifically by outlining the limitations of safety assessment in premarketing clinical trials of drugs. Methods The related literature abroad, guidelines and group recommendations related to the safety assessment in premarketing clinical trials of drugs were collected, while the representative opinions, views and suggestions in these documents were summarized and analyzed. Results The current ways of safety assessment in premarketing clinical trials of drugs have some weaknesses, such as an insufficient number and composition of subjects, inaccurate coding of adverse events, neglect of exposure time, and difficulty in determining causal relationships. Conclusion It is suggested that sponsors should do what they can to improve the design of safety assessment in premarketing clinical trials of drugs, collect as much safety information as possible, evaluate drug exposure time properly, use data visualization appropriately, analyze safety data in depth and make full use of safety evidence.
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    Construction of Informationalized Adverse Drug Reactions Reporting System
    LIU Chang, LIU Shuya, ZHANG Tai, SHEN Hongxia, YAN Meixing
    2020, 17(8): 471-473. 
    DOI: 10.19803/j.1672-8629.2020.08.05

    Abstract ( 675 )   PDF (1146KB) ( 313 )  
    Objective To improve the quality of adverse drug reactions reporting via the rapid reporting system, and to promote pharmaceutical care. Methods After the construction of an ADR reporting system, adverse drug reactions in our hospital were retrospectively analyzed in terms of quantity and quality and clinical pharmaceutical safety service. Results After application of the ADR reporting system, the total number of standard reports of ADRs increased from 112 in 2014 to 641 in 2018. The first pass yield was increased from 17.48% in 2014 to 80.87% in 2018. About 99.69% of ADR reports in 2018 were qualified, compared with 78.32% in 2014. The timeliness (<3 d) of reporting of ADRs increased from 0.89% in 2014 to 53.82% in 2018. Conclusion The ADR reporting system in our hospital can contribute to the efficiency of reports, ensure the quality of reports and enhance supervision of drug safety.
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    Thoughts on the Establishment of Pharmacovigilance System for Marketing Authorization Holders(MAHs)
    CHEN Cancan, CHEN Wei, ZHANG Yanan, HU Xiaoguang, LI Wanjun
    2020, 17(8): 474-479. 
    DOI: 10.19803/j.1672-8629.2020.08.06

    Abstract ( 899 )   PDF (1414KB) ( 942 )  
    Objective To provide reference for the development and supervision of pharmacovigilance by introducing the establishment of MAH pharmacovigilance systems and related considerations. Methods In combination with laws and regulations as well as the actual situation of enterprises, we summarized and analyzed the status quo of and problems with pharmacovigilance, and presented our views. Results It's necessary and urgent for MAHs to establish pharmacovigilance that is of great significance for the safety of patients and businesses. Conclusion It is vital for MAHs to speed up the establishment of a sound pharmacovigilance system in order to make pharmacovigilance more effective.
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    Drug-associated Toxicities of Cemiplimab: A Real-world Study Based on FARES Database
    HU Fangyuan, YE Xiaofei, ZHAI Yinghong, XU Jinfang, GUO Xiaojing, GUO Zhijian, ZHUANG Yonglong, HE Jia
    2020, 17(8): 480-486. 
    DOI: 10.19803/j.1672-8629.2020.08.07

    Abstract ( 361 )   PDF (1418KB) ( 319 )  
    Objective To systematically characterize the potential drug toxicities of cemiplimab, a PD-1 inhibitor approved as an immune checkpoint inhibitor (ICI) in 2018 and used as an orphan drug for patients with metastatic or locally advanced cutaneous squamous cell carcinoma, in order to provide more evidence for subsequent ICIs immunotherapies. Methods Data was harvested from US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database. Disproportionality analysis involving the information component (IC) and reporting odds ratio (ROR) was used to detect potential association between cemiplimab and adverse events (AEs). MedDRA software was used to code data on adverse events in FAERS database into a standardized terminology. Results A total of 10 051 679 records were extracted from the database, with 131 of them for cemiplimab. It was shown that toxicities were detected in cemiplimab, which included asthenia, back pain, decreased blood pressure, cytokine release syndrome, muscle spasms, neutropenia, pulmonary embolism, cellulitis, tumour inflammation and pyrexia. The proportion of such severe outcomes as death, life-threating conditions and disability in most of these AEs was quite high, which deserves more attention. Conclusion Toxicities have been detected in cemiplimab, and most of the outcomes of cemiplimab-related AEs are undesirable. Thus, it is important for clinicians to be alert to AEs in cemiplimab immunotherapies and take measures to prevent the occurrence of AEs so as to ensure the safety of patients.
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    Pharmaceutical Care for a Patient with Bradycardia Induced by Lenalidomide
    TIAN Jixin, MIAO Wenjuan, LIAO Yingxi, ZHANG Ping, WANG Xiaodan, LI Shan, YAN Haihong
    2020, 17(8): 487-490. 
    DOI: 10.19803/j.1672-8629.2020.08.08

