Journal of Basic and Clinical Pharmacy最新文献_第4页

Type I hypersensitivity reaction as a complication of lepa lepa并发症的I型超敏反应

Journal of Basic and Clinical Pharmacy

Pub Date : 2015-12-01 DOI: 10.4103/0976-0105.170583

Deepa Manjunath Janthli, A. Chaturvedi, S. Somashekar, B. Lohith

Adverse drug reaction is defined as response to a drug which is noxious and unintended, and which occurs at doses normally used in man for the prophylaxis, diagnosis or therapy of disease, or for the modification of physiological functions. Type I hypersensitivity reaction is known as anaphylactic reaction which is due to immediate immunoglobulin E-mediated reaction. It is characterized by symptoms such as fever nausea, back pain, angiodema, rash, flushing, etc. Lepa generally refers to the application of pastes formed by mixing powder of herbs with water, milk, etc., and liquids. Complementary and alternative medicines are frequently used by the general population. Many people consider them to be without side effects. Ayurvedic treatment involves Shodhana (biopurification), Shaman (pacification), Bahya (external therapy), and Abhyantara karma's (internal therapy) for treating different diseases. One such bahya karma or external therapy is lepa. Even though lepa is said as "Aadhya Upakrama," undue hypersensitivity is observed in many patients. A 60-year-old woman had an adverse reaction to lepa after being administered as an external medication. The observations were erythema, eruptions, and itching. Such case of hypersensitivity is discussed in the present study.

药物不良反应被定义为对有害和非预期药物的反应，并且在通常用于预防、诊断或治疗疾病或改变生理功能的剂量下发生。I型超敏反应又称过敏性反应，是由免疫球蛋白e介导的即时反应引起的。其特征是发热、恶心、背部疼痛、血管水肿、皮疹、潮红等症状。乐帕一般是指将草药粉末与水、牛奶等和液体混合而成的膏体。一般人群经常使用补充和替代药物。许多人认为它们没有副作用。阿育吠陀的治疗包括Shodhana(生物净化)、Shaman(安抚)、Bahya(外部治疗)和Abhyantara karma(内部治疗)来治疗不同的疾病。一种这样的因果报应或外部治疗是乐帕。尽管lepa被称为“Aadhya Upakrama”，但在许多患者中观察到过度过敏。一名60岁的妇女在作为外用药物服用大麻后出现了不良反应。观察结果为红斑、皮疹和瘙痒。本研究讨论了这类过敏病例。

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引用次数: 0

Development and validation of reversed phase high-performance liquid chromatography method for estimation of lercanidipine HCl in pure form and from nanosuspension formulation 反相高效液相色谱法测定盐酸来卡尼地平的纯度和纳米混悬液的含量

Journal of Basic and Clinical Pharmacy

Pub Date : 2015-12-01 DOI: 10.4103/0976-0105.170586

Ankita D. Chonkar, R. S. Managuli, J. Rao, N. Udupa

Aim: Quantitative estimation of lercanidipine HCl in bulk material as well as from nanosuspension formulations via a developed reverse phase HPLC method. Materials and Methods: Optimized chromatographic condition was used to achieve separation on a Kromasil (100-5c18 250 × 4.6 mm) column using Shimadzu HPLC system. The mobile phase consisted of a mixture of acetate buffer (20 mM pH 4.5) and acetonitrile in the ratio of 10:90, v/v. It is pumped through the chromatographic system at a flow rate of 1 ml/min. The detection was carried out at 240 nm using ultraviolet-visible spectrophotometry detector. The method was validated as per Q2 (R1) guidelines, and suitability of the developed method was established by optimized nanosuspension formulation. Results: The method is specific to lercanidipine (RT: 7.7 min), and has ability to resolve the analyte peak from excipient interferences. It is linear (regression coefficient: 0.9993), accurate (average recovery: 100%), and passed all the system suitability requirements. Conclusion: Developed method was found applicable for evaluation of drug content, content uniformity, and analyzing samples of dissolution studies of nanosuspension.

