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15 March 2021, Volume 18 Issue 3 Previous Issue    Next Issue

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Antibody-Dependent Enhancement of Vaccines and Development of Coronavirus Vaccines DENG Xia, LIU Bo, WANG Yuanzheng, YIN Xiao, SU Yao, ZHANG Yan, LI Yingli, GAO Chenyan, YANG Huan, WANG Tao 2021, 18(3): 201-205.  DOI: 10.19803/j.1672-8629.2021.03.01 Abstract ( 668 )   PDF (1108KB) ( 355 )   Generally, the neutralizing antibodies may bind specifically to the invading virus particles, and prevent the virus from entering host cells and developing diseases. However, in some cases, these antibodies not only fail to function well, but also aggravate the clinical manifestations of the disease, known as antibody-dependent enhancement (ADE) that leads to vaccine-enhanced disease(VED). In this article, we investigated and analyzed cases of ADE that had occurred in previous clinical studies or during animal experiments related coronavirus vaccines, and the potential function mechanisms of ADE, and reflected on safety issues concerning the development of coronavirus vaccines, so as to provide reference for the early detection and recognition of ADE and risk control. References | Related Articles | Metrics

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Enhanced Hepatotoxicity of Extract of Polygoni Multiflori Radix after Inhibition of CYP2E1 and Screening of Toxic Constituents HU Yinghuan, WANG Zijian, LI Dengke, QUAN Zhengyang, WANG Chengyu, SUN Zhenxiao 2021, 18(3): 206-212.  DOI: 10.19803/j.1672-8629.2021.03.02 Abstract ( 123 )   PDF (1731KB) ( 162 )   Objective To study the relationship between cytochrome oxidase P450(CYP450) subtype CYP2E1 and the hepatotoxicity of Polygoni Multiflori Radix(PMR), and screen the toxic components. Methods MTT assay was used to detect the toxic effects of aqueous extract of PMRE on L02 cells treated with CYP2E1 specific inhibitor sodium diethyldithiocarbamate (DDTC), and the toxic effects of PMR and 6 major ingredients 2,3,5,4'-tetrahydroxystilbene-2-O-β-D- glucoside (TSG), emodin-8-O-β-D-glucoside (EG), emodin (EM), gallic acid (GA), physcione (PH) and rhein (RH) on stably transfected HepaRG-shCYP2E1 cells.Then, the effects of PMR combined with CYP2E1 specific inhibitor 4-methylpyrazole (4-MP) on hepatotoxicity were studied in rats. Results CYP2E1 activity was decreased significantly when treated with DDTC, so was cell viability after being treated with PMR combined with DDTC compared with PMR alone(P<0.01). A stably transfected cell line, HepaRG-shCYP2E1,was successfully constructed, and the mRNA expression of CYP2E1 in HepaRG-shCYP2E1 cells decreased by more than 70%. Compared with the control group, the cytotoxic effect of PMR, EM, PH and RH on HepaRG-shCYP2E1 was significantly increased (P<0.01), while TSG and EG showed a decreasing toxicity at certain concentrations(P<0.01). The rat experiment showed that the levels of ALT and AST in PMR combined with CYP2E1 specific inhibitor 4-MP group were significantly increased compared with the control group and the 4-MP group, and the levels of AST in PMR combined with 4-MP group were significantly increased compared with PMR group, indicating that the hepatotoxicity of PMR increased after the inhibition of CYP2E1 in rats. Conclusion The decrease of CYP2E1 activity or expression in rats could increase the hepatotoxicity of PMR. The main cytotoxic components are free anthraquinones including EM, PH and RH. References | Related Articles | Metrics

