1.Establishment and Application of Pharmaceutical Care Pathway for the Anti-tumor Drugs
Weiqiang ZENG ; Yunting QU ; Qixing YAN ; Dehua ZHAO ; Haiyan LAO ; Yingtong ZENG ; Min YANG
China Pharmacy 2016;27(35):5017-5020
OBJECTIVE:To provide the new idea for clinical pharmacists providing pharmaceutical care in oncology depart-ment. METHODS:Applying the principles and methods of clinical pathway,the pharmaceutical care of anti-tumor drugs could be divided into before medication,during medication,after medication and patient education,according to the sequence of taking med-icine. On the basis of evidence-based medicine,the care contents of each unit were established,and the pharmaceutical care path-way (PCP) was formed. During chemotherapy duration for a breast cancer metastasis patient with liver function injury,clinical pharmacists conducted pharmaceutical care for drug pretreatment,ADR monitoring and disposal,patient education,as well as put forward the proposal of drug treatment as supplementing calcium,adjusting the dose of epirubicin and paclitaxel targeting on PCP of zoledronic acid,epirubicin and paclitaxel. RESULTS:Physicians adopted the pharmacist’s recommendations. The patient suf-fered from joint and muscle pain during chemotherapy,and the symptom was relieved after symptomatic treatment by celecoxib;chest and back discomfort was relieved significantly after chemotherapy,and the disease condition kept stable. The patient was dis-charged from the hospital. CONCLUSIONS:PCP focus on the time,content and countermeasures of pharmaceutical care,the pro-gram and treatment results of pharmaceutical care,and promote standardization,formalization,simplification and procedure of pharmaceutical care. Clinical pharmacists conduct individualized pharmaceutical care rapidly targeting on PCP so as to deepen the communication of clinical pharmacists with physicians,nurses and patients,and promote the development of pharmaceutical care smoothly.
2.Clinical Observation of Qingjin Huatan Decoction for Patients with AECOPD Phlegm-heat Obstructing Lung
Shenghan ZHANG ; Zhigang DENG ; Suhua ZHANG
China Pharmacy 2016;27(35):5003-5005
OBJECTIVE:To observe the clinical efficacy and safety of Qingjin huatan decoction for patients with AECOPD phlegm-heat obstructing lung. METHODS:120 patients with AECOPD phlegm-heat obstructing lung were divided into observation group and control group according to random number table,with 60 cases in each group. Control group received routine therapy as low-flow oxygen therapy,anti-infective,bronchiectasis,expectorant,etc.;observation group additionally received Qingjin huatan decoction(decocted by 400 ml pure water),tid,on the basis of control group. The levels of IL-8,IL-17,IL-23 and TNF-α were observed in 2 groups before and 7 d after treatment. Clinical efficacies and the occurrence of ADR were compared between 2 groups. RESULTS:Before treatment,there was no statistical significance in the levels of IL-8,IL-17,IL-23 and TNF-α between 2 groups (P>0.05). After treatment,the levels of IL-8,IL-17,IL-23 and TNF-α in observation group were significantly decreased and lower than in control group,with statistical significance (P<0.05). The levels of IL-17,IL-23 and TNF-α in control group were decreased significantly compared to before treatment,with statistical significance(P<0.05);the level of IL-8 had no signifi-cant change compared to before treatment,without statistical significance (P>0.05). Excellent rate of observation group was 95.00%,which was significantly higher than 78.95% of control group,with statistical significance(P<0.05). There was no statis-tical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Qingjin huatan decoction shows signifi-cant therapeutic efficacy in the treatment of AECOPD phlegm-heat obstructing lung,and can improve inflammatory factors with good safety.