目的:建立一种反相高效液相色谱法定量测定原料药和纳米混悬液中盐酸来卡尼地平的含量。材料与方法:采用优化的色谱条件，在Kromasil (100-5c18 250 × 4.6 mm)柱上采用Shimadzu高效液相色谱系统进行分离。流动相为醋酸缓冲液(20 mM pH 4.5)与乙腈的混合物，比例为10:90,v/v。以1ml /min的流速泵送通过色谱系统。采用紫外-可见分光光度法在240 nm处进行检测。根据Q2 (R1)指南对该方法进行了验证，并通过优化的纳米混悬液配方确定了该方法的适用性。结果:该方法对来卡尼地平具有特异性(RT: 7.7 min)，且能分辨出受辅料干扰的分析物峰。它是线性的(回归系数:0.9993)，准确(平均回收率:100%)，并通过了所有的系统适用性要求。结论:该方法适用于纳米混悬液的药物含量评价、含量均匀性及溶出度分析。

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引用次数: 5

Respiratory arrest due to nitrofurantoin treatment in the absence of pulmonary pathology 在没有肺部病理的情况下，因呋喃妥因治疗导致呼吸骤停

Journal of Basic and Clinical Pharmacy

Pub Date : 2015-09-01 DOI: 10.4103/0976-0105.168050

Hikmet Çoban

In the case we present, an elderly female patient developed respiratory arrest in the absence of pulmonary pathology after using nitrofurantoin (NF). To our current knowledge, this case is the first in the literature. The patient was monitored on mechanical ventilation, and her condition improved only after discontinuing NF treatment.

在我们报告的病例中，一位老年女性患者在没有肺部病理的情况下使用呋喃妥英(NF)后出现呼吸骤停。据我们目前所知，这是文献中的第一例。患者在机械通气监护下，仅在停止NF治疗后病情才有所改善。

引用次数: 2

A rare case of bilateral lower extremity edema due to low dose gabapentin therapy in a young male patient 一例罕见的双侧下肢水肿由于低剂量加巴喷丁治疗的年轻男性患者

Journal of Basic and Clinical Pharmacy

Pub Date : 2015-09-01 DOI: 10.4103/0976-0105.168053

A. Kahlon, Naveen Gnanabakthan, A. Dhillon, D. Subedi

46 year old male with past medical history of schizoaffective disorder and chronic lower back pain, was admitted for management of worsening depression and anxiety. He was started on gabapentin, 300mg twice daily for his back pain and anxiety symptoms. His only other medication was hydrocodone. Over next few days, he started developing worsening bilateral lower extremity edema. He did not have any cardiovascular related symptoms. Physical exam was only significant for 3+ pitting edema with all laboratory values and imaging being unremarkable. Gabapentin was discontinued and his lower extremity swelling improved over subsequent days. Incidence of pedal edema with gabapentin use is approximately 7 to 7.5% with all studies being in elderly patients receiving doses above 1200 mg/day. This case illustrates that lower doses of gabapentin can also cause this adverse effect. It is important to recognize this adverse effect because gabapentin is used in conditions like diabetic neuropathy, which is associated with multiple co-morbidities that can give rise to bilateral leg swelling. Presence of gabapentin induced leg swelling can thus confound the clinical picture.

46岁男性，既往有精神分裂情感性障碍和慢性腰痛病史，因抑郁和焦虑加重而入院。他开始服用加巴喷丁，300毫克，每日两次，治疗背部疼痛和焦虑症状。他唯一的其他药物是氢可酮。在接下来的几天里，他的双侧下肢水肿开始恶化。他没有任何心血管相关症状。体格检查仅对3+点蚀性水肿有显著意义，所有实验室值和影像学检查均无显著差异。加巴喷丁停用后，他的下肢肿胀在随后几天有所改善。使用加巴喷丁的足部水肿发生率约为7%至7.5%，所有研究都是在服用剂量高于1200mg /天的老年患者中进行的。这个病例说明，低剂量的加巴喷丁也会引起这种不良反应。认识到这种副作用是很重要的，因为加巴喷丁用于糖尿病神经病变等疾病，这与多种合并症有关，可能导致双侧腿肿胀。加巴喷丁引起的腿部肿胀会混淆临床表现。

