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15 March 2020, Volume 17 Issue 3 Previous Issue    Next Issue

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Present Situation and Prospect of Antiviral Treatments for COVID-19 TIAN Di, WANG Lin, GE Ziruo, CUI Shuping, CHEN Zhihai 2020, 17(3): 129-135.  DOI: 10.19803/j.1672-8629.2020.03.01 Abstract ( 2352 )   PDF (1004KB) ( 1305 )   In December 2019, a series of pneumonia cases of unknown cause emerged in Wuhan, Hubei Province. In January 2020, a new type of coronavirus (2019-nCoV) was isolated. With the outbreak of COVID-19, the number of severe, critical and death cases is increasing gradually. In the diagnosis and treatment program of our country, the oral administration of lopinavir/ritonavir and the atomization of α-interferon were used, and ribavirin, chloroquine phosphate and abidol can also be used for antiviral treatment.The plasma of convalescent patients can be used for the treatment of severe and critical patients. Recently, a United States report that the first case of 2019-nCoV infection confirmed patient have been significantly improved after treatment with remdesivir. Fabiravir is also considered to have potential efficacy. Antiviral treatment is the key to the treatment of severe and critical diseases. In this paper, the present situation and prospect of selective antiviral treatments for COVID-19 is reviewed. References | Related Articles | Metrics

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Comparative Study of Acute Toxicity of Different Enriched Components of Volatile Oil of Asarum in Mice ZHAO Shaozhe, WANG Lin, ZHAO Xiujuan, GAO Shuang, YANG Jinghua, ZHENG Qingge, ZHANG Xiaochen, LI Lingjun, RONG Rong, YANG Yong 2020, 17(3): 137-142.  DOI: 10.19803/j.1672-8629.2020.03.02 Abstract ( 774 )   PDF (1415KB) ( 305 )   Objective To explore the acute toxicity of different enriched components in Asarum on mice. Methods The Asarum volatile oil group, supercritical fluid extraction group and water extraction group were prepared respectively. The acute toxicity of different components of Asarum on mice was compared using classical acute toxicity test methods. Results The main symptoms and signs of acute toxicity were convulsions, dispiritedness and breathlessness. Most of the deaths occurred within 12 hours of drug treatment. 24 hours after drug treatment, the surviving mice started to recover their spirits and appetite, and few mice died within the next 14 days. Enriched volatile oil of xanthine, enriched volatile oil of methyl eugenol, total volatile oil LD50 and 95% confidence intervals were 428.9 g·kg-1(373.28~530.61 g·kg-1·d-1),576.92 g·kg-1(492.04~653.17 g·kg-1·d-1) and 158.35 g·kg-1(126.07~184.29 g·kg-1·d-1) respectively. Conclusion The acute toxicity intensity of different components of Asarum volatile oil in mice is the highest in the total volatile oil group, followed by the enriched safrol volatile oil group and enriched methyl eugenol volatile oil group. This study is expected to provide reference for the safe use of Asarum. References | Related Articles | Metrics

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Evaluation of Azithromycin in Different Treatment Protocols on Pediatric Mycoplasma Pneumoniae Pneumonia GOU Jinghui, RAN Hailong, XI Xin, DU Qian 2020, 17(3): 143-147.  DOI: 10.19803/j.1672-8629.2020.03.03 Abstract ( 1076 )   PDF (993KB) ( 415 )   Objective To evaluate the efficacy, safety and cost of azithromycin in the treatment of pediatric Mycoplasma pneumoniae pneumonia. Methods A total of 220 children with Mycoplasma pneumoniae pneumonia who were treated in a hospital in 2018 were selected. According to the treatment protocols, these patients were divided into two groups: group A that had 123 patients treated with azithromycin intravenous infusion plus cefuroxime and group B in which 97 patients received azithromycin intravenous monotherapy. The clinical manifestations, length of hospital stay and cost of antibiotics were compared between the two groups. Results There was no significant difference in the general data between the two groups (P>0.05). There was also no significant difference in the clinical symptoms of fever, duration of cough and lung rale, length of hospital stay, clinical effect, or incidence of adverse reactions between the two groups after treatment (P>0.05). However, there was statistically significant difference in the cost of antibiotics and the total cost of hospitalization (P<0.05), The cost-effectiveness ratio of treatment protocols in group B was significantly lower than that of group A. Conclusion Different treatment protocols of azithromycin have similar efficacy and safety in the treatment of pediatric Mycoplasma pneumoniae pneumonia, but azithromycin monotherapy regimens are more economical. References | Related Articles | Metrics

