Journal of Clinical Pharmacy and Therapeutics最新文献_第2页

Population Pharmacokinetics of Tigecycline in Critically Ill Patients and Optimal Dosage Regimens With Dose Simulations Based on Infection Type and Renal Function 危重患者替加环素的人群药动学及基于感染类型和肾功能的剂量模拟的最佳给药方案

IF 2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of Clinical Pharmacy and Therapeutics

Pub Date : 2025-12-12 DOI: 10.1155/jcpt/6889748

Fen Yao, Yunpeng Bai, Junjiang Zhu, Feng Wang, Xipei Wang, Jingchun Chen, Yirong Wang, Wendong Huang, Wenting Li, Xin Liu, Xiao Wang, Jianglin Li, Chunbo Chen

Background

The present study was conducted to establish a population pharmacokinetic (PK) model that describes tigecycline concentrations in critically ill patients and optimises the detailed dosing regimens of tigecycline via Monte Carlo simulations.

Methods

A single-centre, prospective, observational study was conducted on 155 patients hospitalised in the intensive care unit (ICU) with 458 plasma samples. This work enrolled 115 eligible patients (348 plasma samples) to establish the population PK model with various covariates and the other 40 patients (110 plasma samples) were validated on such a model. Monte Carlo simulations were performed to calculate the probability of target attainment (PTA) of proposal dosage regimens.

Results

The two-compartment model of zero-order absorption and first-order elimination can be used to fully describe the concentration–time curve of tigecycline. The estimated values of population PK parameters were 16.3 and 40.7 L/h for clearance (CL) and Q, respectively, and 145 and 345 L for the volumes of the central and peripheral compartments. Creatinine clearance (CrCL) was the only factor that exhibited a relation to systemic CL in the final PK model, with a CrCL adjustment factor of 0.00692. According to dose simulations, the standard dosage regimen only sufficed for pneumonia patients with a low value of minimal inhibitory concentration (MIC = 0.25 mg/L) or renal dysfunction (MIC ≤ 1 mg/L, estimated glomerular filtration rate (eGFR) ≤ 60 mL/min/1.73 m²). High doses of tigecycline were needed in such patients with a high MIC or a normal/high renal CL rate. For complicated intra-abdominal infections, the standard dose can achieve a high PTA when MIC ≤ 0.5 mg/L and under nonaugmented renal CL conditions. For complicated skin-structure infections, the standard dose can only achieve the expected therapeutic effect for patients with MIC = 0.25 mg/L and renal dysfunction (eGFR ≤ 60 mL/min/1.73 m²).

Conclusion

The recommended standard dosage regimen of tigecycline is insufficient for most critically ill patients. This study provides detailed dose regimens of tigecycline for ICU patients based on infection type and renal function.

本研究旨在建立一个群体药代动力学（PK）模型，该模型描述了危重患者的替加环素浓度，并通过蒙特卡罗模拟优化了替加环素的详细给药方案。方法采用单中心、前瞻性、观察性研究，对155例重症监护病房（ICU）住院患者进行458份血浆样本分析。本研究招募了115例符合条件的患者（348份血浆样本），建立了包含各种协变量的群体PK模型，并对另外40例患者（110份血浆样本）进行了模型验证。蒙特卡罗模拟计算了建议给药方案的目标实现概率（PTA）。结果替加环素的浓度-时间曲线可以用零阶吸收-一阶消除的双室模型来描述。净度（CL）和Q的种群PK参数估计值分别为16.3和40.7 L/h，中央室和周围室容积的种群PK参数估计值分别为145和345 L/h。在最终的PK模型中，肌酸酐清除率（CrCL）是唯一与全身CL相关的因素，其调节因子为0.00692。根据剂量模拟，标准给药方案仅适用于最低抑制浓度低值（MIC = 0.25 mg/L）或肾功能不全（MIC≤1mg /L，估计肾小球滤过率(eGFR)≤60ml /min/1.73 m2）的肺炎患者。高MIC或正常/高肾CL率的患者需要大剂量的替加环素。对于复杂的腹腔内感染，当MIC≤0.5 mg/L和非增强的肾CL情况下，标准剂量可以达到较高的PTA。对于复杂皮肤结构感染，标准剂量只能对MIC = 0.25 mg/L、肾功能不正常（eGFR≤60 mL/min/1.73 m2）的患者达到预期治疗效果。结论推荐的替加环素标准给药方案对大多数危重患者是不够的。本研究根据感染类型和肾功能为ICU患者提供了详细的替加环素剂量方案。

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引用次数: 0

Correction to “Impaired Autophagic Flux by Citalopram Inhibits DR5 Degradation and Increases TRAIL-Mediated Apoptosis” 对“西酞普兰抑制DR5降解并增加trail介导的细胞凋亡”的修正

IF 2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of Clinical Pharmacy and Therapeutics

Pub Date : 2025-12-02 DOI: 10.1155/jcpt/9816367

K. M. A. Zinnah, A. N. Munna, J.-W. Seol, and S.-Y. Park, “Impaired Autophagic Flux by Citalopram Inhibits DR5 Degradation and Increases TRAIL-Mediated Apoptosis,” Journal of Clinical Pharmacy and Therapeutics, vol. 2025 (2025). https://doi.org/10.1155/jcpt/7538839.