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CYP1A2 Depletion by shRNA Enhances Hepatotoxicity of Extract of Polygoni Multiflori Radix and Related Monomer Compositions QUAN Zhengyang, LI Dengke, LI Yiqun, WANG Chengyu, ZHOU Ming, HU Yinghuan, SUN Zhenxiao 2021, 18(3): 213-219.  DOI: 10.19803/j.1672-8629.2021.03.03 Abstract ( 84 )   PDF (1548KB) ( 59 )   Objective To construct the CYP1A2 depletion human liver cell lines by shRNA, and to explore the relationship between depletion of CYP1A2 and hepatotoxicity of extract of Polygoni Multiflori Radix (PMR)and related monomer compositions. Method We constructed stably transfected L02-shCYP1A2 and HepaRG-shCYP1A2 cells with depletion of CYP1A2 by shRNA, verified by RT-qPCR. CYP1A2 depletion L02 and HepaRG cells were treated for 48 h with extract of PMR, and related monomer compositions included 2,3,5,4'-Tetrahydroxystilbene-2-O-β-D-glucoside (TSG), emodin (EM), aloe-emodin (AE), emodin-8-O-β-D-glucopyranoside (EG), gallic acid (GA), physcion (PH), rhein (RH). Cell viability was detected by MTT assay. Result Successfully constructed two stably transfected cell lines, named L02-shCYP1A2 and HepaRG-shCYP1A2 cells, and the mRNA expression of CYP1A2 decreased by 59.81% in L02-shCYP1A2 and 66.60% in HepaRG-shCYP1A2, respectively. After L02-shCYP1A2 were treated with PMR for 48 h, cytotoxicity were significantly increased (P<0.01). After HepaRG-shCYP1A2 were treated with PMR for 48 h, cytotoxicity were significantly increased (P<0.05, P<0.01). The cytotoxicity of GA was significantly increased in L02-shCYP1A2 cells and HepaRG-shCYP1A2 cells (P<0.01, P<0.01). The cytotoxicity of AE was also significantly increased in HepaRG-shCYP1A2 cells (P<0.01). Conclusion The depletion of CYP1A2 significantly increased the hepatotoxicity of PMR, of which GA and AE were suggested to be the related monomer compositions. References | Related Articles | Metrics

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Hepatotoxicity and Related Components of Polygoni Multiflori Radix Based on Cytochrome Oxidase CYP2D6 WANG Chengyu, LI Dengke, QUAN Zhengyang, HU Yinghuan, SUN Zhenxiao 2021, 18(3): 220-227.  DOI: 10.19803/j.1672-8629.2021.03.04 Abstract ( 84 )   PDF (1651KB) ( 83 )   Objective To study the effects of Polygoni Multiflori Radix and its main components on the mRNA expression of CYP2D6 in L02 human liver cells and the effects of CYP2D6 inhibition on Polygoni Multiflori Radix and its main components induced hepatocyte toxicity. Methods The mRNA expression of CYP2D6 was determined by RT-XqPCR in L02 cells treated with Polygoni Multiflori Radix (PMR) or its main components. Quinidine (CYP2D6 inhibitor) was used to explore the cytotoxic effect of PMR on L02 cells with low CYP2D6 activity. Then, L02-shCYP2D6 cell line was constructed by RNA interference and used to investigate the main hepatotoxic components of PMR related to CYP2D6. Finally, the major CYP450 enzymes that affected the metabolism of possible hepatotoxic components were determined by the substrate metabolic clearance rate in human liver microsomes after different CYP450 enzyme specific inhibitors were added. Results PMR and aloe-emodin (AE), rather than emodin (EM), inhibited the mRNA expression of CYP2D6 significantly (P<0.01), while 2,3,5,4'-tetrahydroxystilbene-2-O-β-D-glucoside (TSG) activated mRNA expression of CYP2D6 at a high concentration (P<0.01). PMR exerted more cytotoxic effect in L02 cells at a high concentration (P<0.01) when combined with quinidine than used alone. Hepatotoxicity was increased significantly when PMR was combined with quinidine at various concentrations (P<0.01). PMR, EM and AE increased hepatotoxicity significantly in L02-shCYP2D6 cells within the experimental concentration range (P<0.01), but TSG increased hepatotoxicity only at high concentrations (P<0.01). CYP2D6 was determined as an important metabolic enzyme for EM and AE in human liver microsomes. Conclusion PMR can inhibit the expression of CYP2D6 in hepatocytes. The low activity or low expression of CYP2D6 aggravates the hepatotoxicity of PMR and its main toxic components are EM and AE. References | Related Articles | Metrics

