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Adverse Drug Reactions Journal

1999  (1,  1)  to  Present  ISSN: 1008-5734

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Role of foreign pharmacists in immunization and vaccine management

Xiaoyan WU ; Helen ZHANG ; Haodong CAI

Adverse Drug Reactions Journal.2018;20(6):436-441. doi:10.3760/cma.j.issn.1008-5734.2018.07.008

In the developed countries such as the United States,Canada,and Australia,phar-macists play an important role not only in pharmacy services,but also in immunization and vaccine management. The American Pharmacists Association (APhA)has been training pharmacists in vaccine management since 1994. The American Hospital Pharmacist Association formulated the guidelines on the pharmacist′s role in immunization in 2003. Since then,the pharmacists began to involve in procurement, distribution,prescription,and immunization of vaccine. In recent years,the pharmacists in France, Australia,Canada,and other countries have been involving in immunization and vaccine management in succession,and even playing an important role in all aspects of vaccine management (such as procurement, storage,prescription and dispensing,vaccine consultation,immunization,vaccine adverse events reporting, public health education,and etc.). The experience of foreign pharmacists participating in immunization is worth learning.

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Nervous system damage caused by nitrous oxide abuse

Bo LIU ; Xingzhuo ZHOU ; Lin ZHENG ; Mingchun LI ; Chunyan WANG

Adverse Drug Reactions Journal.2019;21(2):152-154. doi:10.3760/cma.j.issn.1008-5734.2019.02.019

An 18-year-old male patient developed numbness and fatigue in the limbs without any obvious causes,which aggravated to be unable to hold objects in hands,have difficulty in writing,standing and walking,and be easy to fall after 3 weeks.Laboratory tests showed his average erythrocyte volume 104 fl,homocysteine 89.1 μmol/L,vitamin B12 76 pmol/ml,and folic acid 14.9 nmol/L.MRI revealed image features of subacute combined degeneration of spinal cord.Nerve conduction velocity,action potential,and electromyography showed nerve damage signs.He was diagnosed with toxic myelopathy,subacute combined degeneration of spinal cord,and peripheral neuropathy.To find the cause of the disease,the doctor asked about the medical history repeatedly,and finally learned that the patient had taken nitrous oxide(N2O) for nearly 6 months(8-50 g/d).An Ⅳ injection of mecobalamine (0.5 mg,once daily),intramuscular injection of rat nerve growth factor (30 μg,once daily),as well as massage and acupuncture treatments were given.After 8 days,his average erythrocyte volume was 102 fl,homocysteine was 12.9 μmol/L,vitamin B12 was > 1 500 pmol/ml,and folic acid was 14.1 nmol/L.After 3 weeks,numbness and fatigue of his upper limbs disappeared.After 3 months,the patient could walk up and down the hill and run.

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Deafness and pancytopenia induced by overdose of aspirin

Han HAN ; Rong WANG ; Cheng XIE

Adverse Drug Reactions Journal.2019;21(2):156-157. doi:10.3760/cma.j.issn.1008-5734.2019.02.021

A 69-year-old female patient mistakenly took overdose of aspirin enteric-coated tablets (4.86 g,twice daily) because of memory confusion.After taking 3 times of aspirin overdose,she developed hearing loss.When the medication was taken for the seventh time (the aspirin cumulative dosage was 34.02 g),the medication error was found by her relatives.The medication was discontinued and the patient was taken to the hospital.Hearing tests suggested the sensorineural deafness and laboratory tests revealed pancytopenia.The lowest white blood cell count(WBC) was 1.9 × 109/L,the lowest red blood cell count (RBC) was 3.0 × 1012/L,the lowest hemoglobin(Hb) was 99 g/L,and the lowest platelet count (PLT)was 39 × 109/L.After 18 days of rehydration and symptomatic treatments,her hearing recovered to normal.Laboratory tests showed WBC 8.4 × 109/L,RBC 3.7 × 1012/L,Hb 123 g/L,and PLT 113 × 109/L.

