A 65-year-old female patient with hepatitis B cirrhosis, pulmonary infection, abdominal infection and respiratory failure received lactulose oral solution, furosemide, spironolactone, entecavir, potassium chloride injection, polyene phosphatidyl choline, ademetionine 1,4-butanedisulfonate, reduced glutathione, human albumin, thymopentin, vitamin K1, L-ornithine L-aspartate, piperacillin sodium tazobactam sodium, teicoplanin, methylprednisolone sodium succinate, compound glycyrrhizin, lanso-prazole, kuhuang injection(苦黄注射液) and salbutamol sulfate solution.Amiodarone hydrochloride injection 0.15 g was given to the patient by slow intravenous infusion due to atrial fibrillation, and then the drug was diluted by 5% glucose injection to 10 mg/ml by a continuous infusion pump delivering 3 ml/h.On day 2, scattered rash appeared on her left thigh.On day 3, the rash extended to the left leg, piperacillin sodium tazobactam sodium and teicoplanin were stopped.She was given intramuscular injection of promethazine hydrochloride 25 mg and intravenous injection of calcium gluconate 1 g, the rash area decreased.That night, the heart rate of the patient was up to 128 beats/min, and the injection pump speed of amiodarone hydrochloride was adjusted for 6 ml/h.The next day, the rash throughout the limbs and chest, kuhuang injection was stopped and oral cyproheptadine hydrochloride 4 mg twice daily was given.On day 7, the patient developed generalized diffuse erythema, thymopentin and compound glycyrrhizin were stopped.On day 8, the rash exacerbated accompanied by desquamation.Scarlatiniform erythema drug eruption induced by amiodarone hydrochloride was considered.Amiodarone hydrochloride was withdrawn.She was given intravenous injection of dexamethasone 10 mg and calcium gluconate 1 g.The next day, the rash subsided significantly.

Objective:To provide reference for the sedation therapy and clinical monitoring for the patients with liver cirrhosis and alcohol withdrawal.Methods:Clinical pharmacist participated in the treatment process of emergency dyspnea in one patient with liver cirrhosis and alcohol withdrawal,and the thoughts and practice methods of clinical pharmacist participating in clinics were shared.Results:Based on the literatures,clinical pharmacist thought the emergency dyspnea was caused by overdose of sedatives.Therefore,medication monitoring and education on the drugs were provided for the patient,and pharmaceutical suggestions were put forward for the next treatment.Conclusion:Clinical pharmacists can help physicians analyze the causes of adverse reactions,and provide pharmaceutical care and medication education to ensure the safety and effectiveness of drug treatment.

A 65-year-old female patient with hepatitis B cirrhosis, pulmonary infection, abdominal infection and respiratory failure received lactulose oral solution, furosemide, spironolactone, entecavir, potassium chloride injection, polyene phosphatidyl choline, ademetionine 1,4-butanedisulfonate, reduced glutathione, human albumin, thymopentin, vitamin K1, L-ornithine L-aspartate, piperacillin sodium tazobactam sodium, teicoplanin, methylprednisolone sodium succinate, compound glycyrrhizin, lanso-prazole, kuhuang injection(苦黄注射液) and salbutamol sulfate solution.Amiodarone hydrochloride injection 0.15 g was given to the patient by slow intravenous infusion due to atrial fibrillation, and then the drug was diluted by 5% glucose injection to 10 mg/ml by a continuous infusion pump delivering 3 ml/h.On day 2, scattered rash appeared on her left thigh.On day 3, the rash extended to the left leg, piperacillin sodium tazobactam sodium and teicoplanin were stopped.She was given intramuscular injection of promethazine hydrochloride 25 mg and intravenous injection of calcium gluconate 1 g, the rash area decreased.That night, the heart rate of the patient was up to 128 beats/min, and the injection pump speed of amiodarone hydrochloride was adjusted for 6 ml/h.The next day, the rash throughout the limbs and chest, kuhuang injection was stopped and oral cyproheptadine hydrochloride 4 mg twice daily was given.On day 7, the patient developed generalized diffuse erythema, thymopentin and compound glycyrrhizin were stopped.On day 8, the rash exacerbated accompanied by desquamation.Scarlatiniform erythema drug eruption induced by amiodarone hydrochloride was considered.Amiodarone hydrochloride was withdrawn.She was given intravenous injection of dexamethasone 10 mg and calcium gluconate 1 g.The next day, the rash subsided significantly.