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Study on the Differential Effects and Mechanism of Polygoni Multiflori Radix and Polygoni Multiflori Radix Praeparata on Human Urine-derived Stem Cells QIAO Yinggu, ZHOU Ming, HU Yinghuan, WANG Chengyu, LIU Xiaoxuan, SHEN Liangliang, SUN Zhenxiao 2021, 18(3): 228-234.  DOI: 10.19803/j.1672-8629.2021.03.05 Abstract ( 83 )   PDF (1475KB) ( 92 )   Objective Human urine-derived stem cells (hUSCs) were used to explore the differentiation effect and mechanism of Polygoni Multiflori Radix(PMR) and Polygoni Multiflori Radix Praeparata(PMRP) on human adult stem cells. Methods Quantitative analysis of Emodin (EM) and 2,3,5,4'-tetrahydroxy-stilbene-2-O-β-D-glycoside (TSG) in the aqueous extract of PMR and PMRP was carried out by high Performance Liquid Chromatography; MTT assay was used to study the influence of PMR and PMRP on hUSCs viability; according to the content and proportion of EM and TSG in the two aqueous extracts, the effects of single component and 2 components combined in proportion on hUSCs viability were compared; cell cycle distribution and cell apoptosis were analyzed by flow cytometry, and cell cycle-related proteins were detected by Western blot. Results The contents of TSG and EM in PMR were 77.68 and 0.53 mg/g, and were 29.37 and 0.36 mg/g in PMRP. PMR had obvious toxicity to cells at 0.5 and 1.0 mg/mL, while PMRP had the effect of promoting cell proliferation at the same dose. EM promoted cell proliferation at 0.5~4 μmol/L,and TSG inhibited cell activity at 320 and 640 μmol/L. The inhibitory effect of the combination of EM and TSG on cell viability was significantly increased compared with the corresponding concentration alone. The G0/G1 cell cycle arrest occurred in the PMR group and the 1∶160 combined group, and the cell apoptosis rates were higher than the PMRP group and the 1∶80 combined group. Western blot results showed that p21 level was up-regulated in the PMR group. CDK1, CDK2 and Rb phosphorylation level were down-regulated in the PMR group, while up-regulated in the PMRP group. Conclusion Under the same conditions, PMR showed obvious cytotoxic effect compared with PMRP, while PMRP showed the effect of promoting cell activity, indicating that the change of EM and TSG proportion may be one of the mechanisms of the PMR processed attenuating toxicity. References | Related Articles | Metrics

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Changes of Liver Function in 35 Patients Orally Taking Polygoin Multiflori Radix Preparations ZHOU Ming, FEI Zhanyang, ZHAO Jiuli, XUE Dan, LI Ming, LI Dengke, Wang Zijian, LI Yiqun, TANG Xuechun, SUN Zhenxiao 2021, 18(3): 235-239.  DOI: 10.19803/j.1672-8629.2021.03.06 Abstract ( 100 )   PDF (1090KB) ( 119 )   Objective To analyze the post-treatment changes of liver function in patients taking a conventional dosage of decoction and Chinese patent medicine containing Polygoni Multiflori Radix(PMR), and to determine the risk of liver injury in clinical application. Methods The clinical data on 35 cases who used decoction and Chinese patent medicine containing PMR was collected. Their liver function indexes, such as alanine aminotransferase(ALT), aspartate aminotransferase(AST), alkaline phosphatase(ALP),γ-glutamyl transpeptadase (GGT), total bilirubin(TBIL), direct bilirubin(DBIL) and indirect bilirubin(IBIL) , were detected. The patients were divided into two groups according to the normality of their liver function indexes before treatment and the incidence of liver injury after treatment was analyzed. Results There was no significant difference in levels of AST, ALP, GGT, TBIL, DBIL or IBIL after treatment（P>0.05）in patients who had normal liver function before treatment, but there was significant difference in ALT（P<0.05）that was in the normal range. Among patients who had abnormal liver function before treatment, there was also no significant difference in levels of ALP, GGT, TBIL or IBIL after treatment（P>0.05）, but some of their liver function indexes decreased after treatment. Conclusion Taking orally a conventional dosage of decoction and Chinese patent medicine containing PMR is relatively safe and has lower clinical risk of liver injury. References | Related Articles | Metrics