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Phlebitis due to 0.9 % sodium chloride injection as solvent of amiodarone hydrochloride injection

Lin SUO ; Jia WANG ; Jing LI

Adverse Drug Reactions Journal.2019;21(2):154-155. doi:10.3760/cma.j.issn.1008-5734.2019.02.020

A 59-year-old male patient with type 2 diabetes mellitus needed to receive continuous intravenous pump infusion of amiodarone hydrochloride injection for atrial fibrillation.Considering the higher blood sugar levels of the patient,the clinician used 0.9% sodium chloride injection as the solvent and gave the infusion at the speed of 1 mg amiodarone hydrochloride injection per min via his left arm.About 1 hour later,the patient developed red and swollen on the skin around the venous access of his left arm with increased skin temperature and obvious pain.He was diagnosed as phlebitis,which was considered to be relevant with 0.9% sodium chloride injection.The solvent was changed to 5% glucose injection immediately and the infusion was given via the right arm.At the same time,the cold compress treatment was given on phlebitis area.One hour later,the skin temperature returned to normal and the symptoms of swollen and pain disappeared.

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Toxic epidermal necrolysis induced by combination of ceftriaxone, lysine acetylsalicylate and Qingkailing(清开灵)

Jike XIE ; Yongfang HU ; Xuelian YAN

Adverse Drug Reactions Journal.2019;21(2):150-151. doi:10.3760/cma.j.issn.1008-5734.2019.02.018

A 30-year-old male patient received Ⅳ infusions of lysine acetylsalicylate 0.9 g dissolved in 0.9% sodium chloride injection 100 ml,ceftriaxone 4.0 g and dexamethasone 5 mg together dissolved in 0.9% sodium chloride injection 250 ml,and Qingkailing injection 30 ml dissolved in 5% glucose injection 250 ml once daily for 2 days in a local clinic for common cold.On day 3 of the drugs withdrawal,the patient developed rash on multiple parts of both hands,accompanied by pruritus.The next day,he developed fever and his body temperature rose to 40 ℃.Over the next few days,the rash gradually spread to his whole body and herpes appeared.Laboratory tests showed that alanine aminotransferase 1 012 U/L,aspartate aminotransferase 413 U/L,total bilirubin 92.5 μ mol/L,and direct bilirubin 72.1 μmol/L.Seven days after the onset of rash,the area of skin lesions,blisters,and exfoliation respectively reached 60%-70%,20%-30%,and > 30% of his body surface area.The patient was diagnosed with toxic epidermal necrolysis complicated with liver injury.The Ⅳ infusions of methylprednisolone and immunoglobulin and symptomatic support treatments including timely skin care,hepatoprotective drugs,and anti-infection drugs were given,and his skin lesions gradually improved.After 7 days of treatments,methylprednisolone was changed to be taken orally and gradually reduced to discontinuation.Symptomatic treatments such as hepatoprotective therapy lasted for more than 3 weeks.After 40 days,his skin lesions healed.

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Mental and behavioral disorders due to tigecycline

Hong CHEN ; Gaoqiong YAO ; Feng QIU

Adverse Drug Reactions Journal.2019;21(2):148-149. doi:10.3760/cma.j.issn.1008-5734.2019.02.017

A 77-year-old male patient received an Ⅳ infusion of tigecycline 100 mg for the acute exacerbation of chronic obstructive pulmonary disease and the flora species being sensitive to tigecycline in his antibiotic sensitivity test.About 3 hours after the infusion,the patient developed mental and behavioral abnormalities such as hallucinations and balderdash.Tigecycline was stopped the next day,and the patient's consciousness improved and he could answer questions correctly.Because of the poor control of the infection,an Ⅳ infusion of tigecycline 50 mg was given 6 days later.About 8 hours after the infusion,the patient developed mental and behavioral abnormalities such as staring at a certain place and unresponsiveness to verbal stimuli.Then tigecycline was stopped,and the patient's consciousness recovered.