    Abstract ( 325 )   PDF (1100KB) ( 428 )  
    Objective To explore the pharmaceutical care for a patient with bradycardia induced by lenalidomide in order to promote the rational use of the drug. Methods A retrospective analysis was conducted of the pharmaceutical care involving clinical pharmacists for a patient with follicular lymphoma, who experienced secondary bradycardia after chemotherapy with lenalidomide. Clinical pharmacists assisted physicians in developing an individualized therapeutic regimen and practiced special pharmaceutical care in the drug therapy. Results Clinical pharmacists analyzed the causes of this case of bradycardia, and gave advice to physicians about how to select therapeutic regimens and adjust concomitant medications, which was taken and achieved very good curative effect. Conclusion There is a significant correlation between the occurrence of bradycardia and the time lenalidomide is administered. If symptoms of arrhythmia occur during the use of lenalidomide, clinical pharmacists and physicians should carefully analyze the medical and medication history to initiate early diagnosis and treatment so as to reduce the harm of adverse drug reactions and lead to a better prognosis.
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    Pharmaceutical Care of Aggravating Renal Function Injury in an Elderly Patient with Lung Cancer Undergoing Chemotherapy
    ZHANG Xiumin, CAI Jing
    2020, 17(8): 491-495. 
    DOI: 10.19803/j.1672-8629.2020.08.09

    Abstract ( 266 )   PDF (1159KB) ( 220 )  
    Objective To analyze drug-caused aggravation of renal function injury during chemotherapy in order to provide reference for the adjustment and monitoring of clinical chemotherapy. Methods The clinical data of an elderly chemotherapy patient with lung cancer was analyzed retrospectively. All the drugs that might have been associated with his aggravating renal damage were analyzed. Results The correlations between his ongoing renal damage and cisplatin, pemetrexed, radiocontrast agents were considered "possible". At the same time, bevacizumab seemed "suspicious". For patients with renal damage, adequate hydration should be combined with cisplatin or a radiocontrast agent. An interval of more than 72 hours is recommended. Cisplatin or pemetrexed should not be used when CrCl is less than 30 mL/min. Conclusion Multiple drugs with renal toxicity may be used at the same time during clinical practice, so it is important to have an intimate knowledge of properties of drugs while working hard to reduce adverse reactions and improve curative effect.
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    Blood Concentration of Voriconazole in Patients with Ultrarapid Metabolism Increased by Combination of Voriconazole and Omeprazole
    LIAN Yufei, LIU Hongtao, REN Bingnan, ZHAO Haijing, WANG Yanze, ZHANG Yue, TIAN Dongdong, CAO Gexi, YUE Yuanyuan, YAN Li
    2020, 17(8): 496-501. 
    DOI: 10.19803/j.1672-8629.2020.08.10

    Abstract ( 428 )   PDF (1343KB) ( 426 )  
    Objective To explore the role of voriconazole combined with omeprazole sodium in increasing the blood concentration of voriconazole and enhancing antifungal efficacy in patients with CYP2C19 ultrarapid metabolism. Methods The clinical data on three patients who had voriconazole-associated gene CYP2C19 with ultrarapid metabolizing invasive pulmonary mycosis was analyzed. The treatment with voriconazole was designed and adjusted based on monitoring results of blood concentrations. Results Two of the three patients were diagnosed with pulmonary mycosis based on clinical symptoms, signs, and sputum culture, suggesting fungal infection (one case with Aspergillus and one case with Candida tropicalis) combined with pulmonary CT changes. The third case was a patient with degree IV myelosuppression after chemotherapy, who had agranulocytosis and fever and needed to be treated with an empirical antifungal therapy due to the poor efficacy of a standardized anti-infective therapy. All the three patients had voriconazole-associated gene CYP2C19 with ultrarapid metabolism. The initial antifungal treatment with voriconazole was not effective (the clinical symptoms were not improved, and the blood concentration was not up to the standard). The treatment plan was adjusted by increasing the single dose of voriconazole and by combining voriconazole with omeprazole sodium so that the antifungal effect was significantly improved (the blood concentration of voriconazole increased and reached the standard, and the symptoms of infection were significantly improved), and the patients were cured. Conclusion When an antifungal therapy with voriconazole is used in patients with CYP2C19 ultrarapid metabolism, the blood concentration of voriconazole can be greatly increased via the competition and inhibitory effect of omeprazole on voriconazole metabolism enzymes. This approach can not only improve the antifungal effect of voriconazole, but also eliminate the risk of adverse reactions caused by excessive drug adjustment. It provides a new idea for clinical individualized treatment of voriconazole.
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    Adverse Drug Reactions/Events Induced by ACEI/ARB
    HE Guilin, ZUO Li, CHEN Jiayin, ZHOU Xueqin, Wang Qian
    2020, 17(8): 502-507. 
    DOI: 10.19803/j.1672-8629.2020.08.11

