1.Study on medication law of traditional Chinese medicine compound for prevention and treatment of viral pneumonia based on national patents
Dongdong XU ; Lei TANG ; Yang AN ; Zhaoshuai JI ; Qiantai MAO
China Modern Doctor 2024;62(33):79-83,102
Objective To analyze the medication rules of compound patents for the prevention and treatment of viral pneumonia through data mining technology,and to provide new ideas for clinical diagnosis and treatment and new drug research and development.Methods Summarizing the patents of traditional Chinese medicine compounds for the prevention and treatment of viral pneumonia in Patent Announcement module of China National Intellectual Property Administration website,search time is from database establishment to December 31,2023,and the statistics on the frequency of use,medicinal properties,efficacy classification,association analysis,and cluster analysis were carried out with the help of data mining software such as Excel 2019,IBM SPSS Statistics 26.0,and IBM SPSS Modeler 18.0.Results Through screening,a total of 218 compound patents met the inclusion criteria,involving 424 kinds of Chinese materia medica,and the top 5 herbs with the highest frequency of use were Glycyrrhizae Radix et Rhizoma,Lonicerae Japonicae Flos,Forsythiae Fructus,Scutellariae Radix,and Platycodon Radix.The medicinal properties are bitter and cold,and mostly belong to the lung meridian.There were 4 medicinal groups of pair medicine,13 medicinal groups of triple medicine,and 1 medicinal group with four related medicine exhibiting strong correlation.A total of 6 high-frequency combinations of traditional Chinese medicine were obtained by cluster analysis.Conclusion The basic pathogenesis of viral pneumonia is that internal deficiency and evil enter,heat toxin is trapped in the ling,the phlegm and blood stasis is occurred inside,and affecting the lung's function of purging and eliminating.In clinical practice,the deficiency tonic drugs Astragali radix and Glycyrrhizae Radix et Rhizoma,are used to strengthen resistance,the heat-clearing drugs Lonicerae Japonicae Flos,Forsythiae Fructus,the phlegm antitussive and antiasthmatic drugs,Platycodon Radix,Armeniacae Semen Amarum,etc,are used to treat the symptoms,simultaneous treatment of the symptoms and root cause,prevention and treatment are organically combined.
2.Individualized Pharmaceutical Care for Digoxin Poisoning in Patient with Dilated Cardiomyopathy
Xiaojuan YANG ; Lan WANG ; Shubin CUI ; Zhaoshuai JI ; Qiantai MAO ; Weiwei SONG ; Chao AI
Herald of Medicine 2024;43(8):1321-1325
Objective To introduces drug treatment and individualized pharmaceutical care for a patient with dilated cardiomyopathy digoxin poisoning and provides ideas for pharmaceutical care.Methods The pharmacist used therapeutic drug management to analyze the course of drug treatment before and after hospitalization,combined with therapeutic drug monitoring and drug-gene detection,to analyze the causes of poisoning in digoxin from the perspectives of underlying diseases,polymor-phism,drug dosage,combination of drugs,physiological and other pathological factors,and to assist in clinical drug reformula-tion and optimization of drug treatment regimens.Results The clinician accepted the clinical pharmacist's suggestion.The pa-tient had a good prognosis,and digoxin poisoning did not occur in the later period.Conclusion This case provides a feasible treatment for dilated cardiomyopathy and other patients with digoxin intoxication;it can be used as a reference for the prevention and treatment of digoxin poisoning and provide a new direction for the development of hospital pharmaceutical care and pharma-ceutical professionals.
3.Application of Medication Therapy Management Combined with Medicine Gene Detection in Individualized Pharmaceutical Care of An Elderly Patient with Warfarin-induced Acute Upper Gastrointestinal Hemorrhage
Lan WANG ; Qiantai MAO ; Xiaoning ZHANG ; Zhaoshuai JI ; Chao AI
China Pharmacy 2019;30(17):2388-2393
OBJECTIVE: To investigate how pharmacists provide through individualized pharmaceutical care for patients medication therapy management(MTM) combined with medicine gene detection, and to promote rational drug use in clinic.METHODS: A case of elderly comorbidity with acute upper gastrointestinal hemorrhage caused by Warfarin sodium tablets was taken as an example. The patient had a history of type 2 diabetes mellitus and hypertension. Coronary artery bypass grafting was performed two months before admission, and urinary tract infection occurred half a month ago. Medication therapy course was analyzed retrospectively before and after hospitalization; based on gene typing detection of CYP2C9*3 and VKORC1-1639, the individualized dose of Warfarin sodium tablets was evaluated. MTM was perfomed for acute upper gastrointestinal hemorrhage and all medication of patient to formulate individualized medication scheme. RESULTS: The genotyping of warfarin CYP2C9*3 and VKORC1-1639 indicated that the patients were of super slow metabolic type. The recommended dosage of warfarin should be 0.86-1.86 mg/d. Based on MTM analysis of acute upper gastrointestinal hemorrhage, the main causes of acute upper gastrointestinal hemorrhage were Warfarin sodium tablets 3.0 mg/d, poor drug compliance, disease status and co-morbidity and multi-drug combination. Clinical gastrointestinal hemorrhage of the patients were improved after drug withdrawal, anticoagulant drugs was changed into Rivaroxaban tablet,10 mg/d. Through MTM for all drug use in the patient, results of medication reorganization showed that Diltiazem hydrochloride tablet, Amoxicillin/clavulanate potassium dispersible tablet, Compound vitamin tablet were stopped; hypoglycemic drug Glimepiride tablet was changed into Gliquidone tablet; Metoprolol tartrate tablet was changed into Bisoprolol tablet after coronary artery bypass graft; proton pump inhibitor Esomeprazole enteric-coated tablet was changed into Pantoprazole sodium enteric-coated capsule. CONCLUSIONS: The pharmaceutical care mode of MTM combined with medicine gene detection can guide rational drug use in clinic, realize individualized pharmaceutical care, improve patient compliance and prevent problems related to adverse drug reactions.
4.Clinical significance of folic acid metabolic gene detection in methotrexate treatment of leukemia
Weiwei SONG ; Yuehua HUANG ; Lan WANG ; Jing TANG ; Qiantai MAO ; Jianxin WANG ; Chao AI
China Pharmacy 2022;33(10):1269-1273
OBJECTIVE To expl ore the clinical significance of folic acid metabolic gene detection in methotrexate (MTX) treatment of acute myeloid leukemia (AML). METHODS Therapeutic drug monitoring (TDM)pharmacists participated in the treatment process of an AML patient who had neurotoxic side effects such as dizziness ,headache,and vomiting after intrathecal injection of MTX. According to the results of the test of the folic acid metabolic gene MTHFR C677T(rs1801133)(mutant homozygous)and the results of MTX blood concentration monitoring (<0.05 μmol/L),combined with clinical manifestations ,it was recommended to stop MTX ,give intravenous drip of calcium folinate for rescue ,and consider using azacytidine for follow-up treatment. RESULTS The doctor took the advice of TDM pharmacist ,and the above symptoms were significantly relieved after the patient rescued for 2 times and successfully discharged from the hospital. CONCLUSIONS For AML patients who meet the indications and receive intrathecal injection of MTX ,drug metabolism genetics testing and MTX drug concentration monitoring can be performed before medication ,which helps doctors and pharmacists evaluate the feasibility of drug treatment options and reduce medical risks.