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Sertraline-induced liver injury

Haixia LIANG ; Fanqiang MENG ; Peng LI ; Sihai LING ; Wei GUO

Adverse Drug Reactions Journal.2019;21(2):146-147. doi:10.3760/cma.j.issn.1008-5734.2019.02.016

A 66-year-old female patient received oral sertraline (initial dose 25 mg once daily,gradually increased to 100 mg once daily on day 10),zopiclone (7.5 mg once per night),lorazepam (0.5 mg thrice daily),and amlodipine (2.5 mg once daily) following the doctor's advice due to recurrent depressive disorder,sleep disorder,and hypertension.Before administration,the patient's serum levels of aspartate aminotransferase (AST),alanine aminotransferase (ALT),and γ-glutamyl transpeptidase (γ-GT)were 21 U/L,16 U/L and 50 U/L,respectively.On day 16 after the medication,the patient's serum levels of AST,ALT,and-γ-GT were 114 U/L,134 U/L,and 192 U/L,respectively,but the treatment protocol was not adjusted.On day 21 after the medication,her serum levels of AST,ALT,and γ-GT turned to be 178 U/L,242 U/L,and 362 U/L,respectively.Then hepatoprotective drugs were given,sertraline was discontinued by gradual reduction (oral escitalopram 5 mg once daily was added when sertraline was reduced to 25 mg once daily,but escitalopram was changed to oral mirtazapine 15 mg at bedtime finally due to the patient's leg discomfort),and the other drugs were continued.The liver function of the patient gradually improved and her serum levels of AST,ALT,and γ-GT were 35 U/L,36 U/L,and 108 U/L,respectively about 50 days after sertraline withdrawal.

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Severe hypoglycemia due to misuse of insulin aspart before bedtime in an elderly patient with type 2 diabetes mellitus

Xian DU ; Yinmei YE ; Peihuan SUN ; Jiangxia CAI ; Xinchun YAN

Adverse Drug Reactions Journal.2019;21(2):144-145. doi:10.3760/cma.j.issn.1008-5734.2019.02.015

A 77-year-old female patient with type 2 diabetes mellitus mistakenly injected insulin aspart 16 U subcutaneously as glargine insulin before bedtime.One hour later,she developed slow response and paraphasia.Her urgent blood glucose level was 2.8 mmol/L.An Ⅳ injection of 50% glucose injection 40 ml,mask oxygen absorption,and continuous ECG monitoring were given immediately.Thirty minutes later,her blood glucose level increased to 8.4 mmol/L.The adjusted hypoglycemic regimen was subcutaneous injection of 8,10,and 8 units of insulin aspart 15 minutes before 3 meals,respectively,and glargine insulin 18 U before bedtime.Six days later,her fasting and 2-hour postprandial blood glucose levels were 7.0-8.3 mmol/L and 9.1-10.2 mmol/L,respectively.

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Apatinib mesylate tablets-induced hand-foot skin reaction: report of two cases

Mei HAN ; Ming GE ; Bingtuan LEI ; Huibo YANG

Adverse Drug Reactions Journal.2019;21(2):142-144. doi:10.3760/cma.j.issn.1008-5734.2019.02.014

Two male patients (patient 1,54 years old;patient 2,63 years old) were treated with apatinib mesylate tablets (apatinib) for adenocarcinoma of cardia and gastric fundus and left lung cancer,respectively.Patient 1 developed erythema and swelling on the extremities,perianal,and perigenital on day 22 after taking apatinib (850 mg/d).Apatinib-induced hand-foot skin reaction (HFSR) was considered.Then apatinib was discontinued,oral vitamin B6 and topical external vitamin E cream were given.After withdrawal of apatinib,his skin symptoms alleviated,and apatinib (750 mg/d) was re-given on day 7 after withdrawal.On day 57 after the resumption of apatinib,the patient's skin symptoms worsened and the medication was discontinued again.Afterwards,apatinib was given and then discontinued for 2 times (first 500 mg/d and then 250 mg/d).Because the symptoms aggravated after medication and alleviated after discontinuation,apatinib treatment was terminated finally.Patient 2 developed skin erythema,swelling,and pain on the palms and soles on day 35 after apatinib treatment at a dose of 500 mg/d.On day 85,he developed skin desquamation and circular keratosis of hands and feet,scattered erythema with desquamation in axilla,perianal region and groin,and increased pain in the skin lesions.Apatinib-induced HFSR was diagnosed.Apatinib was discontinued and symptomatic treatments were given.On day 17 of drug withdrawal,his skin symptoms improved and apatinib (500 mg/d) was given again.About 2 weeks later,the patient's skin symptoms aggravated again,and the drug was discontinued.

