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20 December 2018, Volume 15 Issue 12 Previous Issue    Next Issue

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Assessment of Rationality, Safety and Adherence of Dabigatran in Patients with Nonvalvular Atrial Fibrillation YANG Yuhui, LUO Zhurong, ZHENG Weixing, HUANG Mingfang, LIN Yi, CAO Xiaozhi, ZHANG Wenli 2018, 15(12): 705-708.  Abstract ( 497 )   PDF (691KB) ( 151 )   Objective To analyze the rationality of dabigatran application in the patients with nonvalvular atrial fibrillation(NVAF), as well as the safety and adherence, so as to better guide clinical therapy and obtain foundation for further research． Methods A retrospective research was conducted on patients with NVAF who were given dabigatran from January 2016 to January 2018． The rationality, safety and adherence of dabigatran application were evaluated by retrospective cases analysis and telephone follow-up method． Results A total of 109 patients (average age 68.26±10.82, average CHA2DS2-VASc score 3.21±1.30, average HAS-BLED score 1.38±1.02)were enrolled． 9 patients had a CHA2DS2-VASc score=0, 3 of them had no indication of anticoagulant therapy. 91 patients were given dabigatran of 110 mg. 18 patients were given dabigatran of 150 mg and 5 of their dosage were unsuitable. 4 patients had wrong frequency of dosage. 13 patients had adverse reactions. 34 patients changed their anticoagulant and 41.18% of them had unreasonable international normalized ratio (INR). 16 patients were given amiodarone at the same time and 7 of them had no regular follow-up. 11 patients stopped taking pills and 7 of them had no doctors' instructions. 15.60% of the patients had no regular follow-up. 43.12% of the patients didn't test their urine occult blood regularly. Conclusion Dabigatran has good safety and adherence with some adverse reactions. Part of the patients paid inadequate attention to the risk and had no regular follow-up. Medication education according to guidelines is necessary to improve the safety and adherence of dabigatran application. References | Related Articles | Metrics

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Comparative Analysis of Long-term Glycemic Control in Patients with Type 2 Diabetes Mellitus Treated with Insulin Glargine and Acarbose Combined with Metformin QI Renjuan, SA Xiaojun, SONG Jie, ZHANG Yongming 2018, 15(12): 709-712.  Abstract ( 404 )   PDF (683KB) ( 140 )   Objective To evaluate the effect of insulin glargine and acarbose combined with metformin on long-term glycemic control in patients with type 2 diabetes. Methods 86 patients with type 2 diabetes were divided into control group (metformin combined with acarbose) and the research group (metformin combined with insulin glargine) randomly, 43 cases each. Blood glucose levels (FBG, 2 h PBG, HbAlc), oxidative stress (MDA, SOD, GSH-PX), and lipid metabolism indicators(TC, TG, LDL-C), blood glucose compliance rate and incidence of adverse reactions were compared between the two groups before treatment, 6 months after treatment, and 12 months after treatment. Results After 6 months and 12 months of treatment, the blood glucose levels of FBG, 2 h PBG and HbAlc in the study group were lower than those in the control group (P <0.05); the levels of SOD and GSH-PX were significantly higher than those in the control group; the level of MDA was significantly lower than that of the control group (P <0.05); and the blood glucose standard-reaching rate and the incidence of adverse reactions were not statistically significant (P >0.05). Conclusion Metformin combined with insulin glargine is effective in the treatment of type 2 diabetes with a better long-term prognosis Keywords: metformin; insulin glargine; acarbose; type 2 diabetes; long-term glycemic control References | Related Articles | Metrics

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Research on Post-marketing Surveillance System of Vaccine in European Union XI Hao, WANG Chong 2018, 15(12): 713-720.  Abstract ( 513 )   PDF (981KB) ( 874 )   Objective To offer reference for China, Post-marketing Surveillance System of Vaccine in European Union was introduced. Methods Literatures, regulations and laws relating to post-marketing surveillance system of vaccine were collected. Results Specific requirements were proposed by European Union through legal framework. Risk management system, periodic safety update report and additional monitoring list were utilized to recognize potential adverse events signal. Reevaluation of vaccine was proceeded by post-authorization safety studies. Conclusion European Union has established unified long-term monitoring system, completed drug safety communication mechanism and put the idea of risk control all through the process of surveillance. References | Related Articles | Metrics