3.Effects of Perioperative Application of ELP Enteric Soft Capsules on Therapeutic Efficacy and Prognosis in Children after Grommet Insertion of Chronic Secretory Otitis Media
Yufeng ZHANG ; Shufen WANG ; Zhinan WANG ; Zhongfang XIA
China Pharmacy 2016;27(35):4995-4997
OBJECTIVE:To investigate the effects of perioperative application of Eucalyptol,limonene and pinene(ELP)en-teric soft capsules on therapeutic efficacy and prognosis in children after grommet insertion of chronic secretory otitis media. METH-ODS:92 cases(145 ears)of chronic secretory otitis media were divided into 2 groups by random number table method,including 46 cases in observation group(68 ears)and 46 cases in control group(77 ears). Both groups received grommet insertion under gen-eral anesthesia by otomicroscope. Control group was not given any drugs;observation group was given ELP enteric soft capsules 1.2 g,bid,from 3 d before operation to 5 d after operation. Subjective therapeutic efficacy and pure tone audiometry of 2 groups were observed 3 days,5 days,2 weeks,1 month and 3 months after surgery as well as acoustic impedance monitoring in children with tube withdrawal from ear 1 month and 3 months after surgery. RESULTS:The total effective rates of observation group 3 days,5 days,2 weeks,1 month and 3 months after surgery were 72.06%,82.35%,85.29%,89.70%and 95.59%;those of con-trol group were 59.74%,66.23%,80.52%,87.01% and 92.21%,with statistical significance(P<0.05). The pure tone audiome-try score of observation group 3 days,5 days,2 weeks,1 month and 3 months after surgery were significantly lower than those of control group,with statistical significance(P<0.05). Therapeutic effective rates of acoustic impedance monitoring in children with tube withdrawal from ear 1 month and 3 months after surgery were 77.78% and 90.48% in observation group,which were signifi-cantly higher than 61.54% and 81.48% in control group,with statistical significance(P<0.05). CONCLUSIONS:The periopera-tive application of ELP enteric soft capsules can significantly improve function recovery and hearing level in children after grommet insertion of chronic secretory otitis media.
4.Clinical Observation of Alprostadil in the Treatment of Heart Failure with Normal Left Ventricular Ejection Fraction
Zhenmin SONG ; Luxia JIANG ; Xuewen QI
China Pharmacy 2016;27(35):4990-4992
OBJECTIVE:To investigate the clinical efficacy and safety of alprostadil in the treatment of heart failure in pa-tients with normal left ventricular ejection fraction (LVEF). METHODS:120 patients diagnosed as heart farlture with normal LVEF were divided into observation group and control group by radom number table method,with 60 cases in each group. Control group was given symptomatic treatment;observation group was additionally treated with Alprostadil dried emulsion for injection 10μg,bid,on the basis of control group. Both groups received treatment for 5 d. The cardiac function indexes,serum inflammatory factors and oxidative stress indexes were observed in 2 groups before and after treatment,and the occurrence of ADR was com-pared between 2 groups. RESULTS:Before treatment,there was no statistical significance in cardiac function indexes,serum in-flammatory factors and oxidative stress indexes between 2 groups (P>0.05). After treatment,above indexes of 2 groups were all improved significantly,and the observation group was significantly better than the control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Alprostadil can improve cardiac function of patients with heart failure of normal LVEF,improve serum inflammatory factors and oxidative stress level with good safety.
