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    15 February 2020, Volume 17 Issue 2 Previous Issue    Next Issue

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    Implementation of Pharmacovigilance System in Drug Administration Law and Application of ICH E2 Guideline
    YANG Yue
    2020, 17(2): 65-71. 
    DOI: 10.19803/j.1672-8629.2020.02.01

    Abstract ( 1753 )   PDF (1079KB) ( 1684 )  
    This paper is intended to analyze the difference in adverse reaction reporting and monitoring systems between the previous Drug Administration Law and the pharmacovigilance system specified in the newly revised Drug Administration Law. Starting with the meaning of pharmacovigilance and combined with the macro background of acceleration of new drug authorization since the reform of drug review and approval in China, this paper points out that the pharmacovigilance system can be compared to the braking mechanism for new drug review to enter the “expressway”. Combined with the transformation and application of ICH E2 series guidelines, this paper makes recommendations for the implementation of pharmacovigilance requirements according to the revised Drug Administration Law, such as changing notions about the monitoring and reporting of drugs, improving the efficiency and ability of signal detection, carrying out cumulative risk benefit evaluation, and exploring the requirements of risk management plans suited to China.
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    Acute Toxicity of Mangrove Plant Lumnitzera racemosa Extract on Mice
    CHEN Qingshu, CAI Shaofang, TAN Yuanfeng, WEI Wei, NING Xiaoqing
    2020, 17(2): 72-74. 
    DOI: 10.19803/j.1672-8629.2020.02.02

    Abstract ( 496 )   PDF (996KB) ( 460 )  
    Objective To study the acute toxicity of different extracts of branches and leaves from mangrove Lumnitzera racemosa Willd. on mice. Methods After intragastric administration of the water or 70% ethanol extract of branches and leaves from Lumnitzera racemosa Willd. in mice, the urine and stools, activities, diet and death were observed daily. The median lethal dose (LD50) and 95% confidence intervals (95% CI) were calculated with the Karber method. Results The LD50 of the water extract was calculated to be 65.47 g·kg-1 and the 95% CI was 56.78~75.68 g·kg-1, compared with 62.26 g·kg-1 for 70% ethanol extract and 53.29~70.97 g·kg-1 for the 95% CI. Conclusion The Lumnitzera racemosa Willd. extracts have some toxicity that is related to the concentration of the drug.
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    Bioassay on Aquatic Extract of Processed Radix Aconiti Carmichaeli
    LIU Lei, ZHANG Qiongling, WANG Jiyong, DING Shilan, YOU Yun, XIAO Suping
    2020, 17(2): 75-80. 
    DOI: 10.19803/j.1672-8629.2020.02.03

    Abstract ( 444 )   PDF (1570KB) ( 148 )  
    Objective To set up the bioassay method for aquatic extract of Processed Radix Aconiti Carmichaeli as the supplementary quality control by its toxic effect on rat myocardial cells H9c2. Methods Aquatic extracts of Processed Radix Aconiti Carmichaeli were provided by China National Traditional Chinese Medicine Co., Ltd. with the batch numbers of HSPYN, HSPSXHZ, HSPSCJY, and HSPSCJY1 separately. The optimized experimental conditions were investigated from the points of cells seeding density, action duration, concentration-response relationship, precision and repeatability test. The growth curve of H9c2 cardiomyocytes was measured by the CCK-8 method to find the optimal cell density and drug action time; and the concentration-response relationship of Processed Radix Aconiti Carmichaeli on cardiomyocytes vitality was determined too. Toxicity evaluation of four batches of Processed Radix Aconiti Carmichaeli was performed and repeated for at least 5 times to determine the dose limit and toxic effect range. Results Batch of HSPYN was used to do the methodological investigation. The cell density was chosen as 5.0×104/ mL and 100μL was seeded in 96-well plates,and the drug action time of 12h showed more stable effects. With the concentrations at 15.6, 31.3, 62.5, and 125.0 μg•mL-1 of Processed Radix Aconiti Carmichaeli, the inhibition rates on H9c2 vitality were 24.5±3.4%, 26.9±6.2%, 27.3±8.8%, and 39.5±11.3% respectively. The main component of Processed Radix Aconiti Carmichaeli, neoaconitine (100 μg•mL-1) was selected as a positive control, and the inhibition rate ranged from 24.6% to 32.4%. With the precision and repeatability of bioassay experiments on all the four batches carried out, it was determined that the inhibition rate on cardiomyocytes vitality was stable within the range of 21.4±1.9% at the concentration of 15.6 μg•mL-1. Conclusion Associated with the clinical indications and toxicity of Processed Radix Aconiti Carmichaeli, its inhibited effect on cardiomyocytes viability might be used as an indicator for bioassay as the supplementary quality control. The testing sample with concentration of 15.6 μg•mL-1 with inhibition rate above 20.0% might be judged as qualified.
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    Effects of Dexmedetomidine on Anesthesia and Cognitive Function in Elderly Patients Undergoing Laparoscopic Cholecystectomy
    QIAO Kekun, LI Xiang
    2020, 17(2): 81-86. 
    DOI: 10.19803/j.1672-8629.2020.02.04

