Archive

15 December 2020, Volume 17 Issue 12 Previous Issue    Next Issue

---

For Selected:

Download Citations EndNote Ris BibTeX

Toggle Thumbnails

Select

Mechanism of Potential Hepatotoxicity of Psoralea Corylifolia L. Based on Network Toxicology Analysis LIU Wei, QIN Ke, ZHANG Yanzhong, BAI Suping 2020, 17(12): 849-855.  DOI: 10.19803/j.1672-8629.2020.12.01 Abstract ( 564 )   PDF (1601KB) ( 352 )   Objective To explore the mechanism of Psoralea corylifolia L. hepatotoxicity using network toxicology and molecular docking.Methods Literature on Psoralea Corylifolia L. was systematically retrieved, toxic components were screened by means of comparative toxicology genomics database (CTD) and admetSAR database, Psoralea Corylifolia targets were predicted by Pharmmapper server and GeneCards database before a toxic component-target interaction network was constructed by using Cytoscape software. Molecular docking validation was carried out on the binding of hub targets and toxic components by using SYBYL software, and finally GO biological function and KEGG pathway enrichment analysis was carried out by using the Metascape platform.Results Fourteen toxic components were screened from Psoralea Corylifolia L., involving 242 hepatotoxic targets. Molecular docking studies confirmed that the toxic components of Psoralea corylifolia L. had good binding activity to 10 hub targets. The results of network analysis showed that hepatotoxic targets of Psoralea Corylifolia L. were mainly related to such biological processes as cellular response to hormone stimuli, kinase activity, lipid binding and response peptide, cofactor metabolic process and to such signaling pathways as pathways in cancer, insulin signaling pathway, chemical carcinogenesis, PPAR signaling pathway, HIF-1 signaling pathway and Th17 cell differentiation.Conclusion The potential mechanism of Psoralea Corylifolia L. hepatotoxicity has been explored based on the multi-component, multi-target, and multi-pathway characteristics of traditional Chinese medicine, which brings new ideas for further research on the mechanism of Psoralea Corylifolia L. hepatotoxicity. References | Related Articles | Metrics

Select

Protective Effects of Wenyang Tongmai Granules against Oxidative Damage to HUVECs Cells ZHANG Li, HOU Lijing, SUN Fujun, LI Guihai, HUANG Dehong, SHENG Guoliang 2020, 17(12): 856-860.  DOI: 10.19803/j.1672-8629.2020.12.02 Abstract ( 248 )   PDF (1169KB) ( 110 )   Objective To explore the protective effect of Wenyang Tongmai Granule-containing serum against oxidative damage to human umbilical vein endothelial cells (HUVECs), and explore the possible mechanism.Methods Twenty-four rats were randomly divided into the blank serum group, low-dose drug-containing serum group (0.125 g/mL) and high-dose serum group (0.25 g/mL) with 8 rats in each. HUVECs were cultured in vitro to establish a normal group, a model group (300 μmol/L H2O2), a blank serum group (300 μmol/LH2O2+10% blank serum), and low-dose and high-dose Wenyang Tongmai groups (300 μmol/L H2O2+ 0.125 g/mL, 0.25 g/mL, 10 % drug-containing serum). MTT method was used to determine cell viability while the biochemical method was adopted to measure SOD activity and LDH release. MCP-1 and ICAM-1 mRNA expressions of endothelial cells were detected via RT-PCR.Results Compared with the model group, the cell viability and SOD activity of the Wenyang Tongmai groups increased (P<0.01), LDH release decreased (P<0.01), and ICAM-1 and MCP-1 mRNA expressions decreased significantly (P<0.01).Conclusion Wenyang Tongmai Granule-containing serum has a protective effect on HUVECs induced by H2O2. The mechanism may be related to its ability to reduce the expressions of inflammatory factors - ICAM-1 and MCP-1 mRNA. It can protect damaged endothelial cells and delay the progression of such vascular diseases as atherosclerosis. References | Related Articles | Metrics