5.Clinical Observation of Different Doses of Calf Pulmonary Surfactant Combined with Nasal Intermittent Posi-tive Pressure Ventilation in the Treatment of Neonatal Respiratory Distress Syndrome
Jing ZHANG ; Huanxin ZHANG ; Jing WANG
China Pharmacy 2016;27(35):4985-4987
OBJECTIVE:To explore clinical efficacy and compliance of different doses of calf pulmonary surfactant combined with nasal intermittent positive pressure ventilation (NIPPV) in the treatment of neonatal respiratory distress syndrome (NRDS). METHODS:90 children diagnosed as NRDS were collected from neonatal department of our hospital,and were divided into high-dose group,middle-dose group and low-dose group by random number table method,with 30 cases in each group. 3 groups received NIPPV combined with calf pulmonary surfactant;the dose of calf pulmonary surfactant in high-dose group,middle-dose group and low-dose group were 100,70,40 mg/kg,respectively. Blood gas indexes,treatment,hospitalization duration,treatment cost,the incidence of compliance were compared among 3 groups. RESULTS:Before treatment,there was no statistical signifi-cance in pH,PaCO2,PaO2,SaO2 among 3 groups(P>0.05);after treatment,above indexes of 3 groups were all improved signifi-cantly,and the high-dose group was significantly better than middle-dose group and low-dose group,with statistical significance (P<0.05). There was no statistical significance in duration of ventilation,oxygen therapy duration,cure rate and treatment cost among 3 groups(P>0.05). Medication times and hospitalization time of high-dose groups were significantly lower or shorter than those of middle-dose group and low-dose group,with statistical significance (P<0.05). The rate of complication in high-dose group,middle-dose group and low-dose group were 20.0%,23.3% and 16.7%,respectively,there was no statistical significance (P>0.05). CONCLUSIONS:Calf pulmonary surfactant combined with NIPPV could effectively improve the blood gas status of newborn with NRDS. High dose of calf pulmonary surfactant can reduce hospitalization time and doesn’t increase treatment cost and the rate of compliance.
6.Safety and Immunological Effects of Measles-mumps-rubella Attenuated Live Vaccine in Children
China Pharmacy 2016;27(35):4980-4982
OBJECTIVE:To observe the safety and immunological effects of Measles-mumps-rubella(MMR)attenuated live at-tenuated vaccine in children. METHODS:300 children aged 8-12 months receiving inoculation were selected from Changsha Hospi-tal for Maternal and Child Health Care during Jan. 2015-Apr. 2016 to observe safety and immunological effects. Those children were divided into MMR group,measles vaccine group,mumps vaccine group and rubella vaccine group according to vaccine type, with 75 cases in each group. The occurrence of ADR in 72 h were compared among 4 groups after inoculation;venous blood of chil-dren was collected before vaccination and 5 months after vaccination,and the antibody positive test was carried out by micro coagu-lation inhibition (HI) test;HI antibody titer was recorded after immunization,and positive rate and genometric meantiter(GMT) were calculated. RESULTS:The incidence of ADR in 4 groups were 9.33%,8.00%,8.00% and 10.67%,respectively. No local ADR was found in 4 groups;among systemic ADR,the incidence of fever was higher than that of other clinical manifestations,be-ing 4.00%,4.00%,4.00% and 5.33%;there was no statistical significance in the incidence of ADR among 4 groups(P>0.05). Measles,mumps and rubella antibody positive rates of MMR group were 100%,92.00% and 100%,respectively;antibody posi-tive rates of measles vaccine group,mumps vaccine group and rubella vaccine group were 100%,85.33% and 100%,respective-ly;there was no statistical significance in same antibody positive rate among 4 groups(P>0.05). GMT of measles in MMR group and measles vaccine group were 1∶41 and 1∶27,that of mumps in MMR group and mumps vaccine group were 1∶6.3 and 1∶6.2, there was no statistical significance (P>0.05);GMT of rubella in MMR group and rubella vaccine group were 1∶320 and 1∶849, with statistical significance (P<0.05). CONCLUSIONS:Compared to traditional single vaccine,MMR dose not increase the inci-dence of ADR and not influence positive rate,but GMT of rubella increases significantly,to which should be paid attention.