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Methods for Quality Evaluation of Individual Case Reports of Adverse Drug Reactions in China CHEN Liye, AN Lianyu, SHI Ping, WANG Shuling 2020, 17(3): 148-153.  DOI: 10.19803/j.1672-8629.2020.03.04 Abstract ( 1360 )   PDF (1099KB) ( 1027 )   Objective To seek a long-term method for evaluating the quality of individual case reports of adverse drug reactions so as to evaluate case reports more accurately. Methods By analyzing literature, looking at current evaluation methods at home and abroad, and consulting experts, the weight of indicators was determined. AHP was used to establish the quality evaluation system of individual case reports on ADRs. Results This evaluation system was well-designed as evidenced by the evaluation of 40 ADR reports from a big A hospital. Conclusion The evaluation system of individual ADR cases based on characteristics of multiplication calculation is scientific and well-grounded, which can facilitate the dynamic management of the content of ADR reports and improve the efficiency of evaluation. References | Related Articles | Metrics

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Thoughts on Establishment of Trans-disciplinary Pharmacovigilance System WANG Xinhao, LU Xianping 2020, 17(3): 154-156.  DOI: 10.19803/j.1672-8629.2020.03.05 Abstract ( 751 )   PDF (843KB) ( 570 )   In recent years, NMPA has accelerated the approval of drugs that are urgently needed and those for rare diseases and innovative treatment by reforming the drug review and approval system. This has gone a long way towards meeting the needs of Chinese patients for innovative drugs. At the same time, serious challenges are posed to drug safety risk monitoring in China. In 2018, NMPA issued a notice (No. 66) to enforce the legal responsibility of Marketing Authorization Holders (MAH) for reporting and monitoring of adverse drug reactions (ADR). Thus, pharmacovigilance by MAHs should be switched from the collection and analysis of individual cases to comprehensive and systematic safety evaluation and risk management of drugs. Pharmacovigilance is a trans-disciplinary science, compelling MAHs to effectively integrate the internal and external resources of the company and build a closely cooperative and coalition network of pharmacovigilance in order to better monitor and assess drug safety risks, fulfill the legal responsibility of the holders, and ensure the drug safety of patients. References | Related Articles | Metrics

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Analysis of Ketoacidosis Induced by Dapagliflozin Tablets YUAN Menghu, QIAN Fengdan 2020, 17(3): 157-160.  DOI: 10.19803/j.1672-8629.2020.03.06 Abstract ( 2212 )   PDF (781KB) ( 3108 )   Objective To explore the safety of dapagliflozin tablets in clinical application. Methods This article summarizes two cases which have been diagnosed with ketoacidosis after using dapagliflozin tablets from Shanghai General Hospital in November 2018. In addition, relevant literatures at home and abroad are reviewed. Results The two diabetic patients began to show symptoms of tolerance, nausea and vomiting without obvious inducement on the 6th and 1st day after taking dapagliflozin tablets respectively. On the 7th and 6th day after taking the tablets, they were diagnosed with ketoacidosis through laboratory examination. Their symptoms improved after drug withdrawal, fluid rehydration, low-dose insulin intravenous drip, electrolyte correction and other treatments. Conclusion Dapagliflozin tablets may cause ketoacidosis. Medical personnel should pay attention and use carefully in high-risk groups. References | Related Articles | Metrics

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Nutritional Support and Pharmaceutical Care of a Case of Severe Acute Pancreatitis by Clinical Pharmacists LI Meng, WANG Xin, ZHANG Shuai, CHEN Gang 2020, 17(3): 161-164.  DOI: 10.19803/j.1672-8629.2020.03.07 Abstract ( 520 )   PDF (918KB) ( 275 )   Objective To explore the methods and significance of pharmaceutical care for patients with severe acute pancreatitis on the part of clinical pharmacists. Methods Clinical pharmacists participated in the treatment of a patient with severe acute pancreatitis, monitored blood lipids and electrolytes without delay, and adjusted the nutrition-supported therapies and pharmaceutical care from the acute stage to the stable stage. Results Clinical pharmacists committed to enteral and parenteral nutrition, when participating in nutrition-supported treatment, could bring into play their expertise, help doctors formulate treatment plans and improve the level of clinical nutritional support. Conclusion Clinical pharmacists with a good knowledge of nutrition can cooperate with clinicians in monitoring adverse reactions, adjusting therapies, promote rational drug use and improve the level of health care. References | Related Articles | Metrics