    Abstract ( 458 )   PDF (1197KB) ( 148 )  
    Objective To study the effect of dexmedetomidine on anesthesia and cognitive functions in elderly patients undergoing laparoscopic cholecystectomy. Methods A total of 100 elderly patients undergoing laparoscopic cholecystectomy in our hospital between March 2017 and March 2019 were selected, who were equally divided into group A and group B using the random number table method. Group A received general anesthesia while group B was additionally given dexmedetomidine. The hemodynamics [mean arterial pressure (MAP), heart rate (HR)], anesthesia effect [bispectral index (BIS)], general anesthesia dosage, cognitive function [mini-mental state examination scale (MMSE)] and adverse reactions were compared between the two groups. Results The MAP, HR and BIS in group B 10 minutes into anesthesia (T1), during cholecystectomy (T2), and post-operatively (T3) were significantly lower than those in group A, and the difference was statistically significant (P < 0.05). The dosage of general anesthesia and the incidence of cognitive impairment in group B were significantly lower than those in group A, while the MMSE scores in group B at 12, 24 and 72 h after operation were significantly higher than those in group A, and the difference was statistically significant (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion Dexmedetomidine can effectively improve the hemodynamics and anesthesia effect of elderly patients undergoing laparoscopic cholecystectomy, thus helping to reduce the dosage of general anesthesia and cognitive impairment. It is safe and should be made more accessible.
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    Drug Risk Communication in the European Union and United States between Regulators and the Public
    WU Shifu, JIN Yi, CHANG Hong, TIAN Yuejie, XU Kui, XU Lili, GUO Fanling, ZHANG Jingdong
    2020, 17(2): 87-92. 
    DOI: 10.19803/j.1672-8629.2020.02.05

    Abstract ( 575 )   PDF (1186KB) ( 385 )  
    Objective To make recommendations for the construction of China's model for drug safety risk communication by analyzing the current drug risk communication in the European Union and United States. Methods By consulting domestic and foreign literature, retrieving relevant regulations on drug safety risk information exchange, browsing the official websites of drug regulatory authorities and other websites, we harvested information on exchange institutions and regulations, contents, timing, methods and effects of such information exchange in the European Union and United States before we made a comparison with China. Results Literature research showed that drug risk communication was an important part of drug risk control. Europe and the United States became aware of the importance of risk communication long ago and built a better risk communication system. In order to achieve a better effect, flexible and diverse communication methods were adopted and improved. This analysis found that strengthening information exchange with the public was the basic means of national drug supervision. The ways of communicating with the public are to be diversified, facilitated, informatized and targeted, and there should be a two-way flow of drug safety information. Conclusion More attention should be paid to the role of risk information exchange in drug risk management. The systems, mechanisms and methods for such communication should be made more accessible, and results of communication should be evaluated.
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    Establishment and Application of Intelligent Reporting System for Adverse Drug Reactions in Hospitals
    ZHOU Hong, JIN Hongchang, QIN Jinfeng, ZHAO Feiyu, HE Renxian, XIE Lixia, TIAN Xiaodong
    2020, 17(2): 93-97. 
    DOI: 10.19803/j.1672-8629.2020.02.06