Select

Genetic Toxicity of Tongguan san WANG Huiping, WANG Enli, XU Jiaoyan, YAO Jingchun 2020, 17(12): 861-866.  DOI: 10.19803/j.1672-8629.2020.12.03 Abstract ( 261 )   PDF (1107KB) ( 116 )   Objective To evaluate the genotoxicity of Tongguan san and provide safety data for evaluation of its clinical medication.Methods The in vitro bacterial reverse mutation (Ames) test, in vitro Chinese hamster lung cell (CHL) chromosome aberration test, and the mouse bone marrow micronucleus test were conducted to study the genetic toxicity of Tongguan san. In Ames test, there were five dose groups respectively as follows: 312.5、625.0、1250.0, 2500.0 and 5000.0 μg/plate. In CHL chromosome aberration assay, the doses were 125.0、250.0 and 500.0 μg/mL respectively while the exposure time was 6 and 24 h respectively. In vivo micronucleus assay, there were three dose groups: 1250.0、2500.0 and 5000.0 mg/kg, for 7 days, once per day.Results In the Ames test, under S9 metabolism and non-metabolic activation, the numbers of five strains of revertant colonies did not show any dose-dependent increase when the Tongguan san concentration ranged from 312.5 to 5000.0μg/plate, and the result of Ames test was negative. In CHL chromosome aberration test, under S9 metabolism and non-metabolic activation, there was no significant difference in the chromosome aberration rate between the control group and dosing groups of Tongguan san (P >0.05), so there was no dose-response relationship. In the micronucleus test of mouse bone marrow cells, the micronuclei rates of mice bone marrow cells in each dosing group of Tongguan san were not significantly different from those of the solvent control (P>0.05).Conclusion Under this test condition, there is no potential genotoxicity in Tongguan san. References | Related Articles | Metrics

Select

Latest Development of International Pharmacovigilance and Its Implications CHEN Feng 2020, 17(12): 867-870.  DOI: 10.19803/j.1672-8629.2020.12.04 Abstract ( 862 )   PDF (1004KB) ( 865 )   As a predictor of development of global pharmacovigilance, the Annual Meeting of WHO Program of International Drug Monitoring (PIDM) is an important event for us to find out hotspots and latest progress in pharmacovigilance worldwide. Based on the agenda of the 42nd Annual Conference held in 2019, this paper analyzes the latest developments of global pharmacovigilance and implications for China. It is believed that the scope of pharmacovigilance has been expanded from adverse reaction monitoring to the detection, reporting and prevention of drug abuse, misuse and medication errors, and that the focus is gradually shifting from drug safety to patient safety. Therefore, there is an urgent need to continue to enhance the awareness of social drug vigilance and streamline public participation. In addition, the application of new generation information technology represented by artificial intelligence (AI) in the field of pharmacovigilance is making a breakthrough, and it has become an international consensus to actively promote smart supervision and smart safety surveillance. References | Related Articles | Metrics

Select

Implementation of US FDA's Drug Risk Evaluation and Mitigation Strategies WEI Fuqian, ZHANG Wei, YANG Yue 2020, 17(12): 871-876.  DOI: 10.19803/j.1672-8629.2020.12.05 Abstract ( 522 )   PDF (1128KB) ( 432 )   Objective To analyze the current implementation and operation methods of the US FDA’s Risk Evaluation and Mitigation Strategies (REMS), and to provide reference for the implementation of the drug risk management plan specified in the Drug Administration Law of China.Methods Chinese and foreign literature and the FDA-approved REMS were reviewed, and the single system and shared system for implementation of REMS that had been approved and revoked were analyzed.Results As a risk management plan, REMS is a dynamic risk management tool. Not all drugs require REMS. The principle of prioritizing the use of risk minimization tools should be from simple to complex, from easy to difficult. Regardless of the risk management tool adopted, the risk management plan has to intervene with doctors and patients directly.Conclusion China should explore ways to execute the risk management plan specified by the Drug Administration Law, establish an adaptive method of implementing the drug risk management plan and formulate supporting documents in order to control drug risks dynamically. References | Related Articles | Metrics