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Thoughts on Promoting the Implementation of Licensed Pharmacist System in the New Era LI Zhaohui 2021, 18(3): 240-244.  DOI: 10.19803/j.1672-8629.2021.03.07 Abstract ( 230 )   PDF (1155KB) ( 229 )   Objective To promote the construction of the licensed pharmacist system, and provide references for the role of licensed pharmacist. Methods The method of literature review and system analysis was adopted to analyze the developmental history of the licensed pharmacist system, the situation of the licensed pharmacist's team building and its existing problems. Based on this, the proposal was made to perfect the system and speed up the team development. Results At this present stage, the work of licensed pharmacists was facing new problems and challenges which included the low registration rate, the insufficiency, the uneven practicing quality and ability, the public's lack of awareness of rational drug use, and the different provision of policies and standards issued by provinces of licensed pharmacists. Conclusion We should strengthen the construction of licensed pharmacists, improve their ability and professional quality, explore and implement the differentiated allocation policy of licensed pharmacists and hierarchical management system of licensed pharmacists in retail pharmacies, assist and support licensed pharmacists to improve pharmaceutical service ability through information technology, and strengthen publicity to enhance the social status of licensed pharmacists. References | Related Articles | Metrics

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Management of Safety Information in Prescription Drug Labeling in China, Japan and the United States CONG Duanduan, XUE Wei, LIU Yue, QI Wenyuan, LIU Xiaohui, WANG Juan, LI Kexin, HU Xin 2021, 18(3): 245-249.  DOI: 10.19803/j.1672-8629.2021.03.08 Abstract ( 323 )   PDF (1300KB) ( 325 )   Objective To provide references for the management of safety information in prescription drug labeling in China. Methods By consulting regulations and literatures, format requirements and revision procedures of safety information in prescription drug labeling were compared among China, the United States and Japan. Results Compared with the United States and Japan, content and format requirements in Chinese regulations and guidelines for the safety-concerning sections of prescription drug labeling were relatively brief,and the implementation was too flexible. The revision process and notification after revision lack detailed basis for implementation. Conclusion It is suggested that both foreign and domestic experts should be widely consulted in combination with the experience of other countries. The safety information management system of the labeling could be further improved based on a comprehensive revision of the“Provisions on the Administration of Pharmaceutical Directions and Labels”and its detailed rules. References | Related Articles | Metrics

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Clinical Use and Safety of Oseltamivir Phosphate LI Sheng, ZHENG Lei 2021, 18(3): 250-255.  DOI: 10.19803/j.1672-8629.2021.03.09 Abstract ( 257 )   PDF (1119KB) ( 307 )   Objective To investigate the clinical use and safety of oseltamivir phosphate, analyze the characteristics of its adverse drug reactions (ADR), and provide reference for rational use of drugs. Methods Data on the use of oseltamivir phosphate in our hospital between February 2016 and February 2018 was retrospectively analyzed in terms of indications, use of drugs, usage and dosage, combined use of drugs and adverse reactions. The rationality and safety of drug use was highlighted. The relationships between adverse reactions and age, allergy history, underlying diseases and combined medication were explored to identify the risk factors. Results There were a total of 1 795 adult patients and 3 199 children who took oseltamivir phosphate. As far as the therapeutic use was concerned, there were 1 481 cases (82.5%) in the adult group, and 2 602 cases (81.3%) in the child group. This drug was prescribed mainly for upper respiratory tract infections, bronchitis and pneumonia, but 767 of these cases were diagnosed with influenza virus infection via virology examination, and the rest were suspected influenza cases or clinically diagnosed cases of influenza. As for preventive medication: the adult group consisted of 314 cases (17.5%), compared with 597 cases (18.7%) in the child group. A lack of indications related to preventive medication was found. Administration started within 48 hours of onset of influenza symptoms, with 109 cases (79.0%) in the child group, and 169 cases (60.1%) in the adult group, Drug usage and dosage, courses of treatment were up to standards, but combined medication was not well-grounded. There were 106 cases of adverse drug reactions, but there was no case of serious adverse drug reactions. Statistical analysis showed that the rate of adverse drug reactions was related to the age of patients and the number of types of combined drugs. Conclusion Excessive use of preventive drugs and inappropriate indications have been found in the clinical use of oseltamivir phosphate. This drug is quite safe and the main adverse reactions involve the digestive system, but the age of patients, combination of drugs and allergy may be regarded as the main risk factors for adverse reactions. The safety of drug use in elderly patients and children has become a concern. References | Related Articles | Metrics

