1.Research advance in pharmacokinetic/pharmacodynamic characteristics and dose adjustment of ceftazidime-avibactam in special populations
Guangcan LI ; Ping ZHANG ; Jiaoni ZHENG ; Xingyan HUANG ; Xuefeng SHAN
China Pharmacy 2024;35(16):2055-2060
Ceftazidime-avibactam (CAZ/AVI)is a novel β-lactam antibiotic with broad-spectrum antibacterial activity and good tolerability. However, the physiological and pathological differences in special populations [e.g. augmented renal clearance (ARC) patients, undergoing continuous renal replacement therapy (CRRT) patients, neonates and children, obese patients, undergoing extracorporeal membrane oxygenation (ECMO) patients, elderly patients and liver dysfunction patients] may affect the pharmacokinetic (PK) properties of CAZ/AVI, leading to treatment failure. At present, there is currently a lack of corresponding guidelines or consensus on dose adjustment of CAZ/AVI in special populations. This article summarizes the research on PK/ pharmacodynamic (PD) characteristics and dose adjustment of CAZ/AVI in special populations and recommends the following dosing regimens: for ARC patients, the recommended dose is 2.5 g, q8 h; for undergoing CRRT patients with infections caused by sensitive strains (i.e. MIC<4 mg/L) and infections at sites where hydrophilic antibiotics distribute well, a dose of 1.25 g, q8 h may be used; for undergoing CRRT patients with less sensitive strains or sites with poorer drug distribution, a dose of 2.5 g, q8 h or continuous infusion may be considered; for children aged 6 months to <18 years with normal or mildly impaired renal function, a dose of 62.5 mg/kg, q8 h is infused for 2 h (maximum dose not exceeding 2.5 g per dose); for infants aged 3~6 months with normal or mildly impaired renal function, a dose of 50 mg/kg, q8 h is infused for 2 h; for obese patients, the recommended dose is 2.5 g, q8 h, with therapeutic drug monitoring recommended;undergoing ECMO patients, elderly patients, and those with impaired liver function may also use the recommended dose of 179368757@qq.com 2.5 g, q8 h.
2.Analysis on pre-donation blood testing in blood services in Chongqing
Li MO ; Huayou DAI ; Jiafei YI ; Zhen ZHANG ; Wei DONG ; Xiaohong RAN ; Qingyu XIA ; Xia HUANG ; Tao HE
Chinese Journal of Blood Transfusion 2021;34(12):1279-1281
【Objective】 To provide data reference for the implementation of the homogenization of pre-donation blood testing by investigating the relevant situation of pre-donation blood testing in various blood services in Chongqing and analyzing their differences. 【Methods】 A questionnaire covering the basic information of pre-donation blood testing items, quality control and the management of deferral donors was developed, and issued to 19 blood services in Chongqing through E-mails by Chongqing Society of Blood Transfusion. The data collected were sorted, revised and analyzed. 【Results】 A total of 19 questionnaires from 19 blood services(including 1 blood center, 1 sub-center, 6 central blood stations and 11 central blood banks) were collected. All of the pre-donation blood test items of 19 blood services met the Blood Donor Health Test Requirements. Hemoglobin, blood group, ALT and HBsAg testing were carried out by 19 blood services, anti-TP testing by 15, and lipid blood testing by 11, using different detection methods and reagents. Significant differences were found in the frequency and rules of internal quality control for quantitative testing items. In addition, the deferral time and re-recruitment strategy of deferral blood donors were also significantly different. 【Conclusion】 There were differences in the management of pre-donation blood testing and blood donor management after blood donation among blood services in Chongqing. Further standardization was needed to realize regional homogenization and guarantee blood safety and the safety of blood donors.
3.Molecular basis and mechanism of action of Albizia julibrissin in depression treatment and clinical application of its formulae.
Bishan HUANG ; Yingyao WU ; Chan LI ; Qingfa TANG ; Yuanwei ZHANG
Chinese Herbal Medicines 2023;15(2):201-213
Albizzia julibrissin is empirically used as an antidepressant in clinical practice. Preclinical studies have indicated that its total extracts or bioactive constituents exerted antidepressant-like responses in animal models, providing the molecular basis to reveal its underlying mechanism of action. While attempts have been made to understand the antidepressant effect of A. julibrissin, many fundamental questions regarding its mechanism of action remain to be addressed at the molecular and systems levels. In this review, we conclusively discussed the mechanism of action of A. julibrissin and A. julibrissin formulae by reviewing recent preclinical and clinical studies conducted by using depressive animal models and depressive patients. Several representative bioactive constituents and formulae were highlighted as examples, and their mechanisms of action were discussed. In addition, some representative A. julibrissin formulae that have been shown to be compatible with conventional antidepressants in clinical practice were also reviewed. Furthermore, we discussed the future research directions to reveal the underlying mechanism of A. julibrissin at the molecular and systems levels in depression treatment. The integrated study using both the molecular and systematic approaches is required not only for improving our understanding of its molecular basis and mechanisms of action, but also for providing a way to discover novel agents or approaches for the effective and systematic treatment of depression.