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Survey and Consideration on Safety Status of Traditional Chinese Medicine Application in 685 Primary Healthcare Workers LI Ang, ZHANG Bing 2018, 15(12): 721-727.  Abstract ( 515 )   PDF (921KB) ( 166 )   Objective To analyze the current situation of safe use of traditional Chinese medicines (TCMs) in primary medical institutions in China, and to provide reference for improving the awareness and ability of safe and rational drug use in primary healthcare workers. Methods 685 primary healthcare workers from 28 provinces were investigated by anonymous survey questionnaires. The questionnaires included the basic information of respondents, the elementary knowledge of TCM safety, how to inform the patients about the medication, adverse reactions of TCM injections during clinical use. And 52 primary healthcare workers were interviewed randomly. The collected information was recorded in the Excel software, and classified, summarized and analyzed. Results 685 questionnaires were distributed, and the recovery was 100%. 55.04% of the respondents were western medicine professional, 12.70% were Chinese medical professional and 29.20% were integrated Chinese and western medical professional. Practitioners could prescribe Chinese patent drug and decoction pieces. But they did not know enough about Chinese patent drug which contains toxic ingredients and western medicine ingredients. Primary healthcare workers could take the particularity of each patient into account and inform them of drug use. In 52 respondents, 36 respondents had not been trained on reporting adverse drug reactions (ADRs). Conclusion Primary healthcare workers have awareness of safe use of Chinese medicine and can correctly handle ADRs. But they lack knowledge about the TCM safety and awareness of ADR; thus they cannot make rational use of drugs in clinical medication. Due to lack of relevant training content of ADR, it is suggested that strengthen the training of drug safety and ADR reporting in basic medical institutions, to promoting rational use of medicine in medical institutions. References | Related Articles | Metrics

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Analysis of 4217 Cases of Adverse Drug Reactions Induced by Progesterone Oral Agents HU Tingxia, LV Xiaoqin, LI Lan, TAO Qiaofeng 2018, 15(12): 728-732.  Abstract ( 411 )   PDF (755KB) ( 438 )   Objective To study the features of adverse drug reactions(ADRs) induced by progesterone oral agents, so as to provide rational use of drugs in clinic. Methods 4 217 cases of ADRs report caused by progesterone oral agents consisted of feedback data of related drug manufacturers and data reported by provincial ADRs monitorting system were collected from 2009 to 2017 and performed the statistical analysis by the Excel 2010 electronic form. Results Most cases of ADRs report caused by progesterone oral agents happened on the day of medication. Adverse reactions mainly included central and peripheral nervous system damage, followed by gastrointestinal system damage and systemic damage. As the extension of the duration of drug application, cases involved in hepatobiliary system damage were reported. Conclusion Hospital staff and patients should pay attention to ADRs induced by progesterone oral agents,especially for the influence of psychiatric and neurological system such as dizziness, vertigo, somnolence, syncope et al. Production enterprises should promptly revise and improve the safety information of drug instructions, so as to ensure the safety of drug use for patients. References | Related Articles | Metrics