    Abstract ( 610 )   PDF (1294KB) ( 297 )  
    Objective To streamline the workflow of reporting adverse drug reactions by the medical staff and improve the quality and timeliness of ADR reporting. Methods Based on the hospital information system and electronic medical record system, an ADR reporting system was developed on our own. This reporting system adopted Brower/Server architecture, Web-service, and EXT technology and related database Sql server 2010, and obtained data on electronic medical records through the Web-service technology. This adverse drug reaction system platform was incorporated into the hospital information system (HIS) and had a seamless connection with the Guangdong Province Adverse Drug Reaction Platform to achieve the integration of data collection, input, printing, export and reporting to provincial platforms. This system was able to monitor the whole process of ADR reporting in the hospital. Results In the four years after the ADR reporting system was applied, the hospital received a total of 2,864 reports of adverse drug reactions. This system simplified the ADR reporting process, made reporting less time-consuming, improved the quality of reporting, and ensured the accuracy of ADR reporting data. This system has also been adopted by other hospitals in the same district. Conclusion The establishment and application of the ADR reporting system can help reduce the workload of medical staff and improve the quality and efficiency of ADR reporting.
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    Current Abuse/Use of Compound Tramadol in Drug Abusers
    WANG Jiayu, YU Dandan, LI Ming, WANG Ling, LIU Pengcheng, SUN Jun
    2020, 17(2): 98-105. 
    DOI: 10.19803/j.1672-8629.2020.02.07

    Abstract ( 652 )   PDF (1558KB) ( 311 )  
    Objective To find out about the behavioral characteristics of abusers/users of compound tramadol in compulsory isolated treatment centers in China in order to provide data for effective management of compound tramadol. Methods A descriptive statistical analysis was conducted on the basis of a self-designed questionnaire distributed among abusers/users of compound tramadol in compulsory isolated treatment centers. Results The abusers/users of compound tramadol were mostly over 30 years old, male, poorly-educated below the level of junior high school or unemployed. More than half of the abusers/users of compound tramadol believed that compound tramadol was easily available. Those who abused/used compound tramadol solely due to easy availability accounted for 25.56% of the total with retail pharmacies as the main source. Conclusion The lack of regulation and easy availability are largely responsible for abuse/use of compound tramadol. It is suggested that compound tramadol should be enlisted in the national catalogue of class II psychotropic drugs. Meanwhile, we should strengthen the supervision of its sales and use, establish a drug traceability system, and improve the monitoring and evaluation system.
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    Pharmacists' Participation in the Treatment of a Patient with Complicated Abdominal Infection Secondary to Invasive Fungal Infection
    ZHOU Ran, CHEN Zhangzhang
    2020, 17(2): 106-110. 
    DOI: 10.19803/j.1672-8629.2020.02.08

    Abstract ( 424 )   PDF (1106KB) ( 388 )  
    Objective To investigate the role of clinical pharmacists in the medication of a patient with complicated intra-abdominal infection after gastrointestinal surgery. Methods By participating in the medication of a patient with complicated abdominal infection secondary to invasive fungal infection, clinical pharmacists were able to find the causes of acute kidney injury of the patient and adjusted the dosage of vancomycin immediately according to the result of treatment with vancomycin. Then, these clinical pharmacists suggested adjusting the therapeutic regimen after comparing the pharmacodynamics and pharmacokinetics of such antifungal agents as triazole, echinocandins and polyene in line with the latest guidelines before the clinicians took the advice. Results After seven days of treatment with this regimen, the blood culture of the patient was negative, so clinical pharmacists suggested that the patient be returned to an ordinary ward for further treatment. Conclusion Clinical pharmacists can assist clinicians in adjusting the drug regimen and improve the level of clinical medication by making full use of their knowledge of pharmacy.
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    Analysis of Acute Coagulation Dysfunction Induced by Cefoperazone Sulbactam Sodium for Injection
    LAN Bo, LI Jia, ZHOU Ganping
    2020, 17(2): 111-113. 
    DOI: 10.19803/j.1672-8629.2020.02.09

