Adrenal Cortex Hormones - therapeutic use ; Contraindications ; Drug Therapy, Combination ; Humans

Animals ; Anticonvulsants ; adverse effects ; Brain ; drug effects ; growth & development ; Contraindications ; Epilepsy ; drug therapy ; Humans

This paper discusses the rational use of traditional Chinese medicine based on chemical composition, body state and biological effect. The essence and connotations of traditional Chinese medicine are explained by modern scientific theory and technical means, and the mechanism of traditional Chinese medicine in the treatment of diseases is defined in modern medicine language, which is conducive to promoting rational and safe clinical use of drugs. Based on the chemical composition of traditional Chinese medicine,the selected genuine medicinal materials were collected and processed in a standardized way, and then used in the combination with other traditional Chinese medicines, with the aim to improve the efficacy of traditional Chinese medicine in clinical indications, increase the advantages, eliminate the disadvantages, and adapt to flexible and safe clinical drug demands. Based on the body state elements, clinical diagnosis and treatment shall be patient-centered, and doctors shall distinguish the differences of pathogenesis, symptoms and diseases, and consider the drug contraindications of special groups. According to the " dose-effect-toxicity" relationship, doctors shall select the appropriate dosage form, control the drug dosage, balance the benefits and risks of drugs, and carry out appropriate medical treatment. Based on the biological effect elements and the regulatory mechanism of traditional Chinese medicine on the target and pathway of disease, traditional Chinese medicine shall strengthen the precise positioning, provide accurate treatment; evaluate the safety of traditional Chinese medicine combination, explore the adverse reaction mechanism, strengthen the clinical safety monitoring of traditional Chinese medicine, and guide the clinical rational use of drugs, in the expectation of ensuring the safe use of traditional Chinese medicine and maximize the clinical efficacy of traditional Chinese medicine.
Contraindications, Drug ; Drug Dosage Calculations ; Drugs, Chinese Herbal/therapeutic use* ; Humans ; Medicine, Chinese Traditional ; Practice Patterns, Physicians'

Adrenergic beta-Antagonists ; therapeutic use ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Contraindications ; Heart Failure ; drug therapy ; Humans

The incidences of both benign prostatic hyperplasia and erectile dysfunction are increasing with aging, so the coexist of the two disease in the same patient is not rare. However, it is stumble for the clinicians to treat the patients. The problem of the combination of phosphodiesterase-5 (PDE5) inhibitors with alpha-blockers is getting more and more attraction. The article reviews the drug information of the combination of sildenafil, vardenafil and tadalafil with alpha-blockers respectively, and reports the results of the latest studies regarding it. The purpose is to help clinicians understand the problem across the board, so as to make the application of this class of drug correctly and the treatment of the disease suitably.
Adrenergic alpha-Antagonists ; therapeutic use ; Contraindications ; Drug Interactions ; Drug Therapy, Combination ; Erectile Dysfunction ; complications ; drug therapy ; Humans ; Male ; Phosphodiesterase Inhibitors ; therapeutic use ; Prostatic Hyperplasia ; complications ; drug therapy

Beta-blockers have long being used as first-line therapy for hypertension as their use had resulted in a reduction in cardiovascular morbidity and mortality in controlled clinical trials. A recent meta-analysis comparing beta-blockers to all other anti-hypertensive drugs taken together has found that stroke reduction was sub-optimal. Specifically, atenolol was associated with a 26% higher risk of stroke compared with other drugs. Several reasons may explain the less favourable outcomes with beta-blocker therapy. These include some adverse metabolic abnormalities such as dyslipidaemia and new-onset diabetes, and less effective reduction of central aortic compared with brachial blood pressure. Newer beta-blockers such as carvedilol or nebivolol are better tolerated. These beta-blockers have a vasodilating effect, which may beneficially affect systolic blood pressure in the aorta. Their long-term cardiovascular outcome in hypertension is still not known. Further studies would be required to show that stroke is adequately reduced by these newer beta-blockers. In conclusion, beta-blockers should not be the first drugs of choice in the management of uncomplicated hypertension. They may be used in addition to other antihypertensive agents to achieve blood pressure goals. However, in patients with angina pectoris, a previous myocardial infarction, heart failure and certain dysrhythmias, beta-blockers still play an important role.
Adrenergic beta-Antagonists ; therapeutic use ; Antihypertensive Agents ; therapeutic use ; Contraindications ; Humans ; Hypertension ; drug therapy ; Meta-Analysis as Topic ; Singapore ; Stroke ; chemically induced

INTRODUCTIONThe use of oral hypoglycaemic drugs in pregnancy is not recommended because of reports of foetal anomalies and other adverse outcomes in animal studies and in some human cases. However, recent studies have suggested that some oral hypoglycaemic drugs may be used in pregnancy. This review will examine these studies critically.