Objective To improve the quality standard of compound Chaihu tea. Methods Pupleuri Radix, Puerariae Lobatae Radix and Forsythiae Fructus were identified by thin layer chromatography (TLC).HPLC method was used to determine the content of puerarin.The determination was performed on a Shimadzu VP-ODS-C18column (250 mm×4.6 mm,5μm) with the mobile phase of methanol-0.2% H3PO4(23:77).The flow rate was 1.0 mL·min-1, the column temperature was set at 30 ℃ and the detection wavelength was 250 nm. Results The TLC spots were clear and well-separated without negative interference.The good linear correlation existed within the range of 1.340 8-56.632 8μg· mL-1 for puerarin (r=0.999 9, n=6) and the average recovery was 102.98% with RSD being 1.48% (n=6). Conclusion The method is simple and accurate.It can be used for quality control of compound Chaihu tea.

Microdialysis is an automatic biological sampling technique that is directed into the target tissue. Microdialysis is used to monitor the changes of drug and related substances associated with pathological physiology of tumor in the target tissue at the molecular level. Microdialysis is applied to evaluate the pharmaco-kinetics of drugs in the target tissue of tumor,optimize the combination therapy,explore molecular targeted therapy and study the early diagnosis and prognosis of tumor. Microdialysis provides a new idea and method for the prevention and cure research of tumor.

OBJECTIVE To study the in virto interaction of allicin combined with cefoperazone against clinical isolates of Pseudomonas aeruginosa.METHODS The protocol was designed by checkerboard method and the MICs of allicin combined with cefoperazone against the 17 strains of sensitive and 14 strains of drug-resistant P.aeruginosa were determined by broth dilution method,the FIC index was calculated according to MIC results.The combined effects were confirmed by FIC index.RESULTS The percentage of the FIC index less than 0.5,from 0.5 to 1,from 1 to 2,and more than 2 was 41.2-64.3% 35.7-41.2% 0-17.6%,and 0%,respectively.CONCLUSIONS Synergism and additivity of allicin combined with cefoperazone against P.aeruginosa are their main action,there are little autonomy and no antagonism.Allicin can significantly improve the antibacterial activity of cefoperazone against drug-resistant P.aeruginosa.

OBJECTIVE To study the in vitro activity of cefepime combined with sulbactam against carbapenem-resistant strains of Acinetobacter spp clinically isolated. METHODS The activity of each drug alone was determined against 24 isolates. Chequerborad synergy testing was then performed against all the isolates. RESULTS The percentage of the FIC index showed 33.3% synergism, 62.5% additive, 4.2% (1/24) indifference, and no antagonism tively. CONCLUSIONS Testing of cefepime and sulbactam combinations revealed synergism and additivity activity against some carbapenem-resistant strains(23/24) of Acinetobacter spp which could be likely to prove beneficial effect for the treatment of infections due to multidrug-resistant strains of Acinetobacter spp.

OBJECTIVE: To investigate the resistance phenotype of acinetobacter baumannii and the expression of ade efflux pump gene. METHODS: Non-repetitive 51 strains of Acinetobacter baumannii were collected in Peking Union Medical Hospital between Feb. 2004 and Feb. 2005. The active efflux system adeB structural gene and sequence were identified by PCR. RESULTS: The tested strains were not susceptible to common broad-spectrum antibiotics. Multidrug resistant Acinetobacter baumannii carried adeB active efflux pump gene. CONCLUSION: The multiple-drug resistance of Acinetobacter baumannii is independent of ?-lactamase. It maybe related to other drug resistance mechanism. The effect of active efflux system is possibly one of the major mechanisms of multidrug resistance of acinetobacter baumannii.

AIM: To compare two methods of HPLC-MS/MS and MEIA to monitor the tacrolimus concentrations for organ transplantation patient.METHODS: After developing and validating the HPLC-MS/MS method to determine the concentrations of tacrolimus,the tacrolimus samples were quantitated by two methods of HPLC-MS/MS and MEIA,respectively.Evaluate two methods by statistical analysis of quantitative results.RESULTS: The mean concentration were(4.86?0.46) ng/mL by HPLC-MS/MS and(5.52?0.43) ng/mL by MEIA.The coefficient correlation of two methods was 0.8771,and the two methods have good correlations in statistics.The mean concentration ratio was(90.3?5.3)%.CONCLUSION: The HPLC-MS/MS method is a more precise method for to determining the effective concentration of tacrolimus,which is suitable for daily TDM.