    Abstract ( 800 )   PDF (840KB) ( 505 )  
    Objective To explore the treatments of acute coagulation dysfunction by cefoperazone sulbactam sodium. Methods A case who diagnosed with acute coagulation dysfunction due to cefoperazone sulbactam sodium was analyzed, we were trying to explore the treatments by medical literature retrieval. Results The patient was diagnosed as dysfunction of blood coagulation due to cefoperazone sulbactam sodium and the drug was stopped the same day, change with IV infusion of piperacillin tazobactam sodium and intramuscular injection of vitamin K1. The coagulation index of the patient decreased gradually and returned to normal on the 4th day after drug withdrawal. Conclusion Acute coagulation dysfunction caused by cefoperazone sulbactam sodium should stop infusing immediately, and intramuscular injection of vitamin K1 must be given with infusion of fresh frozen plasma.
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    Analysis of Muscle Ache Induced by Pirfenidone Capsules
    LIU Lei, WANG Yong, QIAN Xiaosen, WANG Pan, SUN Ruifang
    2020, 17(2): 114-116. 
    DOI: 10.19803/j.1672-8629.2020.02.10

    Abstract ( 598 )   PDF (817KB) ( 453 )  
    Objective To explore the mechanism and treatment of muscle ache caused by pirfenidone. Methods The diagnosis and treatment process of one patient with muscle ache caused by pirfenidone were analyzed. Based on literature review, the causal relationships between pirfenidone and muscle ache, the mechanism of its occurrence and the focus of treatment were outlined. Results and Conclusion The symptoms of muscle ache caused by pirfenidone are related to the increased dose of pirfenidone, which can remind clinicians to pay attention to the new pharmaceutical care points in the process of treatment with pirfenidone. Doctors can take such active measures as reducing the dosage, stopping the medication or adjusting the treatment plan according to the condition of patients.
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    Aflatoxin and Ochratoxin A Contamination in Chinese Herbal Medicines
    LIU Rui, ZHANG Xinyue, MAO Wenwen, FENG Hong, WANG Yadong, ZHANG Donghao, ZHANG Lanlan
    2020, 17(2): 117-120. 
    DOI: 10.19803/j.1672-8629.2020.02.11

    Abstract ( 505 )   PDF (1093KB) ( 460 )  
    In recent years, there have been increasing incidents of mycotoxin excess that attract attention both at home and abroad, which has a negative effect on the development of traditional Chinese medicine. In this paper, the contamination of Chinese herbal medicines by mycotoxinin was analyzed, the limit standard of mycotoxin was summarized, and the current research of detection methods of mycotoxin was outlined in the hopes of contributing to the study on the safety of Chinese herbal medicines.
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    A Summary of Report of the Council for International Organizations of Medical Sciences (CIOMS) Working Group X on Evidence Synthesis and Meta-Analysis for Drug Safety
    Jesse A. BERLIN, FANG Xiaoyan, ZHANG Yongjing
    2020, 17(2): 121-125. 
    DOI: 10.19803/j.1672-8629.2020.02.12

    Abstract ( 812 )   PDF (501KB) ( 348 )  
    Meta-analysis is the most important quantitative method in evidence-based medicine and has been widely applied to assess the efficacy during (and after) drug development. Recently, Meta-analysis used in studying safety outcomes has had a major impact on clinical or drug regulatory decisions. However, due to the difference of study design between safety and efficacy study, there are currently a number of challenges to the use of Meta-analysis to study drug safety. Hence, this paper is intended to present the aims of the CIOMS X guidance document, including comments on the intended audiences for the document. We present the key issues in Meta-analysis for drug safety, focusing on Meta-analyses of randomized clinical trials.
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