In the article titled “Impaired Autophagic Flux by Citalopram Inhibits DR5 Degradation and Increases TRAIL-Mediated Apoptosis,” there was an error in Figure 1(j) related to an incorrect image being used to represent the morphology of the Calu-3 cells.

This error was introduced by the authors during figure assembly and should be corrected as follows:

We apologize for this error.

K. M. A. Zinnah， A. N. Munna， J.-W。Seol和s - y。Park，“西酞普兰抑制DR5降解和增加trail介导的细胞凋亡的自噬通量受损”，《临床药学和治疗学杂志》，vol. 2025（2025）。https://doi.org/10.1155/jcpt/7538839.In在题为“西酞普兰抑制DR5降解并增加trail介导的细胞凋亡损害自噬通量”的文章中，图1(j)中有一个错误，与使用不正确的图像来表示Calu-3细胞的形态有关。此错误是由作者在图形组装过程中引入的，应按以下方式纠正：我们对此错误道歉。

引用次数: 0

Organoids for Drug Repurposing: A Literature Review 药物再利用的类器官：文献综述

IF 2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of Clinical Pharmacy and Therapeutics

Pub Date : 2025-11-30 DOI: 10.1155/jcpt/8827167

Ryo Okuyama

What is Known and Objective

Drug repurposing offers a time- and cost-effective means for drug development. Accordingly, the accurate prediction of human efficacy is crucial for its success. Organoids have emerged as valuable tools for evaluating compound efficacy in three-dimensional environments closely resembling in vivo organs. However, a comprehensive overview of their application in drug repurposing is lacking. This systematic literature review discusses the origins, applications, and target diseases of organoids employed for drug repurposing.

Methods

A systematic search of original articles published up to March 5, 2025, was conducted in PubMed using the keywords “organoid” and “drug repurposing.” Trends in publications, organoid sources, research objectives, and target diseases were analyzed.

Results and Discussion

Research on drug repurposing using organoids initially emerged in 2016 and has grown rapidly since the 2020s. Patient-derived tissue organoids, primarily derived from cancer tissues, are the most used. Organoids derived from pluripotent stem cells are mainly utilized for organs that are difficult to obtain from human tissues. These organoids are most frequently used for evaluation of the efficacy of repurposed drug candidates identified through other methods as well as for the primary screening of existing drug libraries, demonstrating broad utility for drug repurposing research. Most target diseases are cancers, with colorectal cancer being predominant. Organoids are anticipated to play increasingly important roles in drug repurposing, particularly for organs with limited tissue availability and complex three-dimensional structures, as well as for a diverse range of diseases beyond cancer.

What is New and Conclusions

This study is the first to comprehensively review the use of organoids for drug repurposing. These findings provide valuable insights for researchers pursuing drug repurposing and encourage effective integration of organoids into drug repurposing strategies.

已知和客观药物再利用为药物开发提供了一种时间和成本效益的方法。因此，对人体功效的准确预测对其成功至关重要。类器官已经成为在三维环境中评估化合物功效的有价值的工具，与体内器官非常相似。然而，缺乏对其在药物再利用中的应用的全面概述。这篇系统的文献综述讨论了用于药物再利用的类器官的起源、应用和目标疾病。方法以“类器官”（organoid）和“药物再利用”（drug repurpose）为关键词，系统检索2025年3月5日前在PubMed发表的原创文章。分析了出版物、类器官来源、研究目标和靶疾病的趋势。使用类器官的药物再利用研究最初出现于2016年，自本世纪20年代以来迅速发展。患者来源的组织类器官，主要来源于癌症组织，是最常用的。多能干细胞衍生的类器官主要用于难以从人体组织中获得的器官。这些类器官最常用于评估通过其他方法确定的重新利用候选药物的疗效，以及对现有药物库的初步筛选，显示了药物重新利用研究的广泛实用性。大多数目标疾病是癌症，以结直肠癌为主。预计类器官将在药物再利用中发挥越来越重要的作用，特别是对于组织可用性有限和三维结构复杂的器官，以及癌症以外的各种疾病。本研究首次全面回顾了类器官在药物再利用中的应用。这些发现为追求药物再利用的研究人员提供了有价值的见解，并鼓励将类器官有效地整合到药物再利用策略中。

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引用次数: 0

Predicting Drug Targets in Human Cancers 预测人类癌症的药物靶点

IF 2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of Clinical Pharmacy and Therapeutics

Pub Date : 2025-11-26 DOI: 10.1155/jcpt/4853636

David Calderón Guzmán, Norma Osnaya Brizuela, Armando Valenzuela Peraza, Maribel Ortiz Herrera, Diego E. Ortega Garcia, Hugo Juarez Olguin, Gerardo Barragán Mejía

Introduction

A large amount of knowledge has accumulated regarding the pharmacology of most cancer types, including their side effects, and during the last decade, many novel agents have emerged, accompanied by increased costs for healthcare systems.