Select

Pharmacovigilance Laws in Europe and America and Their Implications for China LIU Pengcheng, WANG Jiayu, CHEN Jinmin, WANG Minjiao, SHEN Mengqiu, LI Ming 2020, 17(12): 877-882.  DOI: 10.19803/j.1672-8629.2020.12.06 Abstract ( 642 )   PDF (1111KB) ( 555 )   Objective To compare the pharmacovigilance regulations in the European Union, the United States and China, analyze the relevant requirements for holders of drug marketing authorization, and offer recommendations on how to improve the pharmacovigilance system in China.Methods Theoretical analysis and comparative analysis were used to compare and analyze the laws and regulations concerning pharmacovigilance in the European Union, the United States and China.Results and Conclusion The laws and regulations of the United States and the European Union have relatively perfect provisions on how to carry out adverse reaction monitoring and reporting, post-market safety research, and risk management. It is suggested that China learn from foreign experience, further improve the pharmacovigilance regulatory system, promote active monitoring and post-marketing safety research, formulate related guidelines for risk management, and take multiple measures to promote the implementation of pharmacovigilance systems. References | Related Articles | Metrics

Select

"Double Classification" Management of Prescription Drugs and Non-prescription Drugs in China based on British System TIAN Chunhua, XIA Dongsheng 2020, 17(12): 883-884.  DOI: 10.19803/j.1672-8629.2020.12.07 Abstract ( 336 )   PDF (951KB) ( 173 )   Objective To analyze the way in which different categories of the same drugs are managed in the drug classification management system in Britain so as to provide reference for the "double classification " management of prescription drugs and non-prescription drugs in China.Methods The similarities and differences in ways of managing prescription drugs and non-prescription drugs between Britain and China were analyzed.Results and Conclusion "Double classification " is consistent with the properties of drugs in China. We can learn from the classification management system and experience of Britain to improve China's drug classification management system. References | Related Articles | Metrics

Select

Quality Risk Management during Implementation of Phase Ⅱa Clinical Trials of Innovative Anti-tumor Drugs ZHANG Rui, PAN Yan, WU Zhiang 2020, 17(12): 886-889.  DOI: 10.19803/j.1672-8629.2020.12.08 Abstract ( 209 )   PDF (1069KB) ( 140 )   Objective To establish a general method for quality risk management of phaseⅡa clinical trials of innovative anti-tumor drugs.Methods Based on theories of quality risk management, literature research and questionnaire survey, failure mode, effects and criticality analysis (FMECA) was used to construct the failure mode of phase Ⅱa clinical trials of innovative anti-tumor drugs. By means of hazard analysis, the risk priority number (RPN) of each failure mode was obtained.Results There were 25 non-critically acceptable low risks such as“lack of relevant documents and records for drug recovery”with RPN <15, and 18 medium risk failure modes such as“without timely treatment of combined medication”with 15≤RPN <25. There were 31 high-risk failure modes with RPN≥25, such as “the problem was not found and resolved in a timely manner through the inspection of the auditor”.Conclusion By analyzing the RPN value, more important risks in the “subject management”“data management”“safety monitoring”and“quality assurance”links with higher risks in clinical trials are identified, and risk control recommendations are proposed. References | Related Articles | Metrics

Select

Automatic Surveillance of Cases of Cefoperazone Sodium and Sulbactam Sodium-related Thrombocytopenia LI Xiaoyang, GUO Daihong, LIU Siyuan, YANG Hongyi, YAO Chong, QI Zhen 2020, 17(12): 890-893.  DOI: 10.19803/j.1672-8629.2020.12.09 Abstract ( 377 )   PDF (1042KB) ( 133 )   Objective To efficiently obtain such real-world risk data as the incidence of cefoperazone sodium and sulbactam sodium-related thrombocytopenia in a large sample of drug users.Methods A retrospective study was conducted to automatically monitor inpatients using cefoperazone sodium and sulbactam sodium for injection in our hospital between July 2013 and June 2018 using ADE-ASAS. The incidence and characteristics of cefoperazone sodium and sulbactam sodium-related thrombocytopenia were obtained via the double evaluation system. Case-control study was conducted to analyze the risk factors.Results The incidence of thrombocytopenia among 17 569 patients was 2.73%. Severe thrombocytopenia was more common in patients with liver diseases. Multivariate logistic regression analysis showed that the basic platelet value, creatinine clearance rate, BMI and duration of treatment were the risk factors for thrombocytopenia induced by cefoperazone sodium and sulbactam sodium.Conclusion The incidence of cefoperazone sodium and sulbactam sodium-related thrombocytopenia is high, which is consistent with the results of the team's previous study (3.0%). Monitoring platelet values from the beginning of treatment can detect and avoid risks in time. Patients with complex conditions should be more vigilant about the occurrence of severe ADRs. Proper control of the duration of treatment and focus on patients with renal insufficiency and low BMI can reduce the risk of ADR. References | Related Articles | Metrics