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Literature Review of 224 Adverse Reactions Cases Induced by Imatinib ZHU Hongmei 2018, 15(12): 733-737.  Abstract ( 376 )   PDF (1201KB) ( 267 )   Objective To pay more attention to the adverse drug reactions induced by imatinib and provide references for rational use of drugs. Methods Using "imatinib", "gleevec", "adverse reaction"and "to"as key words, the articles in the CNKI database from January 2000 to March 2018 were searched and retrieved. Fifty-five references which met the inclusion and exclusion criteria were extracted and analyzed. Results 224 cases were extracted. There were more male patients than female patients, and more elderly patients. Chronic myeloid leukemia and gastrointestinal stromal tumors were the primary diseases. Systems and organs mainly involved in adverse reactions were blood, skin and its appendages, general reactions, cardiovascular, urinary, liver, gallbladder and respiratory systems. The main clinical manifestations were neutropenia, thrombocytopenia, elevated SGOT/SGPT, etc. Other clinical manifestations were erythema multiforme, edema, fluid retention, myalgia, muscle pain spasm and abnormal function of liver and kidney. Conclusion Clinical application of imatinib should be highly alert to adverse reactions; drug monitoring, risk communication and rational drug use guidance should be strengthened; so as to improve drug safety. References | Related Articles | Metrics

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Thinking on Rational and Safe Use of Miao Medicines Based on Pharmacovigilance SI Yuancheng, WU Gaoxin, QING Lei, CHEN Bo 2018, 15(12): 738-740.  Abstract ( 452 )   PDF (713KB) ( 222 )   Objective To think about rational and safe use of Miao medicines based on pharmacovigilance. Methods Through retrieving the literatures of Miao medicines, we arranged and summarized the irrational and unsafe use of Miao medicines to put forward suggestions based on pharmacovigilance. Results Using the Methods of pharmacovigilance, comprehensive monitoring of the production, circulation, listing and reevaluation of Miao medicines, they will be better and safer. Conclusion It is imperative to use the theory of pharmacovigilance to guide Miao medicines use for rationality and safety. References | Related Articles | Metrics

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Drug Composition and Rationality Evaluation of Respiratory Diseases in Pediatric Emergency Department of Our Hospital HU Xue, LIU Xin, LANG Luji, ZHANG Yongkai 2018, 15(12): 741-745.  Abstract ( 381 )   PDF (706KB) ( 144 )   Objective To understand the drug composition of respiratory diseases in pediatric emergency department in our hospital and provide reference for clinical rational use of drugs. Methods We collected 17 210 pediatric emergency prescriptions and 50 613 medical orders of our hospital in the first 6 days of each month from August to October in 2017, including 14 424 prescriptions for respiratory diseases and 41 927 medical orders, to analyze the pharmacologic categories, drug dosage forms and different pharmacologic categories of respiratory diseases. Results Among the 41 927 medical orders of the respiratory system, 10 049 (23.97%) were antibacterial agents, 9 347 (22.29%) were Chinese patent medicine, 8 873 (21.16%) were antiviral agents, 31 508 (75.15%) were injections and 10419 (24.85%) were other types of drugs. Conclusion Antibiotics, Chinese patent medicines and antiviral drugs were the main drugs used in the pediatric emergency respiratory system diseases in our hospital, but there was an imbalance in the selection of drug dosage forms, especially antibiotics, antiphlegm, antitussive, antiasthmatic drugs and antipyretic analgesics, in which injections were overused. References | Related Articles | Metrics

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Analysis of Clinical Medications in Children with Acute Bronchopneumonia FANG Sixiao, YANG Yue 2018, 15(12): 746-750.  Abstract ( 422 )   PDF (728KB) ( 188 )   ObjectiveBy collecting the medications of acute bronchopneumonia in children in our hospital, to analyze drug use in these patients, and provide some reference for the rational use of drugs. Methods The medical records of acute bronchopneumonia in children from November 2016 to November 2017 were collected, and the rationalities of the use of drugs with acute bronchopneumonia in children were analyzed. Results A total of 432 cases were collected, where 3 961 medications in total and 9.17 medications per patient were prescribed. These medications were involved in 6 types of 25 kinds of drugs, and the selection of drug varieties was generally reasonable. There were 618 irrational medical orders, accounting for 15.60% of the total medication orders. Irrationally used drugs included traditional Chinese medicine injections and antibacterial drugs. The categories of irrational use were mainly inappropriate usage/dosage and inappropriate route of administration. Conclusion The use of drugs in children with acute bronchial pneumonia in our hospital was basically reasonable, but there were still a few irrational prescriptions. The use of antibacterial drugs and traditional Chinese medicine injections should be strengthened to improve the rational use. References | Related Articles | Metrics

