The adverse drug events (ADE) is not only common but also expensive. Although it was expected that ADE could be prevented by using computer-based clinical decision support system (CDSS), it is not widely accepted in the clinical field. Therefore the purpose of this study was to verify whether CDSS can reduce ADE by meta-analysis. We searched literatures by Medline from 1975 to 2002 with key words of clinical decision support system, medication error, and adverse drug event. We also searched references of review articles as well as textbooks on medical informatics. The criteria for quality evaluation were as follows: 1) the objec t were physician, nurse, pharmacist, 2) case design for CDSS analysis was pe rformed random c linical te st of experimental-control group, 3) deal with a adverse drug event organization whether or not. Among 290 retrieved articles five studies were selected for quantitative meta-analysis. The overall effect size of the risk of adverse drug event due to CDSS was calculated by common odds ratio using MetaKorea (http://www.metakorea.or.kr). Before the integration of each effect sized into common eff ect sizes the homogene ity test were conducted. All studies were ca se control design and cases were ADEs. Homogenity of studies were conducted by Mantel-Haenszel method. The chi-square is 10.78 (p<0.05). For evaluation of odds ratio, random effec t model was used. The overall odds ratio of CDSS associated with ADE was 0.315201 (95% confidence interval = 0.191411-0.519049). Our result suggested a negative association between use of CDSS and the development of serious ADE. So we concluded that the development of serious ADE was reduced using CDSS.
Drug Toxicity

PURPOSE: Recent randomized phase III trial by the Breast Cancer International Research Group (BCIRG 001) showed that docetaxel plus doxorubicin and cyclophosphamide (TAC) is superior to fluorouracil plus doxorubicin and cyclophosphamide (FAC) as adjuvant chemotherapy for node-positive operable breast cancer. Unfortunately, TAC was clearly more toxic than FAC not only with respect to neutropenic fever events, but also with respect to many extrahematological side effects. The aim of this study was to evaluate the toxicity and tolerability of Korean patients with breast cancer treated with TAC. METHODS: This study was conducted on 80 patients with breast cancer who underwent primary surgery at the Department of Surgery in Soonchunhyang University (4 affiliated hospitals) from October 2005 to October 2008. The patients received 480 courses consisting of TAC (75/50/500 mg/m2, every 3 weeks for 6 cycles) without prophylactic granulocyte colony-stimulating factor (G-CSF). Toxicity was graded according to the National Cancer Institute Common Toxicity Criteria version 3.0. RESULTS: The main toxicities were hematologic (neutropenia grade 3/4 in 98.8% of patients and 92.3% of cycles; febrile neutropenia in 42.5% of patients and 16.0% of cycles). No cases of septic death occurred. The peak time of occurrence for febrile neutropenia was 7-10 days after receiving chemotherapy (mean duration, 2.05 days). Severe nonhematologic adverse events were as follows: myalgia (30.0%), neurotoxicity (17.5%), fatigue (16.3%), stomatitis (12.5%), and nausea (11.3%). CONCLUSION: An adjuvant TAC regimen without prophylactic G-CSF was tolerable in Korean patients with breast cancer. Although most of the patients developed neutropenia, the nonhematologic toxicities (cardiac toxicity) were tolerable. Further studies on prophylactic G-CSF use to assess the contribution to reduced hematologic toxicities are required in Korean patients with breast cancer.
Breast Neoplasms ; Drug Toxicity

In order to manage and safely and rationally use the drug, the Ministry of Health promulgates the regulations for management of toxic drug, stupefacients and psychotrope such as the toxic drug regulation accopanying the Dicision No 278BYT-QD; The addictive drug regulation and the list of addictive drug; the psychotic drug regulation and list of psychotropes. Concurrently, there have many texts of government, criminal law, inter-ministry circular letter, decree of president, the programs of ministry of health.
Pharmaceutical Preparations ; Drug Toxicity

BACKGROUND AND OBJECTIVES: The purposes of this study was to investigate the characteristics of gentamicin-induced vestibulotoxicity of s otolith organs by assessing the results of earth vertical and the off-vertical axis rotation tests with a morphologic study. MATERIALS AND METHODS: Rabbits were grouped into two groups, ototoxic and ototoxic prevention group. Vestibulotoxicity was induced by injecting gentamicin (GM) into the peritoneum. Prevention of the vestibulotoxicity was studied by injecting NMDA receptor inhibitors (MK-801), iron chelating agents (deferoxamine) peritonially, and osmotic pumps filled with neurotrophic factors (GDNF, BDNF), respectively. The animal rotation system was designed to rotate the animal sinusoidally or in velocity step (constant velocity) rotation. Off-vertical rotation was applied to evaluate the otolithic function. Scanning electron microscopy were examined for the structural changes of the otolithic organs. RESULTS AND CONCLUSIONS: GM-induced vestibulotoxicity was confirmed by gain decreasing in the earth vertical SHA rotation test and bias decreasing in the off-vertical rotation test. However, changes in modulation was not definite. Bilateral prevention of GM-induced vestibulotoxicity was confirmed by systemic injection of deferoxamine and MK-801, and characteristics of unilateral prevention was confirmed by local application of the neurotrophic factors using osmotic pumps. In the SEM study, the GM-induced hair cell damages of the vestibule were identified, which was prevented by the preventive drugs. The reduction of bias value without change of modulation was comparable with the reduction of gain in the earth vertical axis rotation after GM-induced vestibulotoxicity.
Rabbits ; Animals ; Drug Toxicity