Aim

Artificial intelligence (AI) was applied in healthcare services, and the benefit of its use in the prediction of the targets of low molecular weight compounds that can affect biological processes was assessed (proportion of the top predicted targets, common name, target class and probability).

Method

Designing the chemical agent or molecule chosen and the program will give the protein target prediction immediately by AI. A tuning algorithm device, with new information input in the web application interface, was used.

Results

Information was arranged in order and fed to an in silico target prediction/Swiss TargetPrediction (STP). This tool is a computational method used to predict the most probable protein targets of small molecules, as well as to envisage what happens when many chemotherapy drugs are combined in cancer treatment. It aids in understanding some molecular processes controlling specific physical traits or biological activities to elucidate probable beneficial and adverse consequences. In addition, it helps to predict imprecision of defined molecules and pave the way to drug repositioning. Prediction is carried out employing the ligand-based drug design (LBDD), which enables comparison of the correlation between the molecule under examination and the known binding molecules of a large set of target proteins.

Conclusion

Target activity profiles enable a systematic repurposing process by extending the target profile of drugs, and then drug repurposing with AI provides a cost-effective strategy to reuse approved drugs for new medical indications and the availability of new treatments, reduces development costs and mitigates risks due to the cost of the cancer drug agents, coupled with high cancer disease prevalence, which means the current cost trajectory is untenable for most world healthcare systems.

关于大多数癌症类型的药理学，包括其副作用，已经积累了大量的知识，并且在过去的十年中，许多新的药物已经出现，伴随着医疗保健系统成本的增加。目的将人工智能（AI）应用于医疗保健服务，并评估其在预测可影响生物过程的低分子量化合物靶点方面的效益（预测前靶点的比例、常用名称、靶点类别和概率）。方法设计化学制剂或分子的选择和程序，通过人工智能对蛋白质靶点进行即时预测。采用了一种调优算法装置，在web应用程序界面中输入新的信息。结果将信息按顺序排列并输入到芯片靶预测/瑞士靶预测（STP）中。这个工具是一种计算方法，用于预测小分子最可能的蛋白质目标，以及设想当许多化疗药物在癌症治疗中联合使用时会发生什么。它有助于理解一些控制特定物理性状或生物活动的分子过程，以阐明可能的有益和有害后果。此外，它还有助于预测已定义分子的不精确性，为药物重新定位铺平道路。采用基于配体的药物设计（LBDD）进行预测，可以比较被检查分子与大量靶蛋白的已知结合分子之间的相关性。结论：靶标活性谱通过扩展药物的靶标谱，实现了系统的药物再利用过程，而人工智能的药物再利用提供了一种具有成本效益的策略，可以将已批准的药物用于新的医学适应症和新疗法的可用性，降低了开发成本，降低了癌症药物成本以及癌症疾病高患病率所带来的风险。这意味着目前的成本轨迹对世界上大多数医疗保健系统来说是站不住脚的。

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引用次数: 0

A Real-World Study of CAR-T Hematological Adverse Events Based on FAERS Database 基于FAERS数据库的CAR-T血液学不良事件的真实世界研究

IF 2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of Clinical Pharmacy and Therapeutics