Select

968 Cases of Drug-induced Kidney Injury and Risk Signal Mining of Anti-infective Drugs YU Chengxuan, GUO Daihong, YAO Chong, YANG Hongyi, ZHU Yu, LIU Siyuan, KONG Xianghao 2020, 17(12): 894-899.  DOI: 10.19803/j.1672-8629.2020.12.10 Abstract ( 298 )   PDF (1175KB) ( 276 )   Objective To analyze the characteristics and regularity of occurrence of drug-induced kidney injury, and to explore the risk signals of kidney injury caused by anti-infective drugs so as to provide reference for safe clinical use.Methods Valid reports of kidney injury collected between 2016 and 2018 in the ADR database of the PLA were retrospectively analyzed, and risk signals mining was carried out using four data mining methods: the reporting odds ratio, proportional reporting ratio, combination x2 test-PRR measure used by the Medicines and Healthcare Products Regulatory Agency, and Bayesian Confidence Propagation Neural Network.Results Among the 968 cases of drug-induced kidney injury, 633 cases (65.39%) involved males and 335 cases (34.61%) females, with an average age of 58.60±19.55 years. The most-frequently reported drugs were anti-infective drugs in 269 cases (27.79%), and the top three drugs were vancomycin in 43 cases (4.44%), mannitol in 30 cases (3.10%), and iodixanol in 29 cases (3.00%). After data mining, eleven types of anti-infective drugs, including vancomycin, generated positive risk signals of kidney injury.Conclusion There are many kinds of drugs involved in drug-induced kidney injury, among which the frequency of anti-infective drugs is the highest. In clinical application, the awareness of relevant drug vigilance should be enhanced and the use of drugs with high risk of nephrotoxicity standardized. References | Related Articles | Metrics

Select

185 Cases of Adverse Drug Reactions Indued by Propylgallate Injection SHEN Xiaohua, HE Jianping, CHANG Hongjian, LIN Qiang 2020, 17(12): 900-903.  DOI: 10.19803/j.1672-8629.2020.12.11 Abstract ( 236 )   PDF (966KB) ( 178 )   Objective To explore the regularity of adverse reactions caused by propylgallate injection.Methods One hundred and eighty-five reports of adverse reactions caused by propylgallate injection were analyzed retrospectively.Results Of the 185 reports, 64.86% of the patients involved were over 60 years old, Adverse reactions occurred during intravenous drip in 159 patients(85.95%). Adverse reactions mainly involved the nervous system, cardiovascular system and respiratory system. Serious adverse reactions included allergic reactions, anaphylactic shock and abnormal liver function.Conclusion During clinical use of propylgallate injection, clinicians should be vigilant about the serious adverse reactions such as anaphylaxis, anaphylactic shock and abnormal liver function. The manufacturer should strengthen the safety monitoring of the product, modify and improve the instructions accordingly. References | Related Articles | Metrics

Select

157 Cases of Adverse Drug Reactions Induced by Iopromide Injection CHENG Xiaoping, ZHU yajian, LIU Xueliang 2020, 17(12): 904-906.  DOI: 10.19803/j.1672-8629.2020.12.12 Abstract ( 215 )   PDF (1061KB) ( 207 )   Objective To explore the clinical characteristics and regularity of adverse reactions (ADR) caused by iopromide injection so as to provide reference for reducing the risk of clinical medication.Methods The ADR reports of 157 cases of iopromide injection collected between 2009 and 2019 from the provincial database of the national adverse drug reaction monitoring system were statistically analyzed using the retrospective research method.Results ADRs caused by iopromide injection were more common among females than among males, and 68.16% of the ADRS occurred within 30 minutes of medication. The dominating clinical manifestations were the damage to the skin and its accessories, and anaphylactic shock was the most serious consequence.Conclusion In order to ensure the safety of drug use, drug instructions should be strictly observed clinically. Attention should be paid to the serious adverse reactions before and after drug use so as to identify and prevent ARDs as soon as possible and reduce the incidence of ADRs related to this injection. References | Related Articles | Metrics