7.Clinical Observation of Vaginal Administration of Lactobacillus Combined with Chlorquinaldol-promestriene for Senile Patients with Atrophic Vaginitis
China Pharmacy 2016;27(35):4968-4970
OBJECTIVE:To investigate therapeutic efficacy and recurrence rate of vaginal administration of lactobacillus com-bined with chlorquinaldol-promestriene for senile patients with atrophic vaginitis. METHODS:150 senile patients with atrophic vag-initis were selected and divided into group A,B,C according to random number table,with 50 cases in each group. Group A was given Lactobacillus vaginal capsules,2 capsules,qd (at bedtime);group B given Chlorquinaldol-promestriene vaginal tablets,1 tablet,qd(at bedtime);group C given Chlorquinaldol-promestriene vaginal tablets,1 tablet,qd(at bedtime),and Lactobacillus vaginal capsules,2 capsules,qd,next morning,implanting into vagina. 3 groups received treatment for 18 d. Clinical efficacy, vaginal health score,vaginal symptom score and vaginal pH value were observed in 3 groups,and the occurrence of ADR and re-currence rate during follow-up period (12 months) were recorded. RESULTS:The total effective rate of group C was 94.00%, which was significantly higher than group A(72.00%)and B(74.00%),with statistical significance(P<0.05). Before treatment, there was no statistical significance in vaginal health score,vaginal symptom score and vaginal pH value among 3 groups (P>0.05). After treatment,vaginal health score of 3 groups were increased significantly,while vaginal symptom score and vaginal pH value were decreased significantly;and the improvement of above indexes in group C were significantly better than in group A and B,with statistical significance(P<0.05). No obvious ADR was found in 3 groups during treatment. The recurrence rate of group C during follow-up period(4.00%)was significantly lower than that of group A(18.00%)and group B(20.00%),with statistical significance(P<0.05). CONCLUSIONS:Vaginal administration of lactobacillus combined with chlorquinaldol-promestriene for se-nile patients with atrophic vaginitis can effectively relieve clinical symptoms and signs,improve vaginal cleanliness,regulate the lo-cal pH value and reduce the risk of recurrence,with good safety.
8.Efficacy Comparison of Xiaoshi Lidan Capsules and Ursodeoxycholic Acid Capsules in the Treatment of Chronic Cholesterol Gallstone Cholecystitis
Jiang XIE ; Mingzhong ZHOU ; Qian MENG ; Xiaodan LIU ; Fan YANG
China Pharmacy 2016;27(35):4965-4967
OBJECTIVE:To compare clinical efficacy of Xiaoshi lidan capsules and Ursodeoxycholic acid capsules in the treat-ment of chronic cholesterol gallstone cholecystitis. METHODS:120 patients with chronic cholesterol gallstone cholecystitis in our hospital were selected and divided into observation group and control group according to random number table,with 60 cases in each group. Observation group was given Xiaoshi lidan capsules 1.2 g,po,tid(after the meal);control group was given Ursodeoxycholic acid capsules 250 mg,po,qd(after dinner). Both group received treatment for 6 months. Effective rate of litholysis were observed in 2 groups as well as abdominal pain score [PRI,VAS score,present pain intensity(PPI)],the thickness of gallbladder wall before and after treatment. Clinical efficacy and the occurrence of ADR were compared between 2 groups during treatment. RESULTS:3 pa-tients withdrew from the observation group and 1 patient withdrew from the control group. Before treatment,there was no statistical significance in PRI,VAS score,PPI and the thickness of gallbladder wall between 2 groups(P>0.05). After treatment,above index-es of 2 groups were decreased significantly,while PRI,VAS score and PPI in observation group was significantly lower than in con-trol group,with statistical significance (P<0.05). The effective rate of litholysis (64.91%) in observation group was significantly lower than in control group (79.67%),with statistical significance (P<0.05). Total effective rate of observation group (57.89%) was slightly higher than that of control group(54.24%),without statistical significance(P>0.05). There was no statistical signifi-cance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Xiaoshi lidan capsules are similar to Ursodeoxycholic acid capsules in clinical efficacy for chronic cholesterol gallstone cholecystitis with good safety,and can be used as optional drug ex-cept for chronic cholesterol gallstone cholecystitis.