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Analysis of Unreasonable Prescription Intervention of A Mental Hospital Outpatient Pharmacy from 2016 to 2017 YANG Chenchen, ZHAO Yinglian, LIU Kai 2018, 15(12): 751-754.  Abstract ( 426 )   PDF (790KB) ( 217 )   Objective To explore how to improve the quality of prescription by prescription intervention in the mental hospital outpatient pharmacy. Methods The retrospective study was used to analyze all the intervened prescriptions from January 2016 to December 2017 in hospital outpatient pharmacy, and the unreasonable prescriptions were classified and evaluated to analyze the cause of error and improve measures. Results A total of 683 cases of prescription interventions were conducted from 2016 to 2017, and the unreasonable prescription rate of intervention decreased from 2.21‰ in 2016 to 1.15‰ in 2017 (χ2 =36.313, P <0.05). The composition difference of unreasonable prescriptions in 2016 and 2017 was statistically significant (χ2 =20.599, P <0.05). In 2016, the success rate of prescription interventions was 79.1%, and in 2017, it was 84.7%. The difference in success rate of interventions between two years was not statistically significant (χ2 =3.230, P =0.072). Conclusion Through the joint development of real-time interventions and administrative interventions, prescription interventions have achieved certain success and the quality of prescriptions has been improved significantly. References | Related Articles | Metrics

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Advances in Research on Targeted Treatment of Alzheimer's Disease WANG Shuo, CHEN Naihong, YUAN Yuhe 2018, 15(12): 755-760.  Abstract ( 548 )   PDF (800KB) ( 378 )   Alzheimer's disease (AD) is a chronic neurodegenerative disease which pathogenesis has not been fully elucidated. Its main pathological features are intracellular formation of neurofibrillary tangles (NFTs) and senile plaques formed by deposition of external amyloid β-peptide (Aβ). The clinical manifestations of AD patients have a gradual decline in memory and a gradual loss of daily behavioral ability, eventually progressing to long-term memory deficits. The long-term nature of AD has caused enormous emotional and financial burdens on patients, families of patients, and even society as a whole. The possible pathogenic factors are also widely discussed, but the pathogenic factors that have been clearly identified are Aβ protein deposition, inflammatory response, mitochondrial dysfunction, oxidative stress damage, and abnormal phosphorylation of Tau protein. Starting from the pathogenesis of AD, with the corresponding pathological factors as the target, the development of drugs with new pharmacological activities is underway. This article mainly discusses some research progress in the treatment of AD in recent years, aiming to provide new strategies and directions for future drug development. References | Related Articles | Metrics

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One Case of Severe Myelosuppression and Diarrhea Induced by Irinotecan Injection in a UGT1A1*28 Wide-type Patient ZHOU Qiuyun, ZHANG Yu, ZHANG Liang, LU Lei, LU Tao 2018, 15(12): 761-763.  Abstract ( 381 )   PDF (575KB) ( 144 )   References | Related Articles | Metrics

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One Case of Gynecomastia Induced by Amlodipine Besylate Tablets ZHAO Yingying, HUANG Bei, CHAI Weibing, CHEN Xiaojiang, XIA Xiaojian, GAO Shiyi 2018, 15(12): 764-765.  Abstract ( 511 )   PDF (552KB) ( 443 )   References | Related Articles | Metrics

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One Case of Hallucination Induced by Levofloxacin Sodium Chloride Injection Combined with Nimesulide Tablets CHEN Congqin, CHEN Zhiqiang, CHEN Chunmei, ZHANG Qiang 2018, 15(12): 766-766.  Abstract ( 426 )   PDF (541KB) ( 192 )   References | Related Articles | Metrics

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One Case of Anaphylactic Shock Induced by Ornithine Aspartate for Injection TIAN Ying, HU Guangxu 2018, 15(12): 767-768.  Abstract ( 351 )   PDF (561KB) ( 203 )   References | Related Articles | Metrics