Pub Date : 2025-11-23 DOI: 10.1155/jcpt/5538794

Xiaoyue Gao, Fangyuan Hu, Yinghong Zhai, Lei Yuan, He Li, Xiaofei Ye, Zhuo Wang

Chimeric antigen receptor T-cell therapy (CAR-T) is an emerging therapy for malignancies, including refractory B-cell lymphoma, follicular lymphoma, multiple myeloma, and chronic lymphocytic leukemia. Postmarketing monitoring is essential to ensure the rational administration of CAR-T because of its high occurrence rate of adverse events. Thus, we collected the adverse event reports from the FAERS database between the first quarter of 2017 and the second quarter of 2025. Disproportion analysis methods, including the reporting odds ratio and information component, were used to identify potential hematological AEs associated with CAR-T therapy. A total of 47,118,226 reports were analyzed, and 99,497 adverse events associated with CAR-T-cell therapy were identified. We found 11,689 hematological adverse events accounted for 11.75% of the total adverse events, of which cytopenia (ROR025 = 33.87, IC025 = 4.95), hemophagocytic lymphohistiocytosis (HLH, ROR025 = 28.20, IC025 = 4.71), and myelodysplastic syndrome (MS, ROR025 = 34.41, IC025 = 4.98) were highly underrated in the real world. All six CAR-T products were associated with hematological adverse events, and the typical hematological adverse events varied among different products. A high proportion and frequency of death outcomes were identified after CAR-T-related hematological adverse events, such as thrombocytopenia, HLH, and cytopenia. Cytokine release syndrome frequently overlapped with hematological adverse events, including cytopenia, HLH, and thrombocytopenia. Our results may help clinicians identify rare but potentially fatal hematological AEs at an early stage, effectively reducing the risk of lethal hematological toxicity of CAR-T therapy.

嵌合抗原受体t细胞疗法（CAR-T）是一种新兴的恶性肿瘤治疗方法，包括难治性b细胞淋巴瘤、滤泡性淋巴瘤、多发性骨髓瘤和慢性淋巴细胞白血病。由于CAR-T不良事件的高发生率，上市后监测对于确保合理给药至关重要。因此，我们从FAERS数据库中收集了2017年第一季度至2025年第二季度的不良事件报告。非比例分析方法，包括报告优势比和信息成分，用于识别与CAR-T治疗相关的潜在血液学ae。共分析了47,118,226份报告，确定了99,497起与car - t细胞治疗相关的不良事件。我们发现11,689例血液学不良事件占总不良事件的11.75%，其中细胞减少症（ROR025 = 33.87, IC025 = 4.95）、噬血细胞淋巴组织细胞增多症（HLH, ROR025 = 28.20, IC025 = 4.71）和骨髓增生异常综合征（MS, ROR025 = 34.41, IC025 = 4.98）在现实生活中被严重低估。所有六种CAR-T产品都与血液学不良事件相关，并且不同产品的典型血液学不良事件各不相同。car - t相关血液学不良事件（如血小板减少症、HLH和细胞减少症）发生后，死亡结果的比例和频率较高。细胞因子释放综合征经常与血液学不良事件重叠，包括血细胞减少症、HLH和血小板减少症。我们的研究结果可以帮助临床医生在早期阶段识别罕见但潜在致命的血液学ae，有效降低CAR-T治疗致命血液学毒性的风险。

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引用次数: 0

Patient Safety Incidents Involving Antipsychotics: A Cross-Sectional Study Based on the Danish Patient Safety Database 涉及抗精神病药物的患者安全事件：基于丹麦患者安全数据库的横断面研究

IF 2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of Clinical Pharmacy and Therapeutics

Pub Date : 2025-11-22 DOI: 10.1155/jcpt/2038343

Tara Hoffmann Faaborg, Mette Gibskov Fløe Andersen, Olga Alexandrovna Tchijevitch, Anne Estrup Olesen

Introduction and Purpose

Antipsychotics are commonly prescribed to treat mental illnesses, with usage increasing. Although they provide therapeutic benefits, these medications can be associated with errors, e.g., wrong dosages or administration to the wrong patient. Such errors can compromise patient safety and treatment outcomes. In Denmark, healthcare professionals must report patient safety incidents (PSIs) to the Danish Patient Safety Database (DPSD). This system aims to identify high-risk situations and facilitate learning. The goal of this study was to gain detailed insights into PSIs involving antipsychotics in the Danish primary healthcare and hospital sectors.

Methods

This descriptive cross-sectional study analyzed all reported moderate, severe, and fatal PSIs related to selected antipsychotics reported to the DPSD between January 2022 and December 2022. Data were categorized by two extractors using REDCap.

Results

A total of 7,042 PSIs were reported with 469 incidents classified as moderate, severe, or fatal. Thirty-four incidents were excluded. Quetiapine, olanzapine, and risperidone were the most frequently involved drugs (247/435, 56.8%). Most PSIs (372/435 85.5%) were of moderate severity. Errors most often occurred during administration (65.3%), with omissions, wrong dosage, and wrong-patient errors being the most common. Social housing (47.1%) and hospitals (25.5%) were the most frequently reported settings for PSIs.

Conclusions

This study highlights the need for targeted interventions to reduce medication errors and improve patient safety in both primary care and hospital settings in Denmark. Most errors occurred during administrations, and overall, the most frequent issues were omissions, incorrect dosages, and wrong-patient incidents. While PSIs related to antipsychotics remain a concern, reported severity indicates that they may not always result in significant clinical severity.