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引用次数: 9

Adverse drug reactions in the era of multi-morbidity and polypharmacy 多病多药时代的药物不良反应

Journal of Basic and Clinical Pharmacy

Pub Date : 2015-09-01 DOI: 10.4103/0976-0105.168052

S. Stawicki, TJavier Birriel, R. Uchino, Noran Barry, Tracy Butryn, Donna M. Sabol, P. Valenza

Dear Sir, We read with great interest the article by Sam et al.[1] on the incidence and types of adverse drug events (ADEs) at a major academic medical center. We congratulate the authors for their very timely and valuable contribution to the area of patient safety. Medication errors are becoming more common in the era of increasingly prevalent multi‐morbidity and polypharmacy as the overall age of the global population increases in a demographic megatrend never before seen by humanity.[2‐4] As Sam et al.[1] pointed out, medication errors constitute a significant proportion of healthcare‐associated adverse events. Although the authors categorize ADEs by primary disorder, type of occurrence, and frequency of IHI triggers, they do not provide specific causative risk factors behind the corresponding ADEs.[1] The authors do, however, go on to discuss specific risk factors for drug‐related adverse events, as compiled from various literature sources. Among many factors, they cite patient age, cardiovascular disease, low patient compliance, and polypharmacy as potential contributors.[1] Polypharmacy by itself may play an important role as a risk factor for ADEs, as pointed out by the authors, due to altered pharmacokinetics, pharmacodynamics, and potential drug‐drug interactions among the most frail and thus most susceptible patients.[1,3]

我们饶有兴趣地阅读了Sam等人[1]关于某大型学术医疗中心药物不良事件(ADEs)的发生率和类型的文章。我们祝贺作者对患者安全领域做出的及时而宝贵的贡献。随着全球人口的总体年龄以人类从未见过的人口大趋势增长，在日益普遍的多病多药时代，用药错误变得越来越普遍。[2‐4]正如Sam等人[1]指出的那样，用药错误在医疗保健相关不良事件中占很大比例。虽然作者根据原发疾病、发生类型和IHI触发频率对ade进行了分类，但他们并没有提供相应ade背后的具体致病危险因素。[1]然而，作者根据各种文献来源，继续讨论药物相关不良事件的具体危险因素。在许多因素中，他们认为患者年龄、心血管疾病、患者依从性低和多药是潜在的影响因素。[1]正如作者所指出的那样，由于在最虚弱和最易感的患者中改变了药代动力学、药效学和潜在的药物-药物相互作用，多药本身可能作为ade的危险因素发挥重要作用。[1,3]

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引用次数: 9

An isobolographic analysis of the antinociceptive effect of xylopic acid in combination with morphine or diclofenac 木糖酸与吗啡或双氯芬酸联用抗痛觉作用的等密度分析

Journal of Basic and Clinical Pharmacy

Pub Date : 2015-09-01 DOI: 10.4103/0976-0105.168055

E. Woode, E. Ameyaw, W. K. Abotsi, Eric Boakye-Gyasi

Background: A common practice of managing pain globally is the combination of analgesics and this is aimed at facilitating patient compliance, simplifying prescription, and improving efficacy without increasing adverse effects. Fruit extracts of Xylopia aethiopica are used traditionally in the management of pain disorders and xylopic acid (XA) present in the fruit extract have been shown to possess analgesic properties in animals. There is the likelihood of concomitant use of XA and the commonly used analgesics in traditional settings. This study, therefore, evaluated the pharmacologic interaction between XA/morphine and xylopic/diclofenac combinations. Methods: The formalin test and acetic acid writhing test were used to study the antinociceptive activity of XA, morphine, and diclofenac. The isobolographic analysis was used to study the antinociceptive interactions between XA co-administered with morphine or diclofenac. Results: Results obtained revealed that XA (10–100 mg/kg), morphine (1–10 mg/kg), and diclofenac (1–10 mg/kg) produced dose-related antinociception with different potencies in the formalin and acetic acid writhing tests. Isobolographic analysis of XA/morphine and XA/diclofenac combinations revealed potentiation of their antinociceptive effects. The degree of potentiation calculated as interaction index showed synergism for both combinations in all the nociceptive tests. Conclusion: In conclusion, the present study demonstrated synergism for the co-administration of XA with morphine or diclofenac.