    Abstract ( 362 )   PDF (1331KB) ( 154 )  
    Objective To analyze the regularities and characteristics of adverse drug reactions/events(ADR/AE) caused by angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers(ARBs) in order to provide reference for rational drug use in the clinic. Methods Cases of ADR/AE caused by ACEI and ARB were screened and analyzed statistically from a total of 32 068 cases of ADR/AE reported in Shenzhen between 2014.1.1 and 2017.12.31. Eighty-three cases of ADR/AE caused by ACEI and 63 caused by ARB were screened out. Results There was no significant difference between males and females in the incidence of ADRs/ADEs caused by the two types of drugs, but the elders were more vulnerable to ADR/AE (for ACEI, those≥40 years old accounted for 89.16% of the cases, compared with 89.71% for ARB). The onset time of most ADR/AE associated with ACEI(72.29%) and ARB(85.29%) was within 1 to 7 days after oral medicine. The main manifestations of adverse effects by ACEI involved the respiratory system(60.19%). The involved organs/systems and manifestations by ARB outnumbered those of ACEI, and adverse drug reactions associated with the nervous system(30.48%) were common. New (ARB 15.88% vs ACEI 7.77%) and serious (ARB 6.54% vs ACEI 2.91%) ADRs/ADEs caused by ARB accounted for a high proportion. The ADRs/ADEs were related to six drug categories, respectively. The top three drug categories of ACEI were perindopril (36.89%), benapril (21.36%), and enapril (21.36%), compared with valsartan (42.06%), irbesartan (28.04%) and losartan (17.76%) for ARB. Most of the manifestations of adverse effects by ACEI and ARB were mild and had good prognosis. Conclusion Clinicians and clinical pharmacists should be alert to ADR/ADE induced by ACEI and ARB within a week of administration. ADR/AE caused by the two kinds of drugs should be distinguished and intervened in as early as possible in order to prevent serious ADR/AE
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    Cases of Adverse Drug Reactions/events Induced by Diclofenac Sodium and Lidocaine Hydrochloride
    WU Wenli, LIU Jiani, LU Zhaogang, JIN jing, WANG Jian, WANG Jiyun, WANG Xiaoxu
    2020, 17(8): 508-512. 
    DOI: 10.19803/j.1672-8629.2020.08.12

    Abstract ( 532 )   PDF (1350KB) ( 521 )  
    Objective To investigate the characteristics and regularities of adverse drug reactions/events (ADR/AE) induced by diclofenac sodium and lidocaine hydrochloride so as to provide reference for rational clinical use. Methods The data on 10 cases of ADR/AE induced by diclofenac sodium and lidocaine hydrochloride reported by a tertiary hospital in Ningxia Hui Autonomous Region and 8 cases from literature was analyzed retrospectively. The types of reports, gender, age, medical history, allergies, indications, times of occurrence, prognosis, systems or organs involved and clinical manifestations were analyzed. Results It was shown that the respiratory system and skin and its appendages were the most vulnerable. Patients with a previous asthma history had a high incidence of acute attack of asthma after medication. There were more severe cases of ADR/AE and death. ADRs occurred soon after administration of diclofenac sodium and lidocaine hydrochioride. Off-label drug use was commonplace. Conclusion The monitoring and rational use of diclofenac sodium and lidocaine hydrochloride should become a concern in order to prevent serious ADR/AE and ensure the safety of drug use.
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    Analysis of the Irrational Use of Antibacterial Drugs Against Respiratory Infections in Emergency and Outpatient
    LIU Lili
    2020, 17(8): 513-517. 
    DOI: 10.19803/j.1672-8629.2020.08.13