前言与目的抗精神病药物通常用于治疗精神疾病，其使用日益增加。虽然这些药物具有治疗效果，但也可能出现错误，例如错误的剂量或给错的病人。此类错误可能危及患者安全和治疗结果。在丹麦，医疗保健专业人员必须向丹麦患者安全数据库（DPSD）报告患者安全事件（psi）。该系统旨在识别高风险情况并促进学习。本研究的目的是详细了解丹麦初级保健和医院部门中涉及抗精神病药物的psi。方法：本描述性横断面研究分析了2022年1月至2022年12月期间报告给DPSD的所有与选定抗精神病药物相关的中度、重度和致死性PSIs。数据由两个使用REDCap的提取器分类。结果共报告了7042例PSIs，其中469例分为中度、重度或致命。34个事件被排除在外。喹硫平、奥氮平和利培酮是最常见的药物（247/435,56.8%）。大多数psi（372/435 85.5%）为中度严重程度。错误最常发生在给药期间（65.3%），其中遗漏、错误剂量和错误患者错误是最常见的。社会住房（47.1%）和医院（25.5%）是最常报告的社会服务提供者的场所。结论：本研究强调需要有针对性的干预措施，以减少用药错误，提高丹麦初级保健和医院环境中的患者安全。大多数错误发生在给药期间，总的来说，最常见的问题是遗漏、不正确的剂量和错误的患者事件。虽然与抗精神病药物相关的PSIs仍然令人担忧，但报告的严重程度表明，它们可能并不总是导致显著的临床严重程度。

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引用次数: 0

The Real-World Analysis of Adverse Events With Two Types of Single-Inhaler Triple Therapy: A VigiAccess Database Study 两种类型的单吸入器三联治疗不良事件的真实世界分析：一项VigiAccess数据库研究

IF 2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of Clinical Pharmacy and Therapeutics

Pub Date : 2025-11-14 DOI: 10.1155/jcpt/6677307

Baiquan Zhang, Jiayu Bai, Lu Zhou

Background

The advent of single-inhaler triple therapies (SITTs), including fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) and beclomethasone dipropionate/formoterol fumarate/glycopyrronium bromide (BDP/FOR/GLY), has expanded treatment options for chronic obstructive pulmonary disease (COPD). This study explores adverse drug reactions (ADRs) related to these SITTs using data from the WHO-VigiAccess database and compares their safety profiles.

Methods

A retrospective analysis was conducted using ADR reports associated with FF/UMEC/VI and BDP/FOR/GLY from the WHO-VigiAccess database. Data included patient demographics and reported adverse events (AEs). Disproportionality analysis was performed using the reporting odds ratio (ROR) and proportional reporting ratio (PRR) to assess the association between SITTs and specific AEs.

Results

A total of 21,539 AEs related to FF/UMEC/VI and BDP/FOR/GLY were identified in the VigiAccess database. Commonly reported ADRs included dyspnoea, cough, COPD, headache, dizziness and pneumonia. FF/UMEC/VI was more frequently associated with injuries, poisoning and procedural complications (39.46%), whereas BDP/FOR/GLY showed a higher incidence of respiratory, thoracic and mediastinal disorders (42.06%). Disproportionality analysis revealed an increased ROR (3.04) and PRR (2.76) for FF/UMEC/VI regarding injury-related events, indicating a stronger signal compared to BDP/FOR/GLY. These findings underscore the diversity of ADRs associated with SITTs and highlight the need for careful clinical monitoring. However, the voluntary nature of VigiAccess and inherent reporting biases, such as visibility and selection bias, may affect the completeness and reliability of the data.

Conclusion

analysis of WHO-VigiAccess reports reveals both shared and distinct ADRs between FF/UMEC/VI and BDP/FOR/GLY. Due to limitations, such as under-reporting and reporting bias inherent to spontaneous databases, these findings should be interpreted with caution. Clinicians are encouraged to tailor COPD treatment based on both efficacy and potential ADR profiles to ensure optimal and personalized care.