背景:全球范围内治疗疼痛的一种常见做法是联合使用镇痛药，目的是促进患者依从性，简化处方，提高疗效，同时不增加不良反应。埃塞俄比亚木的果实提取物传统上用于治疗疼痛疾病和存在于果实提取物中的木酸(XA)已被证明在动物中具有镇痛特性。在传统情况下，有可能同时使用XA和常用的镇痛药。因此，本研究评估了XA/吗啡和木氯芬酸/双氯芬酸组合之间的药理学相互作用。方法:采用福尔马林试验和醋酸扭体试验研究XA、吗啡和双氯芬酸的抗伤性。等密度分析用于研究XA与吗啡或双氯芬酸共给药之间的抗痛觉相互作用。结果:XA (10 ~ 100mg /kg)、吗啡(1 ~ 10mg /kg)、双氯芬酸(1 ~ 10mg /kg)在福尔马林和醋酸扭体试验中产生不同效度的剂量相关抗避孕作用。XA/吗啡和XA/双氯芬酸联合用药的等密度分析显示其抗感觉作用增强。以相互作用指数计算的增强程度显示两种组合在所有伤害性测试中都具有协同作用。结论:本研究表明XA与吗啡或双氯芬酸合用具有协同作用。

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引用次数: 15

An evaluation of the prescribing patterns for under-five patients at a Tertiary Paediatric Hospital in Sierra Leone 对塞拉利昂一家三级儿科医院五岁以下患者的处方模式的评估

Journal of Basic and Clinical Pharmacy

Pub Date : 2015-09-01 DOI: 10.4103/0976-0105.168051

Christine Cole, Peter Bai James, A. Kargbo

Purpose: There is limited information on pediatric prescribing in Sierra Leone. This study evaluated prescribing patterns for under-five patients at Ola During Children's Hospital (ODCH) and assessed the extent of rational prescribing. Methods: A descriptive, cross-sectional, retrospective study of 294 prescriptions, selected by systematic random sampling was conducted at the outpatient department of ODCH. The World Health Organisation prescribing indicators were analyzed using the SPSS package 16.0. The index of rational drug prescribing (IRDP) was calculated to assess rational prescribing. Results: The average number of medicines per prescription was 3.77. The percentage of medicines prescribed by generic names was 71.0%, while 74.8% and 21.1% of prescriptions had an antibiotic and injection, respectively. The percentage of medicines prescribed from the national essential medicines list was 70.6%. The most commonly prescribed pharmacological groups of medicines were vitamins (85.37%) and antibiotics (82.99%). The IRDP was 2.71, instead of the ideal value of 5. Conclusion: Pediatric prescribing patterns at the outpatient department of ODCH cannot be said to be entirely rational, especially with regards to antibiotic and injection prescribing.

目的:关于塞拉利昂儿科处方的信息有限。本研究评估Ola During儿童医院(ODCH) 5岁以下患者的处方模式，并评估合理处方的程度。方法:采用系统随机抽样的方法，对我院门诊294张处方进行描述性、横断面、回顾性研究。使用SPSS软件包16.0对世界卫生组织处方指标进行分析。计算合理处方指数(IRDP)，对合理处方进行评价。结果:平均每张处方药品数为3.77种。药品通用名处方占71.0%，抗生素处方占74.8%，注射剂处方占21.1%。国家基本药物目录药品处方比例为70.6%。最常见的药物类群是维生素(85.37%)和抗生素(82.99%)。IRDP为2.71，而不是理想值5。结论:我院门诊儿科处方模式不能说是完全合理的，尤其是抗生素和注射剂处方。