Select

Adverse Drug Reactions of Nicotinic Acid Injection ZHANG Shu, LIN Qiang, DENG Wen, CHEN Shen 2020, 17(12): 907-912.  DOI: 10.19803/j.1672-8629.2020.12.13 Abstract ( 424 )   PDF (1091KB) ( 1040 )   Objective To analyze the characteristics and regularity of adverse drug reactions (ADR) caused by nicotinic acid injection in order to provide reference for clinical rational drug use.Methods The 1 174 ADR/AE of reported to the ADRS by fujian Province between January 2017 and December 2019 were analyzed using the retrospective study method.Results ADRs caused by nicotinic acid injection mostly occurred in the process of medication. These ADRs were mostly allergic reactions and angiectasis reactions and manifested themselves as the damage to the skin and its accessories, vascular damage and systemic damage.Conclusion We should strengthen the clinical monitoring of nicotinic acid injection, update the drug labeling without delay and promote the rational use of medicines so as to ensure the safety of medication. References | Related Articles | Metrics

Select

Monitoring of Safety of Home-made Subcutaneous Bortezomib by CHPS PAN Daowei, WAN Lei 2020, 17(12): 913-916.  DOI: 10.19803/j.1672-8629.2020.12.14 Abstract ( 240 )   PDF (1056KB) ( 183 )   Objective To monitor adverse drug events (AE) induced by home-made bortezomib for subcutaneous injection using the Chinese hospital pharmacovigilance system (CHPS).Methods Thirty-two cases involving the use of home-made bortezomib injected subcutaneously of Guiyang first people's Hospital from January to June 2019 were selected by the CHPS, and all the AE were calculated manually. Combined with the AE listed in the specifications of imported drugs, the drug trial evaluation scheme in the CHPS was formulated. Finally, all the AE related to the 32 cases were screened by the scheme, and the numbers of AE obtained by the two methods were compared.Results The positive rate of the CHPS was 73.07% (20 items), and 100% in 6 items. There was no significant difference between the two groups(P>0.05).Conclusion The drug test evaluation scheme in the CHPS is applicable to the detection of home-made bortezomib AE for subcutaneous injection, but it still needs to be further improved. References | Related Articles | Metrics

Select

Adverse Drug Reactions of Cephalosporins and Influencing Factors in Hospitalized Patients for General Surgery CHEN Yanfang, WANG Yiqiao 2020, 17(12): 917-920.  DOI: 10.19803/j.1672-8629.2020.12.15 Abstract ( 253 )   PDF (995KB) ( 121 )   Objective To study the adverse drug reactions and influencing factors of cephalosporins in the perioperative period and seek targeted prevention in order to ensure the safety of patients.Methods A total of 246 medical records of patients with cephalosporins admitted to our hospital between January in 2017 and November in 2019 were randomly selected for retrospective analysis.Results The adverse drug reactions of cephalosporins involved the skin and accessory damage, digestive system damage, and central nervous system reactions. The main route of administration was intravenous injection and adverse drug reactions usually occurred within 1 hour of administration. There was statistically significant difference in the occurrence of adverse drug reactions between patients who were different in age, allergy history, concomitant medications, and routes of administration(P<0.05), but no significant difference was found in gender,weight or primary diseases between the ADR group and the non-ADR group (P>0.05).Conclusion Age above 60 years, a history of allergies, combined medications and intravenous administration are risk factors for adverse drug reactions of cephalosporins. During clinical medication, patients should be carefully evaluated for risk factors for adverse drug reactions to ensure the proper use of cephalosporins. Symptomatic treatment and rescue measures are critical to control of adverse drug reactions. References | Related Articles | Metrics

