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Comparison of Divided Dose versus Bolus Administration Morphine Sulfate for Management of Acute Pain in Traumatic Fracture in Patients Admitted to Emergency Department 分剂量硫酸吗啡与大剂量硫酸吗啡治疗急诊科创伤性骨折急性疼痛的比较
IF 0.1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2019-07-01 DOI: 10.13189/APP.2019.070302
S. M. Hosseininejad, Fatemeh Jahanian, Iraj Goli Khatir, Seyed Hossein Montazer, F. Bozorgi, Nazanin Nosrati, F. H. Kiabi
Introduction: Pain is one of the most common reasons that patients visit emergency departments. Morphine has been used extensively in pain management but there is no consensus about the effectiveness of method of administration. The aim of this study was to compare the divided dose vs bolus medication form of morphine sulfate for management of acute pain in traumatic fracture. Methods: we designed a randomized double-blind clinical trial. On basis of inclusion and exclusion criteria, 160 patients with acute traumatic fracture were enrolled to the study and randomly divided into two groups. The first group (bolus group) received 0.1mg/kg morphine and then 0.1mg/kg normal saline every 5 minutes. The second group (titration group) received 0.1mg/kg of morphine in divided doses every 5 minutes. All injections were intravenously. The primary outcome was pain and before of injection, 15 minutes and 60 minutes after injection were recorded. Data were analyzed using SPSS 19. Results: 77 patients included 49 (63.6%) male with mean age of 47.42 ± 13.15 years were in titration group and 83 patients included 47 males (56.6%) with mean age of 52.40 ± 15.62 years were in bolus group. The complication rate was significantly higher in bolus group (75.9% vs 53.2%, P <0.0001). The need to extra morphine injection in bolus and titration group were 62.7% and 28.6%, respectively (P <0.0001). The mean pain score before and at 15 and 60 minutes after injection were 9.56 ± 1.03, 6.61 ± 1.86 and 1.85 ± 1.13 in titration group and 9.76 ± 0.48, 6.53 ± 1.59 and 0.61 ± 0.46 in bolus group, respectively. The pain score was significantly lower in titration group at 60 minutes after injection (P <0.0001). Discussion: The results of this study showed that titration of morphine are a safe and effective method in compared with bolus administration to reducing acute pain in traumatic fracture.
疼痛是患者到急诊科就诊最常见的原因之一。吗啡已广泛应用于疼痛治疗,但对给药方法的有效性尚无共识。本研究的目的是比较分剂量vs丸药物形式的硫酸吗啡急性疼痛管理的创伤性骨折。方法:设计随机双盲临床试验。根据纳入和排除标准,160例急性外伤性骨折患者被纳入研究,随机分为两组。第一组(丸组)注射吗啡0.1mg/kg,再注射生理盐水0.1mg/kg,每5分钟注射一次。第二组(滴定组)给予吗啡0.1mg/kg,每5分钟分次给药。注射都是静脉注射。主要观察指标为疼痛、注射前、注射后15分钟和60分钟。数据采用SPSS 19进行分析。结果:滴剂组77例49例(63.6%),男性,平均年龄47.42±13.15岁;丸剂组83例47例(56.6%),平均年龄52.40±15.62岁。大剂量组并发症发生率明显高于大剂量组(75.9% vs 53.2%, P <0.0001)。大剂量组和滴注组需要额外注射吗啡的比例分别为62.7%和28.6% (P <0.0001)。注射前、注射后15分钟、60分钟的平均疼痛评分,滴注组分别为9.56±1.03、6.61±1.86、1.85±1.13,大剂量组分别为9.76±0.48、6.53±1.59、0.61±0.46。注射后60min,滴注组疼痛评分明显低于滴注组(P <0.0001)。讨论:本研究结果表明,与大剂量给药相比,吗啡滴定是一种安全有效的减轻外伤性骨折急性疼痛的方法。
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引用次数: 0
Diversity of Fungi in the Public Hand-pump Borehole Water in Onueke, Ezza Local Government Area, Ebonyi State, Nigeria 尼日利亚Ebonyi州Ezza地方政府区Onueke公共手泵钻孔水中真菌的多样性
IF 0.1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2019-04-01 DOI: 10.13189/APP.2019.070201
Onuorah Samuel, N. John, Odibo Frederick