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引用次数: 38

Hypersensitivity reaction associated with phenytoin 与苯妥英有关的过敏反应

Journal of Basic and Clinical Pharmacy

Pub Date : 2015-09-01 DOI: 10.4103/0976-0105.168054

T. Indu, R. Basutkar

Hypersensitivity reactions with antiepileptic drugs (AEDs) are generally associated with aromatic AEDs. We present a case of hypersensitivity reactions followed by administration of phenytoin with diazepam and ranitidine in a patient with generalized tonic-clonic seizures. Antigen-antibody reactions or decreased levels of epoxide hydrolase are well known with phenytoin. Increased level of serum phenytoin causing toxicities due to competitive inhibition with diazepam on co-administration was also reported in the literature. Prevention of the adverse effects with AEDs is a multi-stage process, which requires implementation of preventive measures through careful monitoring and prompts interventions.

抗癫痫药物的超敏反应通常与芳香型抗癫痫药物有关。我们提出了一个病例的过敏反应，随后施用苯妥英与地西泮和雷尼替丁在一个病人的全身性强直阵挛性癫痫。在苯妥英中，抗原抗体反应或环氧化物水解酶水平降低是众所周知的。在文献中也有报道，由于与地西泮共同给药的竞争性抑制，血清苯妥英水平升高引起毒性。预防aed的不良影响是一个多阶段的过程，需要通过仔细监测和提示干预措施来实施预防措施。

引用次数: 1

Antiarthritic activity of a polyherbal formulation against Freund's complete adjuvant induced arthritis in Female Wistar rats. 多药制剂对雌性Wistar大鼠完全佐剂性关节炎的抗关节炎活性。

Journal of Basic and Clinical Pharmacy

Pub Date : 2015-06-01 DOI: 10.4103/0976-0105.160738

R Ramesh Petchi, S Parasuraman, C Vijaya, S V Gopala Krishna, M Kiran Kumar

Objectives: To formulate a polyherbal formulation and evaluate its antiarthritic activity against Freund's complete adjuvant induced arthritis in Female Wistar rats.

Materials and methods: Glycosmis pentaphylla, Tridax procumbens, and Mangifera indica are well-known plants available throughout India and they are commonly used for the treatment of various diseases including arthritis. The polyherbal formulation was formulated using the ethanol extracts of the stem bark of G. pentaphylla , whole plant of T. procumbens, and leaves of M. indica. The polyherbal formulation contains the ethanol extracts of G. pentaphylla, T. procumbens, and M. indica in the ratio of 2:2:1. The quality of the finished product was evaluated as per the World Health Organization's guidelines for the quality control of herbal materials. Arthritis was induced in female Wistar rats using Freund's complete adjuvant (FCA), and the antiarthritic effect of polyherbal formulation was studied at doses of 250 and 500 mg/kg. The effects were compared with those of indomethacin (10 mg/kg). At the end of the study, blood samples were collected for biochemical and hematological analysis. The radiological examination was carried out before terminating the study.

Results: Polyherbal formulation showed significant antiarthritic activity at 250 and 500 mg/kg, respectively, and this effect was comparable with that of indomethacin. The antiarthritic activity of polyherbal formulation is supported by biochemical and hematological analysis.

Conclusion: The polyherbal formulation showed signinicant antiarthritic activity against FCA-induced arthritis in female Wistar rats.

目的:制备一种复方中药制剂，并评价其对雌性Wistar大鼠完全佐剂性关节炎的抗关节炎活性。材料和方法:五谷糖、原藜和芒果是印度著名的植物，它们通常用于治疗包括关节炎在内的各种疾病。该复方以五味子茎皮、原甘菊整株和籼稻叶片的乙醇提取物配制而成。该复方含有五味草、原藜和籼稻的乙醇提取物，其比例为2:2:1。成品的质量是按照世界卫生组织草药材料质量控制准则进行评估的。采用Freund's完全佐剂(FCA)诱导雌性Wistar大鼠关节炎，并以250和500 mg/kg剂量研究复方的抗关节炎作用。比较了吲哚美辛(10 mg/kg)的效果。在研究结束时，采集血样进行生化和血液学分析。在终止研究前进行了放射学检查。结果:复方在250 mg/kg和500 mg/kg时均表现出明显的抗关节炎活性，其作用与吲哚美辛相当。生物化学和血液学分析支持复方的抗关节炎活性。结论:复方对fca诱导的雌性Wistar大鼠关节炎有明显的抗炎作用。