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Clinical Medication for Hand Foot Mouth Disease in a Hospital YI Dan, LUO Shengping, HUANG Li 2021, 18(3): 256-259.  DOI: 10.19803/j.1672-8629.2021.03.10 Abstract ( 99 )   PDF (1104KB) ( 190 )   Objective To analyze the rationality of use of drugs for patients with HFMD in our hospital, and to provide reference for clinical rational use of drugs. Methods The prescriptions for patients with HFMD diagnosed in the Department of Outpatients and Emergency Department of our hospital between January and December 2018 were collected, and the rationality of drugs used was analyzed. Results A total of 1 508 cases of HFMD were collected. There were 69 kinds of drugs used for treatment, including antiviral drugs, antibacterial drugs, antipyretic and analgesic drugs, and Chinese patent medicines for clearing heat and detoxification. The selection of drug varieties was basically appropriate. There were 68 problematic prescriptions, accounting for 4.51% of the total. Most of the improper prescriptions were sub-standard ones. Conclusion The use of drugs for HFMD in our hospital is basically well-grounded, but off-label instructions are common, and there are some defective prescriptions. The clinical research on and prescriptions for HFMD should be improved to promote rational drug use. References | Related Articles | Metrics

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Literature Analysis of Adverse Drug Reactions Induced by Olanzapine ZHAO Zeqing, WANG Rui, YU Panpan, QIAO Pingping 2021, 18(3): 260-264.  DOI: 10.19803/j.1672-8629.2021.03.11 Abstract ( 199 )   PDF (1048KB) ( 201 )   Objective To investigate the regularity and characteristics of adverse drug reactions (ADR) induced by olanzapine so as to provide reference for safe and rational use of drugs. Methods CNKI, Wanfang and VIP databases were searched for literature related to ADR induced by olanzapine. The included articles were analyzed retrospectively. Results A total of 82 articles involving 104 patients were retrieved. The ratio of males to females was 1∶1.08, and the age of most of these patients ranged from 18 to 44 (51 cases, 49.04%). Thirty-three of these patients (31.73%) had adverse reactions within 2 to 7 days of medication. The dominating systems or organs involved were the central nervous system (56 cases, 29.79%) as manifested by tardive dystonia and restless leg syndrome, followed by metabolic and nutritional disorders (33 cases, 17.55%). Conclusion Adverse reactions induced by olanzapine are worthy of attention. Drug use monitoring has to be strengthened to ensure drug safety. References | Related Articles | Metrics

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Application of Global Trigger Tool in Monitoring Adverse Drug Events of Immunosuppressive Drugs in Kidney Transplant Recipients HAN Zhongling, XIA Jumei, WANG Yirui, YANG Li, TENG Liang 2021, 18(3): 265-270.  DOI: 10.19803/j.1672-8629.2021.03.12 Abstract ( 83 )   PDF (1167KB) ( 346 )   ：Objective To establish an active monitoring model of immunosuppressive drug adverse events (ADE) in renal transplant recipients in a hospital in Xinjiang by using the Global Trigger Tool (GTT). Methods A retrospective analysis of 324 cases of renal transplant recipients was conducted using the GTT. ADE in these cases were classified and graded. Logistic analysis was used to explore the possible factors related to ADE, and a monitoring model of ADE was established. Results All the 39 triggers were positive, the total PPV% was 27.74%, and the positive trigger rate was 97.22%. The detection rate of ADE by the GTT was 68.52% (222/324), the number of ADE detected among every 100 patients was 174.07, compared with 32.03 for every 1 000 patient days. The ADE were divided into 13 categories, the main ones of which were metabolic and nutritional disorders (30.67%), damage to the blood system (17.2%), and opportunistic infections (15.07%). According to the results of binomial logistic analysis, 7 factors were independent risk factors for ADE in renal transplant recipients. The results of methodological study showed that the model was of good predictive value (AUC 0.863). Conclusion The GTT can be used to monitor adverse events of immunosuppressive drugs in renal transplant recipients, but this approach needs to be improved and verified. References | Related Articles | Metrics