Select

Pareto Diagram Analysis of Intervention in Irrational Medical Orders for Inpatients of Endocrinology YU Ying, LIU Dongling, CHEN Fei, ZHANG Fan 2020, 17(12): 921-925.  DOI: 10.19803/j.1672-8629.2020.12.16 Abstract ( 256 )   PDF (1240KB) ( 130 )   Objective To investigate the incidence and causes of irrational medical orders for inpatients from the department of Endocrinology of Liaocheng People’s Hospital.Methods All medical orders written between April 2017 and March 2019 from the Department of Endocrinology in this hospital were previously reviewed by the automatic screening system of prescriptions combined with manual examination. Imperfect medical orders were classified and counted according to types of problems. The Pareto diagram method was used to analyze the primary, secondary and common factors that were responsible for irrational medical orders each quarter. Interventions were formulated according to the results of analysis.Results A total of 795 out of 137,904 medical orders for 4,056 inpatients were problematic, which were of eight types involving solvents, administration frequencies, single dosage, administration time, indications, drug combinations, drug selection and administration routes. By reinforcing rational use of drugs and pharmaceutical care, providing pharmaceutical services, and carrying out multi-departmental interventions, the rate of proper medical orders for inpatients from the Department of Endocrinology increased from 65.19% to over 90%, with a stable index control.Conclusion Pareto diagram analysis can help reduce irrational drug usage clinically, contribute to rational medications, and improve the quality of services rendered by clinical pharmacists. References | Related Articles | Metrics

Select

Pipeline Service System Model in Control of High-risk Drugs WEN Yu, CHEN Yunyan, ZHANG Qiuping 2020, 17(12): 926-929.  DOI: 10.19803/j.1672-8629.2020.12.17 Abstract ( 158 )   PDF (1112KB) ( 64 )   Objective To explore the working mode in which clinical pharmacists participate in the control of high-risk drugs and promote medication safety.Methods Clinical pharmacists participated in pharmaceutical service to high-risk drugs using the pipeline service system model. The pipe head indicated control measures. The pipe wall indicated not only good cooperation between clinical pharmacists and doctors and nurses while controlling high-risk drugs but also a safe medication channel during interactions with patients. The pipe end indicated that by means of follow-up and assessment of patients using high-risk drugs, clinical pharmacists optimized medications, hence the elastic circular effect with the pipe head at any time. The levels of knowledge of high-risk drugs by nurses were compared by the scores of numerical rating scale.Results After the adoption of the pipeline service model, nurses’levels of knowledge of high-risk drugs were improved( 40.0% to 88.9%).Among the 204 patients prior to the implementation of the pipeline service model, the total number of cases of irrational use of high-risk drugs accounted for 49.5%, compared with 36.1% after the pipeline service model was adopted. The number of proper medications improved.Conclusion Use of the pipeline service system model can help ensure the safety of high-risk drugs. References | Related Articles | Metrics

Select

One Case of Participation of Clinical Pharmacists in Treatment of Brucella Endocarditis YU Xiongjie, ZHANG Jing, LI Yuan, WANG Peng, HUANG Nianxu, CHEN Jinhua 2020, 17(12): 930-933.  DOI: 10.19803/j.1672-8629.2020.12.18 Abstract ( 189 )   PDF (972KB) ( 128 )   Objective To investigate the role of clinical pharmacists in the treatment of infective endocarditis with brucella.Methods Clinical pharmacists, using their pharmaceutical expertise, participated in the process of anti-infection treatment, adverse reaction disposal and anticoagulant treatment of one patient while assisting physicians in formulating optimal drug treatment programs.Results The clinicians took the advice of clinical pharmacists, and the patients' condition was effectively controlled.Conclusion The participation of clinical pharmacists in clinical drug therapy can better promote rational clinical drug use and ensure the safety of drug use for patients. References | Related Articles | Metrics