The diversity of fungi in fifteen public hand-pump borehole water in Onueke, Ezza Local Government Area of Ebonyi State, Nigeria was studied during the dry and wet seasons using standard analytical procedures. The total moulds and yeasts counts were 2-8cfu/ml and 1-5cfu/ml respectively during the dry season and 3-12cfu/ml and 1-4cfu/ml respectively during the wet season. More moulds were isolated from the samples during the wet than the dry season while more yeasts were isolated during the dry than the wet season. The fungi were characterized and identified on the basis of their colonial, microscopic, biochemical and molecular characteristics as Candida albicans, Microsporum canis, Aspergillus fumigatus, Geotrichum candidum, Basidiobolus ranarum, Microsporum audouinii, Fonsecaea pedrosoi and Trichosporon cutaneum. More of the boreholes contained Candida albicans than the other isolates during both seasons. Candida albicans occurred most frequently in the water samples during both seasons while Fonsecaea pedrosoi had the lowest frequency of occurrence in the water samples during both seasons. All the isolates were resistant to Griseofulvin while they exhibited varying degree of resistance and sensitivity to the other antifungal agents used. This study indicated that the borehole water samples examined did not comply with the standard established by regulatory bodies for potable water and therefore must be adequately treated before drinking and use for domestic purposes as these fungi have been reported to cause diseases of humans and animals. Boiling, chlorination, sand filtration and exposure to ultraviolet radiation are recommended.
在尼日利亚Ebonyi州Ezza地方政府区的Onueke,使用标准分析程序研究了旱季和雨季15个公共手泵钻孔水中真菌的多样性。枯水期霉菌和酵母菌总数分别为2 ~ 8cfu/ml和1 ~ 5cfu/ml,雨季霉菌和酵母菌总数分别为3 ~ 12cfu/ml和1 ~ 4cfu/ml。湿季比干季分离到的霉菌多,干季比湿季分离到的酵母菌多。根据菌落、显微、生化和分子特征对这些真菌进行鉴定,分别为白色念珠菌、犬小孢子菌、烟曲霉、白念珠菌、ranarum担子菌、audouinii小孢子菌、Fonsecaea pedrosoi和Trichosporon cutanum。在两个季节中,白色念珠菌在钻孔中的含量都高于其他分离株。白色念珠菌在两个季节的水样中出现频率最高,而水样中出现频率最低的是水样中的水珠菌。所有分离株均对灰黄霉素耐药,但对其他抗真菌药物表现出不同程度的耐药和敏感性。这项研究表明,所检查的钻孔水样不符合管理机构为饮用水制定的标准,因此必须在饮用和用于家庭用途之前进行充分处理,因为据报道这些真菌会引起人类和动物的疾病。建议煮沸,氯化,砂过滤和暴露于紫外线辐射。
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引用次数: 1
In-vivo Assessment of Neuropharmacological Activity of Methanol Bark Extract of Mimosa Pudica in Mice 含羞草树皮甲醇提取物对小鼠神经药理活性的体内评价
IF 0.1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2019-04-01 DOI: 10.13189/APP.2019.070202
M. L. Hossain, S. Sultana
Background: Mimosa pudica, a common plant of Mimosoideae family has been used as Ayurvedic herbal medicine by Bangladeshi and Chinese to treat several diseases such as hemorrhoids, hair loss, arthritis, dysentery, leprosy, jaundice, leukoderma, asthma, uterine problems. The root and bark of the plant is said to display antimicrobial activity. Hence, gargling with a decoction of the root and bark of Mimosa pudica diluted in water may help to treat toothaches. Aim of the study: The present study was designed to evaluate the presence of phytochemical groups and to investigate the neuropharmacological activity of methanol extract of Mimosa pudica (MEMP). Methodology: The neuropharmacological activity was determined by hole cross and open field test using Swiss Albino mice as experimental animal. Results: Phytochemical analysis of Mimosa pudica extract indicated the presence of tannins, alkaloids, terpenoids and flavonoids. The sample showed dose-dependent sedative activity at the doses of 200 and 400 mg/kg body weight compared to standard drug Diazepam (1 mg/kg body weight). Conclusion: MEMP showed significant sedative activity demonstrating that the extract may be useful in the development of a new sedative and anti-anxiety drug.