单吸入器三联疗法（SITTs）的出现，包括糠酸氟替卡松/乌莫替尼/维兰特罗（FF/UMEC/VI）和二丙酸倍氯米松/富马酸福莫特罗/溴化甘溴铵（BDP/FOR/GLY），扩大了慢性阻塞性肺疾病（COPD）的治疗选择。本研究利用来自世卫组织- viiaccess数据库的数据探讨了与这些sitt相关的药物不良反应（adr），并比较了它们的安全性概况。方法对WHO-VigiAccess数据库中FF/UMEC/VI和BDP/FOR/GLY相关的ADR报告进行回顾性分析。数据包括患者人口统计数据和报告的不良事件（ae）。使用报告优势比（ROR）和比例报告比（PRR）进行歧化分析，以评估sitt与特定ae之间的关联。结果在VigiAccess数据库中共鉴定出与FF/UMEC/VI和BDP/FOR/GLY相关的ae 21,539例。常见的不良反应包括呼吸困难、咳嗽、慢性阻塞性肺病、头痛、头晕和肺炎。FF/UMEC/VI更易发生损伤、中毒和手术并发症（39.46%），而BDP/FOR/GLY的呼吸、胸部和纵隔疾病发生率较高（42.06%）。歧化分析显示，FF/UMEC/VI在损伤相关事件上的ROR（3.04）和PRR（2.76）增加，表明与BDP/ for /GLY相比，信号更强。这些发现强调了与sitt相关的不良反应的多样性，并强调了仔细临床监测的必要性。然而，VigiAccess的自愿性质和固有的报告偏差，如可见性和选择偏差，可能会影响数据的完整性和可靠性。结论：对WHO-VigiAccess报告的分析显示，FF/UMEC/VI和BDP/FOR/GLY之间既有共同的adr，也有不同的adr。由于局限性，如自发性数据库固有的报告不足和报告偏倚，这些发现应谨慎解释。鼓励临床医生根据疗效和潜在不良反应概况定制COPD治疗，以确保最佳和个性化护理。

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引用次数: 0

A Systematic Review of Traditional Uses, Phytochemistry, and Pharmacology of Chinese Herb Medicine for Schizophrenia 中药治疗精神分裂症的传统用途、植物化学和药理学综述

IF 2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of Clinical Pharmacy and Therapeutics

Pub Date : 2025-11-13 DOI: 10.1155/jcpt/9996801

Sihan Zhao, Yonghou Zhao, Ming Yu, Jianbo Chai, Xinhui Yao

Ethnopharmacological Significance

Schizophrenia, a complex psychiatric disorder with multifactorial etiology, profoundly affects patients’ behavior, cognition, affect, and thought processes. Given the stagnation in novel drug development, notable treatment-related adverse effects, and suboptimal recovery rates, the identification of innovative therapeutic agents and strategies to mitigate side effects remains a critical unmet need. Preclinical advances have increasingly validated the scientific rationale for the clinical efficacy of medicinal plants. Consequently, the exploration of botanical antipsychotic agents has gained global traction due to their favorable safety profiles and emerging evidence of efficacy.

Objective of the Review

This review synthesizes a decade of preclinical and translational research on medicinal plants and traditional ethnomedicines for schizophrenia treatment. It provides a comprehensive analysis of the pharmacology and molecular mechanisms underlying the therapeutic potential of plant-derived active ingredients, serving as a foundational resource for future drug development and clinical translation efforts.

Materials and Methods

A systematic literature review was conducted using PubMed, Web of Science, Elsevier, Scopus, SciFinder, Springer, and the China National Knowledge Infrastructure (CNKI). Search terms included “schizophrenia,” “traditional medicinal plants,” “Chinese materia medica,” “active ingredients,” and “phytochemicals.” Studies were selected based on their focus on natural products and ethnopharmacological interventions for schizophrenia published in the last decade. Following rigorous screening, data were categorized by plant-derived bioactive compounds (e.g., flavonoids, polysaccharides, and alkaloids) and their mechanisms of action.

Conclusions

Natural products and traditional ethnomedicines constitute promising sources for novel antipsychotic drug development. Emerging evidence supports the translational potential of integrating phytotherapeutics into clinical practice, though significant gaps persist. Future research must prioritize comprehensive pharmacokinetic/toxicological profiling, standardized clinical trials, and mechanistic elucidation of plant-derived compounds to realize their full therapeutic potential.

精神分裂症是一种多因素致病的复杂精神障碍，深刻影响患者的行为、认知、情感和思维过程。鉴于新药开发停滞不前，显著的治疗相关不良反应，以及次优的恢复率，确定创新的治疗药物和策略以减轻副作用仍然是一个关键的未满足的需求。临床前研究的进展日益证实了药用植物临床疗效的科学依据。因此，植物性抗精神病药物的探索由于其良好的安全性和新出现的有效性证据而获得了全球的关注。本文综述了近十年来药用植物和传统民族药治疗精神分裂症的临床前和转化研究。它提供了植物源性活性成分潜在治疗潜力的药理学和分子机制的全面分析，为未来药物开发和临床转化工作提供了基础资源。材料与方法采用PubMed、Web of Science、Elsevier、Scopus、SciFinder、b施普林格和中国知网（CNKI）进行系统文献综述。搜索词包括“精神分裂症”、“传统药用植物”、“中药”、“有效成分”和“植物化学物质”。研究的选择是基于它们对过去十年发表的精神分裂症的天然产物和民族药理学干预的关注。经过严格筛选，数据按植物源性生物活性化合物（如类黄酮、多糖和生物碱）及其作用机制进行分类。结论天然产物和传统民族药是开发新型抗精神病药物的重要资源。新出现的证据支持将植物疗法纳入临床实践的转化潜力，尽管仍存在显着差距。未来的研究必须优先考虑全面的药代动力学/毒理学分析、标准化的临床试验和植物源性化合物的机制阐明，以充分发挥其治疗潜力。