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Two Cases of Euglycemic Diabetic Ketosis Induced by Dapagliflozin Tablets CAI Jun, WEI Jing, JI Liwei 2021, 18(3): 271-273.  DOI: 10.19803/j.1672-8629.2021.03.13 Abstract ( 402 )   PDF (845KB) ( 343 )   Objective To remind medical staff to be more vigilant about Dapagliflozin tablets-induced euglycemic diabetic ketosis, and provide reference for safe use of Dapagliflozin tablets. Methods The process of diagnosis and treatment of 2 patients with euglycemic diabetic ketosis caused by Dapagliflozin tablets was analyzed, and the incidence and related risk factors were analyzed based on domestic and foreign literature. Results Two patients with a history of diabetic ketosis developed euglycemic diabetic ketosis 52 and 18 days after taking Dapagliflozin tablets, respectively. Dapagliflozin tablets were discontinued immediately and insulin therapy was given. The ketone bodies turned negative. Conclusion Clinicians should be alert to the risk of euglycemic diabetic ketosis induced by Dapagliflozin tablets, especially in patients with a history of diabetic ketosis. References | Related Articles | Metrics

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One Case of Anaphylaxis Induced by Peg-containing Cyclosporine Injection MAO Min, LIAO Mingyan, MAO Jian 2021, 18(3): 274-276.  DOI: 10.19803/j.1672-8629.2021.03.14 Abstract ( 130 )   PDF (839KB) ( 214 )   Objective To analyze one case of anaphylactic shock caused by cyclosporine injection containing polyethylene glycol (PEG) so as to highlight the need to analyze the potential sensitizing components of the drug. Methods The causes of anaphylactic shock induced by cyclosporine injection during hematopoietic stem cell transplantation in a patient with severe aplastic anemia were analyzed according to the Knoop's score and literature analysis. Results The score was 11, and the "positive" allergic reaction was related to the infusion of cyclosporine injection. Conclusion In case of allergic reaction of drugs containing polyethylene glycol, the causes of allergic reactions need to be analyzed and evaluated with proper evaluation tools. Once the allergic reactions are proved to be related to polyethylene glycol, clinicians should be alert to the possible fatal adverse reactions caused by other drugs containing polyethylene glycol components when they are reused. The adverse reactions should be identified and treated immediately, or other drugs without these ingredients should be used. References | Related Articles | Metrics

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One Case of Severe Diarrhea Induced by Pituitrin Injection YUAN Shijia, HUANG Hui, YANG Xin, FANG Qing, ZHOU Hang 2021, 18(3): 277-279.  DOI: 10.19803/j.1672-8629.2021.03.15 Abstract ( 222 )   PDF (806KB) ( 615 )   ：Objective To explore the mechanism and high-risk factors of diarrhea caused by pituitrin, and to provide reference for clinical rational use of pituitrin. Methods One case of severe diarrhea caused by pituitrin was analyzed. Combined with literature, the measures to prevent and alleviate diarrhea were proposed. Results Diarrhea caused by pituitrin is a new serious adverse reaction. The dosage and a patient's age are closely related to the severity of diarrhea. Conclusion The adverse reactions of diarrhea can be prevented and alleviated by adjusting the route of administration, dosage or via combination of drugs. References | Related Articles | Metrics

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One Case of Severe Skin Damage Induced by Combination of Doxorubicin Hydrochloride Liposome Injection and Paclitaxel for Injection (albumin-binding) ZHOU Xiangzhen, LI Jingtai, REN Shaolin, ZHANG Chunping, ZHANG Tianhua 2021, 18(3): 280-283.  DOI: 10.19803/j.1672-8629.2021.03.16 Abstract ( 1630 )   PDF (853KB) ( 462 )   Objective To remind clinicians to pay close attention to medication safety when doxorubicin liposomes and paclitaxel (albumin-bound type) are used in combination. Methods One case of a 43-year-old female patient with grade 3 hand-foot syndrome and grade 2 intertrigo-like eruption after combined use of doxorubicin liposome and paclitaxel (albumin-bound type) was analyzed. Literature about the clinical manifestations, pathogenesis and prevention of skin toxicity caused by the above two drugs was reviewed. Results The patient's hand-foot syndrome was probably caused by doxorubicin liposomes, and the intertrigo-like eruption by the combined use of doxorubicin liposomes and paclitaxel (albumin-bound). After such symptomatic interventions as dose reduction, delayed chemotherapy and traditional Chinese medicine, the patient' s skin symptoms were gradually relieved. Conclusion The combined use of doxorubicin liposomes and paclitaxel (albumin-bound type) may cause serious skin toxicity and impact the quality of life of patients, which deserves the attention of clinicians. Patients should be better informed of the related risk and take precautions. References | Related Articles | Metrics