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Sudden deafness caused by azithromycin for injection in a boy with bronchopneumonia

Lei XU ; Junhui WANG ; Li ZHAO ; Feiyu LIU ; Lei ZHANG ; Yinglin WANG ; Haiyan SUN

Adverse Drug Reactions Journal.2019;21(2):140-141. doi:10.3760/cma.j.issn.1008-5734.2019.02.013

An 11-year-old boy received Ⅳ infusions of azithromycin for injection 0.5 g for 3 hours once daily and cefotiam for injection 1.0 g thrice daily for bronchopneumonia.The boy did not complain of hearing abnormality before medication.Tinnitus appeared about 2 hours after the beginning of the first and second Ⅳ infusions of azithromycin and disappeared about 2 and 3 hours later,respectively.Additionally,his hearing decreased after the second dose of azithromycin (the pure-tone audiometry showed that the average hearing thresholds of his right and left ears were 43 and 47 dB,respectively).Sensorineural deafness was diagnosed.The boy developed persistent tinnitus and further hearing loss I hour after the beginning of the third Ⅳ infusion of azithromycin (the average hearing thresholds of the right and left ears were 51 and 60 dB,respectively).Azithromycin was discontinued,cefotiam was continued,and extract of ginkgo biloba leaves tablets were given orally (1 tablet twice daily).On day 2 after azithromycin discontinuation,his tinnitus improved.On day 5,his tinnitus disappeared and hearing improved (the average hearing thresholds of the right and left ears were 42 and 49 dB,respectively).On day 40,his hearing improved further (the average hearing thresholds of his right and left ears were 32 and 36 dB,respectively).

Country

China

Publisher

Chinese Medical Journals Publishing House Co., Ltd.