Select

Analysis of One Case of Warfarin Related Nephropathy BAI Hehe, NIE Xiaojing, XIA Li, ZHAO Meng, WANG Jinping, YAO Yanqin 2020, 17(12): 934-938.  DOI: 10.19803/j.1672-8629.2020.12.19 Abstract ( 203 )   PDF (1069KB) ( 146 )   Objective To investigate the clinical features, risk factors, mechanism, prevention and treatment strategies of warfarin related nephropathy (WRN) and the selection of anticoagulant drugs after WRN so as to provide reference for pharmaceutical care by clinical pharmacists.Methods One case of warfarin induced hematuria and AKI was reported. By searching such databases as PubMed, Medline, CNKI, Wanfang, and VIP, literature related to WRN was screened and analyzed.Results A total of 48 WRN cases were retrieved, in 87.50% of which INR was>3. The incidence of WRN was high 6-8 weeks after medication (29.17%). Patients aged 65 or older were more vulnerable (47.92%). The main clinical manifestations were increased levels of serum creatinine, microscopic/macroscopic hematuria and proteinuria. Forty-seven patients (97.92%) received renal puncture biopsy. Eighteen patients (37.50%) were complicated with basic nephropathy. Patients who did not use anticoagulant drugs a second time accounted for 8.33% (4/48) and relapsed warfarin treatment accounted for 27.27% (12/44). Renal function returned to normal in eleven patients (22.92%), incomplete renal function occurred in thirty-two patients (66.66%), and death in five patients (10.42%) within two years.Conclusion The incidence of WRN is not low and medical staff should be vigilant. Quick diagnosis and treatment of WRN and optimization of anticoagulant drug selection can contribute to patients' expected prognosis. References | Related Articles | Metrics

Select

Individualized Anticoagulant Therapy for Warfarin in a Patient with Poor Metabolism LI Yu, FAN Huihui, FENG Xiaojun, WANG Yunhong, CHEN Chuantao, ZHANG Lei 2020, 17(12): 939-942.  DOI: 10.19803/j.1672-8629.2020.12.20 Abstract ( 233 )   PDF (1000KB) ( 139 )   Objective To investigate the role of clinical pharmacists in individualized anticoagulation therapy of warfarin.Methods The clinical pharmacist participated in the individualized anticoagulant treatment of warfarin in one patient. According to the guidelines, the clinical pharmacist recommend discontinuing aspirin and using warfarin monotherapy. The dose of warfarin was adjusted according to the genetic test results, the prothrombin time, INR and the occurrence of bleeding events and other pharmaceutical monitoring datas were followed.Results The doctor accepted the advice of clinical pharmacists, discontinued aspirin and warfarin 1.25mg/d was applied. The detection results were within the target range, no bleeding and embolic events occurred.Conclusion Clinical pharmacists guide individualized administration of warfarin through genetic testing to ensure the safety and effectiveness of medication for patients and realize the whole-process, individualization and optimization of anticoagulation therapy. References | Related Articles | Metrics

Select

Analysis of One Case of Liver Injury Induced by Levetiracetam Oral Liquid YANG Bei, FANG Yuting 2020, 17(12): 943-945.  DOI: 10.19803/j.1672-8629.2020.12.21 Abstract ( 338 )   PDF (941KB) ( 367 )   Objective To remind the medical staff to pay close attention to medication safety of levetiracetam.Methods An epileptic pediatric patient who developed a significant elevation of the liver enzymes during levetiracetam monotherapy was reported while literature about the relativity and pathogenesis of levetiracetam-induced liver injury was consulted.Results The liver enzymes were surprisingly decreased to normal after levetiracetam discontinuation in this patient. The Roussel Uclaf causality assessment method score was 6, indicating levetiracetam was a probable cause for the liver damaged.Conclusion The levetiracetam-associated potential liver enzymes elevation should be considered when levetiracetam is prescribed to patients, especially pediatric patients, close liver function monitoring was necessary.. References | Related Articles | Metrics

Select

Analysis of One Case of Delayed Anaphylaxis Induced by Clarithromycin Tablets LIU Jingjing, WANG Yilei, WANG Tong, KANG Yansheng, ZHANG Wei, XU Xiaoya, CHANG Renyuan, WANG Xiaoqin 2020, 17(12): 946-948.  DOI: 10.19803/j.1672-8629.2020.12.22 Abstract ( 473 )   PDF (788KB) ( 231 )   Objective To analyze one case of delayed anaphylaxis induced by clarithromycin and provide safe references for clinical prescriptions.Methods To evaluate the relevance between drugs taken by patients and analyze the literature.Results The patient was sensitive constitution and delayed allergic reaction were caused by clarithromycin, after the antiallergic treatment, the patients recovered.Conclusion Clarithromycin has a low incidence of anaphylaxis and can caused delayed anaphylaxis with mild general symptoms. The patient of sensitive constitution should be used with caution. References | Related Articles | Metrics