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One Case of Drug Treatment and Pharmaceutical Care in Patients with HIT after Coronary Artery Bypass Grafting ZHANG Yongna, ZHANG Yanjiao, ZHAO Li, HAN Yongxin 2021, 18(3): 284-288.  DOI: 10.19803/j.1672-8629.2021.03.17 Abstract ( 108 )   PDF (1005KB) ( 111 )   Objective To investigate the formulation and pharmaceutical care of a case of heparin- induced thrombocytopenia after coronary artery bypass grafting Methods The related literature were searched in recent years, the correlation evaluation of adverse drug reaction was carried out in combination with this case to assist clinicians to formulate individualized treatment plans, including the selection of anticoagulant drugs, the intervention of antibacterial drug use and the dose adjustment of warfarin sodium after discharge, and to give the patients the whole course of pharmaceutical care. Results The patient was discharged from hospital stably, platelet returned to normal, the international normalized ratio reached the standard, and no obvious embolism and bleeding were found during hospitalization. Conclusion Clinical pharmacists assist doctors to formulate and optimize the whole course treatment plan and pharmaceutical care to ensure the safety, effectiveness and economy of drug use. References | Related Articles | Metrics

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Research Progress in Ubrogepant ZHAO Shuang, CHEN Hongying, MIAO Qiuli, LIU Weibing, SONG Yanqing 2021, 18(3): 289-293.  DOI: 10.19803/j.1672-8629.2021.03.18 Abstract ( 130 )   PDF (1171KB) ( 232 )   ：Ubrogepant (trade name: Ubralvy) is an oral, small molecule, highly selective, calcitonin gene-related peptide receptor antagonist (CGRP P-receptor) , which won the first approval of FDA for the treatment of episodic migraine by inhibiting CRGP activity. Compared with conventional drugs for acute migraine, ubrogepant can prevent the episode of acute migraine and reduce the number of episodes, which is better tolerated and has fewer contraindications. This article reviews the mechanism, pharmacokinetics, pharmacodynamics, clinical evaluation and safety of ubrogepant in order toprovide reference for clinical treatment and further research. References | Related Articles | Metrics

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Clinical Application and Adverse Reactions of Lithium Carbonate in Anti-mania DAI Hui, LI Ming, DUANMU Yantao, WANG Fudong, PENG Dongming, YUAN Xiuju, LUO Juan 2021, 18(3): 294-299.  DOI: 10.19803/j.1672-8629.2021.03.19 Abstract ( 189 )   PDF (1116KB) ( 160 )   Objective To summarize the research progress in clinical application and safety of lithium carbonate used for mania, and to provide reference for clinical rational drug use. Methods Domestic and foreign literature on the clinical application and safety of lithium carbonate was reviewed for analysis and comparison. Results The treatment dose of lithium carbonate is close to the toxic dose, which is likely to cause damage to the nervous system, urinary system, endocrine system, gastrointestinal system, and even lithium poisoning. Lithium carbonate is currently often used in combination with other antipsychotic drugs in the treatment of mania, and the blood lithium concentration has to be detected many times during the treatment to ensure the safety of medication. Conclusion Lithium carbonate remains the first-line drug for the prevention and treatment of mania at home and abroad. It is suggested that the combination of lithium carbonate with other antipsychotics be considered in clinical medication. Attention should be paid to the occurrence of adverse reactions, and the rational use of drugs should be promoted according to the blood lithium concentration and individual differences. References | Related Articles | Metrics