9.Clinical Observation of Hyperbaric Oxygen Combined with Flupentixol and Melitracen in the Treatment of Post-stroke Depression
Zhenjie ZHU ; Yuming HU ; Aisong GUO ; Guangyu SHEN ; Weiguan CHEN ; Yan REN
China Pharmacy 2016;27(35):4947-4949
OBJECTIVE:To investigate the effects of hyperbaric oxygen combined with flupentixol and melitracen on depres-sion improvement,extremity motor function and ability of daily living and activity in patients with post-stroke depression (PSD). METHODS:60 PSD patients were divided into control group and observation group according to random number table,with 30 cases in each group. Both groups received routine clinical treatment,comprehensive rehabilitation therapy and psychotherapy. The control group was additionally given Flupentixol and melitracen tablets,orally,one tablet each time,in the morning;3 days later, one tablet each time,in the morning and noon,for 4 weeks. Other anti-depressive agents were not given during treatment. Observa-tion group was additionally given hyperbaric oxygen,0.12 MPa,for 90 min,qd,5 times a week,for 4 weeks,on the basis of control group. Depression degree [Hamilton depression scale (HAMD) and Self-rating depression scale(SDS)],extremity motor function [Fugl-Mayer motor function assessment (FMA)] and ability of daily living and activity [modified Barthel index (MBI)] were scored in 2 groups before and after treatment,and ADR was observed. RESULTS:After 4 weeks of treatment,HAMD and SDS of 2 groups were decreased significantly compared to before treatment,while FMA and MBI were increased significantly;the improvement of observation group was significantly better than that of control group,with statistical significance(P<0.05). No ob-vious ADR was found in 2 groups. CONCLUSIONS:Hyperbaric oxygen combined with flupentixol and melitracen can effectively improve PSD,relieve negative emotion and improve extremity motor function and ability of daily living and activity.
10.Effects of Puerarin on Bone Mineral Density around the Femoral Prosthesis of Elderly Women after Osteopo-rotic Fracture Artificial Hip Joint Replacement
Yumin SUN ; Xiaolin XU ; Jinxiu XU ; Xiuli LIU ; Dongdong HUANG ; Cai CHENG
China Pharmacy 2016;27(35):4944-4946
OBJECTIVE:To investigate the effects of puerarin on bone mineral density around the femoral prosthesis of el-derly women after osteoporotic fracture artificial hip joint replacement. METHODS:99 elderly women after osteoporotic fracture artificial hip joint replacement were divided into control group(49 cases)and test group(50 cases)according to random number table. Control group received conventional treatment:calcium carbonate and vitamin D3+alendronate sodium+salmon calcitonin;test group was additionally given Puerarin injection 200-400 mg dissolved in Glucose injection 500 ml intravenously,qd,on the basis of control group. A treatment course lasted for 20 d,and both groups received 2 courses of treatment. The hip joint function score and bone mineral density around the femoral prosthesis of 2 groups were observed and compared after surgery,and the oc-currence of ADR was also observed. RESULTS:3 and 2 patients withdrew from control group and test group,respectively. 18 months after surgery,the patients with hip joint function score ranged 70-79 in test group was significantly less than in control group;the rate of excellent hip joint function score in test group was significantly higher than in control group,with statistical significance (P<0.05). 15 and 18 months after surgery,bone mineral density in R1-R5 range of Gruen range in test group was slightly higher than in control group,without statistical significance(P>0.05);bone mineral density in R6-R7 range was signifi-cantly higher than control group(89.58% vs. 69.57%),with statistical significance(P<0.05). The prosthesis loosening was not found in both groups,and ADR was also not found as fever,erythra,nausea,vomiting,headache,dizziness,etc. CONCLU-SIONS:For the use of puerarin in elderly women after osteoporotic fracture artificial hip joint replacement,puerarin can increase the periprosthetic femur bone mineral density with good safety.