背景:含羞草(Mimosa pudica)是含羞草科的一种常见植物,被孟加拉人和中国人用作阿育吠陀草药治疗痔疮、脱发、关节炎、痢疾、麻风病、黄疸、白皮病、哮喘、子宫问题等多种疾病。据说这种植物的根和树皮具有抗菌活性。因此,用含羞草根和树皮的水稀释液漱口可能有助于治疗牙痛。目的:研究含羞草(Mimosa pudica, MEMP)甲醇提取物中植物化学基团的存在性,探讨其神经药理活性。方法:以瑞士白化病小鼠为实验动物,采用孔交叉法和空地法测定其神经药理活性。结果:含羞草提取物中含有单宁、生物碱、萜类和黄酮类化合物。与标准药物地西泮(1 mg/kg体重)相比,样品在200和400 mg/kg体重剂量下显示出剂量依赖性镇静活性。结论:MEMP具有明显的镇静作用,可作为一种新型的镇静抗焦虑药物。
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引用次数: 6
In-vitro Inhibitory Effects of Polyphenolic Extract of Ichnocarpus Frutescens on Carbohydrate Digestive Enzymes 石竹多酚提取物对碳水化合物消化酶的体外抑制作用
IF 0.1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2019-01-01 DOI: 10.13189/APP.2019.070103
K. Chidambaram, Kumar Venketesan, S. Dharmalingam, R. Siddalingam, T. Ellappan, S. Mandal
Background: Ichnocarpus frutescens has been used as Ayurvedic herbal medicine by Gond tribes in India to treat several diseases such as diabetes mellitus and Jaundice. The growing incidence of diabetes mellitus and its complications have headed to the search of novel therapeutic approaches engrossed on preventing postprandial hyperglycemia. The practice of carbohydrate breakdown enzyme inhibitors from plant resources might be a potential approach to prevent glucose absorption with the least adverse effects. Aims: The objective of the present investigation was to provide in-vitro evidence for the potential inhibitory activity of polyphenolic extract (PPE) of Ichnocarpus frutescens on amylase and glucosidase enzymes. Methods: the in the vitro inhibitory effect of polyphenolic extract (PPE) of Ichnocarpus frutescens focused on the evaluation of pancreatic amylase inhibition, rat serum amylase inhibition and rat intestinal glucosidase inhibition of polyphenolic extract (PPE) of Ichnocarpus frutescens by in vitro. The different concentrations of polyphenolic extract were subjected to amylase and glucosidase inhibitory assay and the percentage of amylase and glucosidase inhibitory activity and IC50 values were calculated. Results: Polyphenolic extract shows appreciable pancreatic amylase inhibitory activity in vitro. The extract also showed an appreciable glucosidase inhibitory effect in a concentration-dependent manner with a moderate amylase inhibitory activity. The in vitro examination of the inhibitory effect of PPE on maltase and sucrase activities revealed that PPE inhibited rat small intestine disaccharidase ( glucosidase) activity. Conclusion: Taken together, these results suggest that inhibitory effect of PPE on amylase and glucosidase activities may delay carbohydrate digestion and absorption with subsequent lowering of blood glucose level leading to prevention of postprandial hyperglycemia in diabetes and its complication.