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Labeling of Instructions for Biopharmaceuticals for Intravenous Infusion LIU Min, HU Xue, LI Yanjiao, SONG Yanqing, WANG Xiangfeng 2020, 17(3): 165-168.  DOI: 10.19803/j.1672-8629.2020.03.08 Abstract ( 503 )   PDF (1020KB) ( 318 )   Objective To find out about the instructions for biopharmaceuticals for intravenous infusions in our hospital in order to provide reference for rational use of drugs. Methods A total of forty-seven instructions for biopharmaceuticals for intravenous infusion were collected in our hospital, and statistical analysis was conducted of the drug delivery route, storage, medium selection, infusion rate, infusion set requirements, flushing, preparation process, and preparation liquid storage. Results Among the forty-seven instructions for intravenous biologics, the labeling rate of drug delivery and storage information was 100%. Despite the high labeling rate of medium selection, infusion rate, and preparation process, some of the information was implicit. Infusion apparatus was labeled in twenty-three instructions (48.94%), flushing in one (2.13%), and the expiry date of preparation liquids was in 20 (42.55%). Conclusion The labeling of instructions for the storage of biological products for intravenous infusion is far from detailed. It is recommended that manufacturers revise instructions. Regulatory authorities should strengthen the approval and supervision of related information in instructions for pharmaceuticals. References | Related Articles | Metrics

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Literature Analysis of Skin Necrosis Induced by Posterior Pituitary Injection CHEN Shiwei, XIE Xiaoyan, XIA Xudong, YANG Xue, LIU Cuili 2020, 17(3): 169-173.  DOI: 10.19803/j.1672-8629.2020.03.09 Abstract ( 508 )   PDF (991KB) ( 271 )   Objective To investigate the common characteristics and regularity of skin necrosis induced by posterior pituitary injection. Methods With " posterior pituitary injection" "skin necrosis", and "adverse drug reaction" as the key words, such databases as CNKI, VIP and WanFang Database were searched. Eighteen articles which met the inclusion and exclusion criteria were selected. Results Skin necrosis caused by posterior pituitary injection mainly occurred in male patients aged 41 to 50, and the primary disease was massive hemorrhage of liver cirrhosis that mostly occurred in lower limbs. The dominating dosages ranged from 20 to 80u per day and skin necrosis was most likely to occur between 3 hours and 2 days. Conclusion Skin necrosis caused by posterior pituitary injection deserves more attention, so clinical drug monitoring has to be strengthened and drug instructions improved. References | Related Articles | Metrics

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Analysis of Henoch-Schonlein Purpura Induced by Combination of Pantoprazole,Puyuan Hewei and Bailemian Capsules NI Beibei, GUO Jian, ZHANG Chuanzhou, WU Guocai, CHU Xianghua 2020, 17(3): 174-176.  DOI: 10.19803/j.1672-8629.2020.03.10 Abstract ( 627 )   PDF (758KB) ( 304 )   Objective To analyze the adverse reactions(ADRs) induced by combination of pantoprazole, Puyuan Hewei and Bailemian Capsules, providing references for clinical safety and rational use of drugs. Methods A case admitted in Department of Dermatology, the Affiliated Hospital of Qingdao University at March 2019 was study who appeard Henoch-Schonlein Purpura after using a combination of pantoprazole, Puyuan Hewei and Bailemian Capsules to analyze the clinical manifestations of ADRs. Results The patient' chief complaints were ecchymosis and petechia at duoble lambs for 5 days. 5 days ago, the patient oral a combination of pantoprazole, Puyuan Hewei and Bailemian Capsules because of abdominal pain. After 1 hour of drugs administration, duoble lambs appeared ecchymosis and petechia. Then the patient diagnosed with Henoch-Schonlein Purpura. The lesions completely subsided after 3 weeks of anti-allergic treatment. Conclusion Henoch-Schonlein Purpura induced by pantoprazole may be 'class effect' of PPIs due to their substituted benzimidazole structure, but we cannot rule out the possibility that the adverse drug reaction induce by Puyuan Hewei or Bailemian Capsules.We should be more careful when using combination of modem and traditional medicines. References | Related Articles | Metrics

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Research Progress in Hepatotoxicity and Prevention and Treatment of Arsenic Trioxide SUN Jiafu, SUN Xiao, SUN Guibo, SUN Xiaobo, NAN Fengwei, LUO Yun, GAO Ye, WANG Shan 2020, 17(3): 177-183.  DOI: 10.19803/j.1672-8629.2020.03.11 Abstract ( 463 )   PDF (981KB) ( 372 )   Arsenic trioxide is used in the treatment of acute promyelocytic leukemia and other malignant tumors, to good effect. However, in recent years, arsenic trioxide has been found to have hepatotoxic effect, which limits its clinical application. There was the finding that the hepatotoxicity of arsenic trioxide was related to the increase of oxidative stress and the induction of apoptosis. In this paper, the mechanism of hepatotoxicity of arsenic trioxide and its prevention and treatment were reviewed. References | Related Articles | Metrics