    Abstract ( 315 )   PDF (1361KB) ( 260 )  
    Objective To provide a reference for promoting the rational use of antibacterial drugs against respiratory infections. Methods The paper collected 25% of irrational prescriptions of antibacterial drugs for respiratory infections by outpatient and emergency physicians from July, 2018 to December, 2019. According to the constituent of irrational prescriptions, the classification and statistical analysis on the constituents of irrational drugs use was made by Excel 2017, showing the major and minor factors by Pareto chart. Results Among 7,937 antibacterial prescriptions in total, 226 were irrational, accounting for 2.85%. The age distribution of irrational prescriptions is mainly between 20 and 60 years old, mainly from emergency department of fever, cardiology, respiratory department, geriatrics, pediatrics, emergency department and endocrinology department. Inappropriate indications and dosages was the major factor of irrational prescriptions, constituting for 80.09%.while the unsuitable drug selection was the minor factor, constituting for 89.18%. Conclusion There are many problems in the use of antibacterial drugs. According to the main departments and age distribution of irrational prescriptions, targeted prescription reviews should be adopted. Moreover, drugs safety warnings should be issued for problems that occurred frequently, and the treatment plan should be continuously optimized, in order to ensure the rational use of antibacterial drugs in emergency and outpatient departments.
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    Prescriptions for Pregnant Outpatients
    YI Dan, ZHANG Juan, HUANG Li
    2020, 17(8): 518-522. 
    DOI: 10.19803/j.1672-8629.2020.08.14

    Abstract ( 304 )   PDF (1345KB) ( 161 )  
    Objective To investigate the prescriptions for pregnant outpatients in order to provide information for pharmacists to improve drug consultation data and standardize the drug consultation for pregnant women. Methods Patients who delivered in June 2018 were selected, whose use of drugs between the last menstrual period and the pre-hospital delivery was analyzed. Results Totally 279 pregnant outpatients were selected involving 968 prescriptions and 156 types of drugs. The main types of drugs used were vitamin and mineral drugs(37.0%), anaemic drugs(20.7%) and traditional Chinese medicine(10.7%). There were 99 off-label prescriptions(10.2%). Twenty-four types of drugs were contraindications during pregnancy in the labels, fourteen of which were prescribed without good reasons. Conclusion Pharmacists need to improve the instructions on medicines commonly used during pregnancy or for patients with common diseases, safety data sheets of Chinese patent medicines during pregnancy, evidence-based evaluation of off-label drugs and specific comments on medication prescriptions during pregnancy in order to ensure safe and rational medication.
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    Clinical Application of Antiemetic Drugs to Tumor Chemotherapy Patients
    YANG Lan
    2020, 17(8): 523-525. 
    DOI: 10.19803/j.1672-8629.2020.08.15

    Abstract ( 280 )   PDF (1162KB) ( 187 )  
    Objective To observe and study the use of antiemetic drugs in tumor chemotherapy patients and to provide reference for clinical rational drug use. Methods Two hundred and five tumor patients who received chemotherapy and antiemetic drugs between January and July 2019 in our hospital were selected as subjects to analyze the use of anti-emetic drugs during treatment. Results The irrational use of antiemetic drugs was mainly manifested in the irregular course of medication, improper usage and dosage, unjustified combined medication and super-grade medication. Conclusion The control rate of CINV in a small number of patients with improper use of antiemetic drugs is lower than that of patients with proper use of antiemetic drugs.
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    Literature Analysis of Adverse Reactions Caused by Polyene Phosphatidyl Choline
    WEN Xiaoling, ZHANG Hailang
    2020, 17(8): 526-530. 
    DOI: 10.19803/j.1672-8629.2020.08.16

    Abstract ( 345 )   PDF (1319KB) ( 316 )  
    Objective To provide reference for safe use of polyene phosphatidyl- choline (PPC) in clinic by analyzing the literature about the adverse reactions of PPC. Methods Wanfang, Cqvip, CNKI, PubMed, Embase, Wiley, Springer, and Cochrane databases were searched online and the literature about adverse reactions (ADRs) caused by polyene phosphatidyl choline that was published between 2010 and 2019 was collected. Then, the data from the screened literature was analyzed. Results According to the screening criteria, 94 related articles were finally included involving a total of 718 subjects who had drug adverse reactions. The common adverse reactions of PPC were skin rash, nausea, vomiting, diarrhea, abdominal distension and loss of appetite. Most of the adverse reactions were relieved after symptomatic treatment or self-improved. Conclusion The oral preparations of PPC have proved to be safe and cause minor ADRs, but the risk posed by the injection deserves attention. Safe and rational application of PPC involves reinforcing standardized monitoring of PPC in the future.
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    Literature Review of Adverse Skin Reactions Induced by Clopidogrel
    WANG Di, ZHANG Yongkai, LI Nan, LI Yanjiao
    2020, 17(8): 531-534. 
    DOI: 10.19803/j.1672-8629.2020.08.17