{"title":"A Systematic Review of Traditional Uses, Phytochemistry, and Pharmacology of Chinese Herb Medicine for Schizophrenia","authors":"Sihan Zhao, Yonghou Zhao, Ming Yu, Jianbo Chai, Xinhui Yao","doi":"10.1155/jcpt/9996801","DOIUrl":"https://doi.org/10.1155/jcpt/9996801","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Ethnopharmacological Significance</h3>\u0000 \u0000 <p>Schizophrenia, a complex psychiatric disorder with multifactorial etiology, profoundly affects patients’ behavior, cognition, affect, and thought processes. Given the stagnation in novel drug development, notable treatment-related adverse effects, and suboptimal recovery rates, the identification of innovative therapeutic agents and strategies to mitigate side effects remains a critical unmet need. Preclinical advances have increasingly validated the scientific rationale for the clinical efficacy of medicinal plants. Consequently, the exploration of botanical antipsychotic agents has gained global traction due to their favorable safety profiles and emerging evidence of efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective of the Review</h3>\u0000 \u0000 <p>This review synthesizes a decade of preclinical and translational research on medicinal plants and traditional ethnomedicines for schizophrenia treatment. It provides a comprehensive analysis of the pharmacology and molecular mechanisms underlying the therapeutic potential of plant-derived active ingredients, serving as a foundational resource for future drug development and clinical translation efforts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A systematic literature review was conducted using PubMed, Web of Science, Elsevier, Scopus, SciFinder, Springer, and the China National Knowledge Infrastructure (CNKI). Search terms included “schizophrenia,” “traditional medicinal plants,” “Chinese materia medica,” “active ingredients,” and “phytochemicals.” Studies were selected based on their focus on natural products and ethnopharmacological interventions for schizophrenia published in the last decade. Following rigorous screening, data were categorized by plant-derived bioactive compounds (e.g., flavonoids, polysaccharides, and alkaloids) and their mechanisms of action.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Natural products and traditional ethnomedicines constitute promising sources for novel antipsychotic drug development. Emerging evidence supports the translational potential of integrating phytotherapeutics into clinical practice, though significant gaps persist. Future research must prioritize comprehensive pharmacokinetic/toxicological profiling, standardized clinical trials, and mechanistic elucidation of plant-derived compounds to realize their full therapeutic potential.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jcpt/9996801","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Determination of the 90% Effective Dose of Remimazolam in Combination With a Low Dose of Alfentanil for Suppressing Responses During Upper Gastrointestinal Endoscopy Insertion 雷马唑仑联合小剂量阿芬太尼抑制上消化道内窥镜插入时90%有效剂量的测定

IF 2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of Clinical Pharmacy and Therapeutics

Pub Date : 2025-11-11 DOI: 10.1155/jcpt/3473867

Pengfei Yin, Yifu Liang, Binwei Hu, Qing Xie, Mi Wang, Zhiying Feng, Xianhui Kang

Remimazolam has shown safety and efficacy in providing sedation during gastroscopy, but research on its specific clinical dosage is limited. This study aimed to determine the 90% effective dose (ED₉₀) of remimazolam when used with a low dose of alfentanil for inducing sedation in adult patients undergoing gastroscopy. Fifty adult participants underwent upper gastrointestinal (GI) endoscopy with anesthesia via intravenous boluses of remimazolam and alfentanil (4 μg/kg). The initial remimazolam dose was 0.2 mg/kg, adjusted using the biased coin up-and-down (BCUD) sequential method. The ED₉₀ of remimazolam, administered with 4 μg/kg alfentanil, was found to be 0.2375 mg/kg (95% CI: 0.1500–0.2725). Hemodynamics remained stable, with no significant adverse events and high satisfaction scores from patients, anesthesiologists, and endoscopists (4.90 ± 0.043, 4.92 ± 0.039, and 4.92 ± 0.039, respectively, on a 5-point scale). The combination of remimazolam and low-dose alfentanil is safe and effective for adult upper GI endoscopy.