Poisoning ; drug therapy ; Thallium ; toxicity

To provide the basis for the future research on the nephrotoxicity of Chinese herbal medicine through systematic and comprehensive summary of all the Chinese herbal medicines which may lead to nephrotoxicity. Foreign resources included PubMed and Cochrane library， and domestic research resources was China Food and Drug Administration(CDFA) Adverse Drug Reaction Monitoring Center database. The databases were searched from establishment to January 1， 2017. There was no limitation on research type. 28 English studies were found， including 97 Chinese herbs or prescriptions with the risk of nephrotoxicity. The following six Chinese herbal medicines with the risk of nephrotoxicity had a large number of studies： aristolochic acid(5 studies)， Tripterygium wilfordii(4 studies)， Erycibe obtusifolia(2 studies)， Rheum palmatum(2 studies)， Ephedra sinica(2 studies)， and Atractylodes lances(2 studies). The remaining 91 Chinese medicines were reported with risk of nephrotoxicity in only 1 study respectively. CDFA reported 16 Chinese herbal medicines with the risk of nephrotoxicity， including Ganmaoqing Pian(capsule)， Zhenju Jiangya Pian， T. wilfordii preparation， Vc-Yinqiao Pian， Chuanhuning injection， Shuanghuanglian injection， Qingkailing injection， Lianbizhi injection， herbal decoction containing Aristolochiae Radix， Guanxin Suhe Wan， Shugan Liqi Wan， Ershiwuwei Songshi Wan， herbal decoction containing Aristolochia Fangchi， herbal granules containing root of Kaempfer Dutchmanspipe， Ganmaotong(tablets)， and Longdan Xiegan Wan. Currently， in addition to aristolochic acids， the most reported Chinese herbal medicine with the risk of nephrotoxicity is T. wilfordii preparation.
Aristolochia ; toxicity ; China ; Drugs, Chinese Herbal ; toxicity ; Ephedra sinica ; toxicity ; Humans ; Kidney ; drug effects ; Tripterygium ; toxicity

OBJECTIVETo investigate the cytotoxicity of the crude ethanol extract of the rhizome of Zingiber zerumbet (Z. zerumbet) (L) Smith. and Curcuma zedoaria (C. zedoaria) Rosc. against Artemia salina Leach.

METHODSFresh rhizomes of Z. zerumbet (L) Smith. and C. zedoaria Rosc. were extracted separately in cold with ethanol (2.5 L) and after concentration a brownish syrupy suspension of ethanol extracts of Z. zerumbet (L) Smith. and C. zedoaria Rosc. was obtained. The cytotoxic effect of the crude ethanol extracts of both plants was determined by brine shrimp lethality bioassay.

RESULTSCrude ethanol extracts of the rhizome of Z. zerumbet (L) Smith. showed the highest cytotoxicity (LC50 was 1.24 µg/mL) against brine shrimp nauplii as compared with C. zedoaria Rosc. (LC50 was 33.593 µg/mL) after 24 h of exposure.

CONCLUSIONSIt can be concluded that the rhizome of Z. zerumbet (L) Smith. and C. zedoaria Rosc. can be used as a source of cytotoxic agent.

Animals ; Artemia ; drug effects ; Curcuma ; metabolism ; toxicity ; Phytotherapy ; Plant Extracts ; pharmacology ; toxicity ; Plants, Medicinal ; toxicity ; Rhizome ; toxicity ; Zingiberaceae ; metabolism ; toxicity

OBJECTIVETo study the effect of Oncomelania hupensis hupensis of niclosamide, and exploring the main influencing factors.

METHODSThe samples of Oncomelania hupensis hupensis were collected from 37 sampling sites in 33 counties of 10 provinces by means of stratified random sampling methods in accordance with the categories of Oncomelania hupensis hupensis habitats. Samples were randomly located into study group and control group. Oncomelania hupensis hupensis of the study group was marinated in different concentration liquor of niclosamide which was confected with water for 24 hours or 48 hours, then LC50 of niclosamide by which Oncomelania hupensis hupensis was killed and amount calculated. The influencing factors of the mortality of Oncomelania hupensis hupensis in the study group was statistically analyzed by 2 test and by multiple logistic regression using SPSS 13.0 statistical software.

RESULTSThe mortality of Oncomelania hupensis hupensis of the two test groups which were marinated in 0.5 mg/L liquor for 48 hours and 1.0 mg/L liquor for 24 hours was 100%. The effect of Oncomelania hupensis hupensis killed by niclosamide was markedly reduced along with the reduction of drug concentration. The average LC50 rates of niclosamide liquor by which Oncomelania hupensis hupensis killed for the 24 hours and 48 hours in the study group, were 0.0939 mg/L and 0.0625 mg/L, respectively. There was significant difference between the two test groups (chi(2) = 5.001, P <0.01) . In determinate range of concentration, the mortality of Oncomelania hupensis hupensis showed significant difference among the geographic types of habitat ( chi(2) = 4.264, P < 0.05). By means of multiple logistic regression using SPSS 13.0 statistical software, the estimate value of coefficient of regression on the influence factors, drug concentration, test time and the geographic types of habitat were 2. 047 ( OR = 5. 573), 0.263 ( OR = 2.924) and 0. 187- 0.210 ( OR = 1.969- 2. 560), respectively.

CONCLUSIONNiclosamide could kill Oncomelania hupensis hupensis effectively. The main influencing factors on the efficacy of niclosamide by which Oncomelania hupensis hupensis was killed, appeared to be drug concentration, time of testing and the geographic types of habitat.

Animals ; China ; Ecosystem ; Molluscacides ; toxicity ; Niclosamide ; toxicity ; Snails ; drug effects

Animals ; Dioxins ; toxicity ; Humans ; Liver ; drug effects ; Polychlorinated Dibenzodioxins ; toxicity

Apoptosis ; drug effects ; Asbestos ; toxicity ; Humans ; Mineral Fibers ; toxicity