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引用次数: 23

In vitro activity of levofloxacin against lower respiratory tract pathogens. 左氧氟沙星体外抗下呼吸道病原菌活性研究。

Journal of Basic and Clinical Pharmacy

Pub Date : 2015-06-01 DOI: 10.4103/0976-0105.160749

Soma Sarkar, Atreyi Chakraborty, Mallika Sengupta, Sougata Ghosh, Subhasish Mukhopadhyay, Manideepa SenGupta

Background: Considerable morbidity and mortality are associated with lower respiratory tract infections (LRTIs) that put a considerable strain on the health budget. Selection of appropriate antibiotics as empirical therapy maximizes positive patient outcomes, and that depends on regular surveillance of infective agents and their antibiograms, which vary according to the geographical areas.

Aim: The aim was to study the drug susceptibility pattern of the isolated pathogens of the respiratory tract infections.

Settings and design: Retrospective study for a period of 1-year 3 months from January 2013 to March 2014 at a Tertiary Care Hospital.

Materials and methods: Eleven hundred and eighty-four sputum samples from both outdoor and indoor patients with symptoms of LRTI were processed, and antibiotic sensitivity test was done to commonly used antibiotics. Descriptive statistics was used to analyze the data.

Results: Among 502 quality sputum samples, 312 (62.15%) samples showed growth of pathogenic bacteria. The most common pathogens were Klebsiella spp. (38.14%), Moraxella spp. (16.02%), Streptococcus pneumoniae (14.10%), Pseudomonas spp. (9.93%), S. aureus (9.29%). It was found that the overall susceptibility pattern was <50% for amoxicillin, amoxicillin-clavulanic acid, cefuroxime, cotrimoxazole and erythromycin whereas for cefotaxime, cefixime, and cefoperazone-sulbactum it was 60.08%, 51.59%, 69.04%, respectively. The susceptibility to ciprofloxacin, ofloxacin, and levofloxacin were 66.67%, 70.19% and 83.33%, respectively.

Conclusion: Klebsiella spp. was the most common LRTI pathogen. There was limited activity of amoxicillin, amoxicillin-clavulanic acid, cefuroxime, cotrimoxazole and erythromycin for the treatment of LRTI whereas levofloxacin, (being an oral drug with good compliance) had good activity against respiratory pathogens and could be used for empiric treatment in LRTI.

背景:相当大的发病率和死亡率与下呼吸道感染(LRTIs)有关，这给卫生预算带来了相当大的压力。选择适当的抗生素作为经验性治疗可最大限度地提高患者的积极结果，这取决于对感染因子及其抗生素谱的定期监测，这些监测因地理区域而异。目的:研究分离的呼吸道感染病原菌的药敏规律。背景和设计:2013年1月至2014年3月在某三级医院进行为期1年3个月的回顾性研究。材料与方法:对1184例有下呼吸道感染症状的室外和室内患者的痰液标本进行处理，并对常用抗生素进行抗生素敏感性试验。采用描述性统计方法对数据进行分析。结果:502份优质痰标本中有312份(62.15%)检出致病菌。常见病原菌为克雷伯氏菌(38.14%)、莫拉氏菌(16.02%)、肺炎链球菌(14.10%)、假单胞菌(9.93%)、金黄色葡萄球菌(9.29%)。结论:克雷伯氏菌是最常见的下呼吸道感染病原菌。阿莫西林、阿莫西林-克拉维酸、头孢呋辛、复方新诺明和红霉素对下呼吸道感染的治疗效果有限，而左氧氟沙星作为一种口服药物，对呼吸道病原体的治疗效果较好，可用于下呼吸道感染的经治性治疗。

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引用次数: 1