Trial Registration: Chinese Registry of Clinical Trials: ChiCTR2200062535

雷马唑仑在胃镜检查中镇静的安全性和有效性已得到证实，但对其具体临床剂量的研究有限。本研究旨在确定雷马唑仑与低剂量阿芬太尼联合用于成人胃镜检查患者镇静时的90%有效剂量（ED90）。50名成年参与者在麻醉下静脉注射雷马唑仑和阿芬太尼（4 μg/kg），进行上消化道内镜检查。雷马唑仑初始剂量为0.2 mg/kg，采用偏置硬币上下（BCUD）顺序法进行调整。阿芬太尼4 μg/kg给药时，雷马唑仑的ED90为0.2375 mg/kg （95% CI: 0.1500 ~ 0.2725）。血流动力学保持稳定，无明显不良事件发生，患者、麻醉医师和内镜医师的满意度得分较高（5分制分别为4.90±0.043、4.92±0.039和4.92±0.039）。雷马唑仑联合小剂量阿芬太尼用于成人上消化道内镜检查安全有效。试验注册：中国临床试验注册中心：ChiCTR2200062535

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引用次数: 0

Interventions to Improve Standard Initiation of Long-Acting Injectable Antipsychotics in a University-Affiliated Psychiatric Hospital: A Quasiexperimental Study 提高大学附属精神病院长效注射抗精神病药物标准起始的干预措施：一项准实验研究

IF 2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of Clinical Pharmacy and Therapeutics

Pub Date : 2025-11-07 DOI: 10.1155/jcpt/9093978

Maryam Mousavi, Maryam Taghizadeh-Ghehi, Aarefeh Jafarzadeh Kohneloo, Zahra Mirsepassi, Ali-Akbar Nejatisafa

Introduction

Long-acting injectable antipsychotics (LAI-APs) were recommended to improve treatment adherence and reduce recurrence rates. Initiating LAI-APs can be challenging due to complexities in dosing schedules.

Aim

We aimed to assess the impact of multifaceted interventions on the initial dosing schedule of LAI-APs in a university-affiliated psychiatric hospital.

Methods

This study consisted of three phases: first, the preintervention baseline evaluation phase, followed by guideline development and active dissemination in the hospital (guideline presentation and educational session). Second, the 1 month peri-intervention phase, in which audit and feedback were performed. The postintervention phase consisted of a 3-month evaluation. All admitted patients for whom LAI-APs were initiated were identified and studied. The concordance with institutional guidelines was determined by considering the initial dose, initial interval, and oral overlap during three phases.

Results

In total, 101, 31, and 51 orders were evaluated in the study phases, respectively. Guideline-concordant orders increased from 2.1% in baseline to 48.4% and 64.5% before and after feedback in the peri-intervention phase, respectively, and decreased to 21.6% in the postintervention phase (p < 0.001). Nonconcordance initial dose decreased from 83.7% at baseline to 38.7% in the second phase and reached 62% in the last phase (p < 0.001). The frequency of LAI-AP and OAP mismatch was 67.6%, 10.5%, and 21.9% in the three study phases, respectively (p < 0.001). The academic level of the attending physician increased the odds of an appropriate initial dose by 3.92 times. The odds of a proper initial interval were higher when the attending physician had a higher academic level (OR = 2.53, 95% CI = 1.25–5.12, p = 0.01) and was female (OR = 2.4, 95% CI = 1.09–5.29, p = 0.029).

Conclusion

Concordance with the institutional guideline in LAI-APs dosing improved following multifaceted interventions; however, the improvement was not sustained. Therefore, continued audit and feedback might be necessary to maintain the effects.

推荐使用长效注射抗精神病药物，以提高治疗依从性，降低复发率。由于给药计划的复杂性，启动ai - ap可能具有挑战性。目的：我们旨在评估多方面干预对大学附属精神病院lai - ap初始给药计划的影响。方法本研究分为三个阶段：首先是干预前基线评估阶段，其次是指南制定和在医院的积极传播（指南发布和教育会议）。第二，为期1个月的围干预阶段，在此阶段进行审计和反馈。干预后阶段包括3个月的评估。所有开始使用LAI-APs的住院患者都被识别和研究。通过考虑三个阶段的初始剂量、初始间隔和口服重叠来确定与机构指南的一致性。结果在研究阶段共评估了101、31和51个订单。在干预期反馈前后，与指南一致的订单分别从基线的2.1%上升到48.4%和64.5%，在干预后阶段下降到21.6% （p < 0.001）。非一致性初始剂量从基线的83.7%下降到第二阶段的38.7%，最后阶段达到62% （p < 0.001）。在三个研究阶段，LAI-AP和OAP不匹配的频率分别为67.6%、10.5%和21.9% （p < 0.001）。主治医师的学术水平使初始剂量合适的几率增加了3.92倍。当主治医师的学术水平较高（OR = 2.53, 95% CI = 1.25-5.12, p = 0.01）且为女性（OR = 2.4, 95% CI = 1.09-5.29, p = 0.029）时，合适的初始间隔的几率更高。结论综合干预后，LAI-APs给药与机构指南的一致性得到改善；然而，这种改善并没有持续下去。因此，可能需要持续的审计和反馈来维持效果。

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引用次数: 0