    Abstract ( 321 )   PDF (1261KB) ( 241 )  
    Objective explore and analyze the regularities and characteristics of skin systemic adverse reactions induced by clopidogrel so as to provide reference for safe clinical drug use. Methods The Cochrane library, PubMed, Web of Science, Springer link, Embase, Scopus, CNKI, Wanfang data, VIP database, Chinese biomedical literature database (CBM) and other database at home and abroad were searched and related articles were retrieved. Those on skin reactions induced by clopidogrel were statistically analyzed. Results A total of 15 patients with skin systemic adverse reactions induced by clopidogrel were collected, including 11 patients aged over 60 years old (73.3%). The shortest time to onset occurred within 30 minutes after administration, the longest occurred 310 days after clopidogrel use. Adverse reactions were manifested as pruritus of different degrees, including one patient with low fever and another one with high fever. The adverse reactions were alleviated until they disappeared after patients stopped taking clopidogrel or started taking other therapeutic drugs. Conclusion Pharmaceutical care should be strengthened in clinical use of clopidogrel, the occurrence of adverse skin reactions should be guarded against, and the risk of re-administration should be cautiously assessed.
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    One Case of Toxic Epidermal Necrolysis Induced by Antibacterial Drugs
    LUO Xiaofeng, DU Qian, XI Xin, RAN Hailong
    2020, 17(8): 535-538. 
    DOI: 10.19803/j.1672-8629.2020.08.18

    Abstract ( 452 )   PDF (1103KB) ( 202 )  
    Objective To remind the medical staff to pay close attention to medication safety of antibacterial drugs. Methods One case of toxic epidermal necrolysis (TEN) after intravenous infusion of piperacillin tazobactam, imipenem/cilastatin, and levofloxacin in a 45-year-old male patient was analyzed while literature about the pathogenesis and treatment of TEN was reviewed. Results Toxic epidermal necrolysis was most likely to be induced by piperacillin tazobactam, imipenem/cilastatin, and levofloxacin in this patient. The symptoms on the patient's skin were relieved gradually via timely discontinuation of the drugs, anti-allergic therapy, systemic immunotherapy, and symptomatic supportive treatment. Conclusion Toxic epidermal necrolysis induced by piperacillin tazobactam, imipenem/cilastatin, and levofloxacin is a disease with low incidence, but with a high mortality and poor prognosis, which deserves attention.
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    Literature Review of Research Progress in Drug Interactions between Ticagrelor and Morphine
    LI Yu, CHAI Shiwei, WANG Xiaodan, HAO limei, LIU Fang, XIN Xiaojing
    2020, 17(8): 539-542. 
    DOI: 10.19803/j.1672-8629.2020.08.19

    Abstract ( 220 )   PDF (1299KB) ( 272 )  
    Ticagrelor and morphine are often used in combination for the treatment of AMI. Studies have found that ticagrelor has a poor drug interaction with morphine, but there are relatively few studies on the interactions betweenof the two drugs. The aim of this review is intendedwas to summarize the pharmacokinetic-pharmacodynamic interactions between ticagrelor and morphine, and further explore theits mechanism and measures of improvement measures to provide guidance for clinical rational drug use.
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    Research Progress in Clinical Application of Shuganning Injection
    WANG Yanchun, WANG Jianqiang
    2020, 17(8): 543-547. 
    DOI: 10.19803/j.1672-8629.2020.08.20

    Abstract ( 346 )   PDF (1376KB) ( 143 )  
    Objective To find out more about the clinical use of Shuganning injection in order to provide data for the safe and proper use of the drug. Methods Domestic and overseas literature about Shuganning injection that was published between 2011 and 2020 was analyzed retrospectively in terms of clinical applications, solvent selection, drug combination, adverse event reports and improper use. Results Shuganning injection was capable of anti-inflammation, liver protection, and comprehensive adjustment. It played a positive role in treating various hepatic diseases, but there were some risks, the major one of which was its allergic effect and irrational use. Conclusion It is recommended that drug manufacturers continue to research this product, modify instructions if necessary, and provide legal basis for clinical use of this drug. Health care authorities and medical institutions should make the principles of syndrome differentiation of TCM better-known to doctors of Western medicine. Clinicians should strictly follow instructions to minimize the harm caused by adverse reactions.
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