ElectronicLinks

http://www.cadrj.com/EN/home

Editor-in-chief

Li Lin

E-mail

cadrj@sina.com

Abbreviation

ADRJ

Vernacular Journal Title

药物不良反应杂志

ISSN

1008-5734

EISSN

Year Approved

2025

Current Indexing Status

Currently Indexed

Start Year

1999

Description

Adverse Drug Reactions Journal (药物不良反应杂志, ADRJ) is an academic journal issued domestically and internationally, which is sponsored by Chinese Medical Association and supervised by China Association for Science and Technology. It was founded in 1999 and published monthly, ISSN was 1008-5734. Its founder was professor Cheng Jinghua (程经华), who was the major pioneer and initiator of the monitoring work on adverse drug reactions in China. The idea of the journal is to run its own characteristics, make its best products, strive for its fame, and go to the world. Professor Li Lin, the current editor-in-chief, is the chief expert of the Pharmaceutical Department of Xuanwu Hospital, Capital Medical University, the vice president of the Chinese Pharmacological Association, the president of the Beijing Pharmacological Association, etc. He has served as the vice president of Xuanwu Hospital of Capital Medical University, the director of the Pharmaceutical Research Office, the deputy director of the National Clinical Research Institute of Drugs, the executive deputy director of the Key Laboratory of Neurodegenerative Diseases of the Ministry of Education, and the director of the Beijing Neuropharmaceutical Engineering and Technology Research Center. The journal has a sound editorial committee with consultants such as academician of Chinese Academy of Sciences, professor Chen Keji (陈可翼), and academician of Chinese Academy of Engineering, professor Gao Runlin (高润霖), Ning Guang (宁光), and Zhong Nanshan (钟南山). Editorial members come from 28 provinces, autonomous regions, municipalities directly under the Central Government, the United States and Singapore, covering clinical medicine (cardiovascular, respiratory, gastroenterology, nephrology, neurology, psychiatry. endocrinology, rheumatology, hematology, infectious diseases, oncology, allergy, dermatology, ophthalmology, etc.), pharmacology (clinical pharmacy, clinical pharmacology, pharmaceutics, pharmacoeconomics, pharmacy administration, etc.), nursing, clinical toxicology, pharmaceutical epidemiology, evidence-based medicine, statistics, and other disciplines. ADRJ focuses on the release of academic achievements in adverse drug events (adverse drug reactions, medication errors and drug quality defects), drug-induced diseases, and medication safety. The aims of the journal are to promote communication of drug safety information through reporting adverse drug reactions and their occurrence rules, improve clinical safe drug use level, protect public drug use safety and serve public health. The main columns include editorial, forum, original article, review, practice and research on clinical medication safety, pharmacist case record, case report, poisoning treatment, adverse reaction of traditional Chinese medicine, and historical story of drug accident, etc. Referring to the Reactions Weekly, ADRJ takes timely reporting new and serious adverse drug events as its feature. Among the reported adverse drug reactions, there is the first case reported globally or nationally. For example, the rhabdomyolysis induced by telbivudine published in 2009, which is the first case in the world, and the infliximab-induced aplastic anemia published in 2012, which is the first case in China and the second case in the world. ADRJ is a peer-reviewed journal and insists on the quality first of the manuscript. The journal follows relevant national standards and Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals. At present, ADRJ is the statistical source journal of “Chinese Science and Technology Paper Citation Database (CSTPCD)”, the source journal of “Chinese Science Citation Database (CSCD)” and is indexed by Ulrich's Periodicals Directory and International Pharmaceutical Abstract. In January 2020, ADRJ was officially included in Scopus, which is owned by Elsevier B.V. and is the largest peer-reviewed literature abstract and citation database in the world. The Scopus Content Selection & Advisory Board (CSAB) evaluate the journal as follows: Timely and accurate drug reaction reporting has global significance. The Chinese experience in this field is thus hugely important, particularly given the scale of the Chinese population and the reach of the Chinese pharmaceutical industry. It raises the journal directly from national to global importance. The journal has been recognized by the important international retrieval system, and the internationalization process of the journal has made great progress. Because the contents inosculate closely to the clinic with strong technicality and practicability, the issue of the journal not only covers in 34 provinces, autonomous regions and municipalities across the country, including Hong Kong, Macao and Taiwan, but also in the United States, the United Kingdom, Germany, France, Australia, New Zealand, Japan, South Korea, Singapore, Malaysia, and other countries. The fruitful work since its inception has established its academic status in the field of adverse drug reaction monitoring and medication safety in China. In September 2012, the National Health and Family Planning Commission decided to set up a clinical medication safety group under the INRUD China Central Group and establish a clinical medication safety monitoring network. The relevant work was entrusted to adverse drug reactions Journal Agency. To better implement the aims of the journal, various forms of academic activities were also held, including the China Forum on Drug-induced Diseases and Medication Safety, the hot topic discussion on medication safety, the difficult case discussion, the special academic seminar, the adverse drug reaction monitoring training course, etc. The China Forum on Drug-induced Diseases and Medication Safety has become an important distinguished academic meeting about clinical drug safety application, which has been held annually since 2009. The Adverse Drug Reaction Journal will, as always, adhere to the aims of running the magazine, never forget the original intention and forge ahead! Address: Room 1089, Teaching Building, Xuanwu Hospital, Capital Medical University, Donghuajinzuo, No.118, Guang’anmennei Street, Xicheng District, Beijing 100053, China Post code: 100053 Website: www.cadrj.com

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