METHODSLiterature review of articles obtained from a PubMed search of peer-reviewed journals on oral hypoglycaemic drug use in pregnancy.

RESULTSIn two prospective studies, one of which was a randomised controlled trial, glibenclamide was as effective and safe as insulin in gestational diabetes. In several studies, metformin did not increase foetal anomalies or malformations when used during pregnancy in women with polycystic ovary syndrome (PCOS). In one prospective study on infants born to mothers who used metformin in pregnancy, follow-up for 18 months showed no adverse effects. In several prospective and retrospective studies on women with PCOS, metformin was shown to prevent early pregnancy loss, decrease insulin resistance, reduce insulin and testosterone levels, and decrease the incidence of gestational diabetes when these women got pregnant while on metformin and continued to take it throughout their pregnancy. In a single small study, acarbose did not cause any adverse effects during pregnancy.

CONCLUSIONSRecent evidence shows promising findings in the safety and efficacy of some oral hypoglycaemic agents in treating pregnant diabetics. However, larger clinical studies will be needed to ensure the safety and efficacy of these drugs in pregnancy.

Administration, Oral ; Contraindications ; Evidence-Based Medicine ; Female ; Humans ; Hypoglycemic Agents ; administration & dosage ; therapeutic use ; Pregnancy ; Pregnancy in Diabetics ; drug therapy ; Safety Management ; Singapore

China pharmacopoeia is a civil code which is to ensure pharmaceutical quality and protect people's drug safety and effectiveness. Drug standards are consist of two parts, the pharmaceutical standards and medical standards. Medical standards include four contents, such as prescription, function and indications, usage and dosage and attentions. This paper summarized the revised contents of medical standards and suggested some propositions.
Contraindications ; Documentation ; Drug Administration Schedule ; Drug Compounding ; standards ; Drug Dosage Calculations ; Drug Prescriptions ; standards ; Drugs, Chinese Herbal ; adverse effects ; pharmacology ; standards ; Female ; Food-Drug Interactions ; Humans ; Pregnancy ; Terminology as Topic

OBJECTIVETo study the indication and contraindication of opening pulp chamber therapy for patients with a history of remote myocardial infarction.

METHODSBlood pressure (BP), heart beat rate and electrocardiographic examination were determined during opening pulp chamber therapy in patients with acute and chronic pulpititis and a history of remote myocardial infarction.

RESULTSHigh blood pressure and quick heart beat were found during local anaesthetic injection and opening of pulp chamber (during local anaesthetic injection BP increased by 12.52/8.04 mmHg, heart rate by 4.02 times/min;during opening of pulp chamber BP and heart rate increased by 15.43/8.0 mmHg, 6.37 times/min respectively). Electrocardiogram showed myocardial ischemic pattern deteriorated in some patients with the history of coronary insufficiency.

CONCLUSIONSMost patients can bear it. Comprehensive physical examinations, evaluations of the patients' cardial status, mental state and indispensible equipment are necessary. The therapy is recommended to be operated under the monitor electrocardiography for the safety of the patients.

Acute Disease ; Aged ; Anesthetics, Local ; administration & dosage ; Blood Pressure ; drug effects ; Chronic Disease ; Contraindications ; Electrocardiography ; Female ; Heart Rate ; drug effects ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; physiopathology ; Pulpectomy ; methods ; Pulpitis ; surgery

We describe herein a case of life-threatening hypoglycemia due to spurious elevation of glucose concentration during the administration of ascorbic acid in a type 2 diabetic patient. A 31-year-old female was admitted for proliferative diabetic retinopathy treatment and prescribed high dose ascorbic acid. During hospitalization, she suddenly lost her consciousness and her glucose concentration was 291 mg/dL, measured using self-monitoring blood glucose (SMBG) device, while venous blood glucose concentration was 12 mg/dL. After intravenous injection of 50% glucose solution, the patient became alert. We reasoned that glucose measurement by SMBG device was interfered by ascorbic acid. Physicians should be aware of this interference; high dose ascorbic acid may cause spurious elevation of glucose concentration when measuring with SMBG devices.
Adult ; Ascorbic Acid/administration & dosage/adverse effects/contraindications/*therapeutic use ; Blood Glucose ; Blood Glucose Self-Monitoring/instrumentation/standards ; Diabetes Mellitus, Type 2/blood/drug therapy ; Female ; Humans ; Hypoglycemia/*diagnosis ; Renal Dialysis