背景:石竹被印度神族用作阿育吠陀草药,治疗糖尿病、黄疸等多种疾病。随着糖尿病及其并发症的发病率不断上升,人们开始寻找新的治疗方法来预防餐后高血糖。从植物中提取碳水化合物分解酶抑制剂可能是一种潜在的防止葡萄糖吸收的方法,而且副作用最小。目的:为枸杞多酚提取物(PPE)对淀粉酶和葡萄糖苷酶的潜在抑制活性提供体外证据。方法:对枸杞多酚提取物(PPE)体外抑制胰腺淀粉酶、大鼠血清淀粉酶和大鼠肠道葡萄糖苷酶的作用进行评价。对不同浓度的多酚提取物进行淀粉酶和葡萄糖苷酶抑制实验,计算淀粉酶和葡萄糖苷酶抑制活性百分比和IC50值。结果:多酚提取物具有明显的胰淀粉酶体外抑制活性。提取物还显示出明显的葡萄糖苷酶抑制作用,并呈浓度依赖性,具有中等的淀粉酶抑制活性。体外检测了PPE对麦芽糖酶和蔗糖酶活性的抑制作用,发现PPE对大鼠小肠双糖酶(葡萄糖苷酶)活性有抑制作用。结论:PPE对淀粉酶和葡萄糖苷酶活性的抑制作用可能延缓糖的消化和吸收,从而降低血糖水平,从而预防糖尿病餐后高血糖及其并发症。
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引用次数: 2
N-acetylcysteine in the Effective Management of TEN-associated Severe Skin Lesions n -乙酰半胱氨酸对ten相关严重皮肤病变的有效治疗
IF 0.1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2019-01-01 DOI: 10.13189/app.2019.070101
Md. Jahidul Hasan, J. Ahmad, A. Anam, R. Rabbani
Adverse drug reaction (ADR) is a serious life-threatening event and toxic epidermal necrolysis (TEN) is a serious ADR where severe skin lesions like, blisters with oral mucosal bleeding (OMB) are most common characteristics. Both watery blisters and OMB are painful conditions in TEN and considered as common source of infections. N-acetylcysteine (NAC) has anti-inflammatory property and the objective of this study was to observe the clinical response of NAC in the TEN-associated lesions management. For this study, we considered 17 patients those were suffering from TEN and admitted in the intensive care unit. Those 17 patients were distributed into 2 groups (A and B), where patients of group-A (n=7) treated with NAC while group-B's patients (n= 10) did not get NAC therapy. As a result, in group-A, 6 (85.71%; n=7) patients were found with complete remission of blisters and OMB progression within the 72 hours with 100% 10-day complete healing rate, whereas 60% patients in group-B (n= 10) required >72 hours for complete remission with 80% 10-day complete healing rate. So, NAC can be an effective therapy for prompt healing of life-threatening TEN-associated severe skin lesions.
药物不良反应(ADR)是一种严重的危及生命的事件,毒性表皮坏死松解(TEN)是一种严重的ADR,其中最常见的特征是严重的皮肤病变,如水疱伴口腔黏膜出血(OMB)。水疱和OMB在TEN中都是痛苦的情况,被认为是常见的感染来源。n -乙酰半胱氨酸(NAC)具有抗炎特性,本研究的目的是观察NAC在ten相关病变治疗中的临床疗效。在这项研究中,我们考虑了17例患有TEN并住在重症监护病房的患者。将17例患者分为A、B两组,其中A组(n=7)患者接受NAC治疗,B组(n= 10)患者未接受NAC治疗。结果a组6例(85.71%);n=7)例患者水泡和OMB进展在72小时内完全缓解,10天完全愈合率为100%,而b组(n= 10)中60%的患者需要>72小时才能完全缓解,10天完全愈合率为80%。因此,NAC是一种有效的治疗方法,可以迅速治愈危及生命的ten相关严重皮肤病变。
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引用次数: 0
Neurobehavioural Mechanism of Antidepressant Effect of Methanol Stem Bark Extract of Adansonia digitata (Linn) in Tail Suspension Test in Mice 鼠尾悬浮试验中苦参甲醇提取物抗抑郁作用的神经行为机制
IF 0.1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2019-01-01 DOI: 10.13189/app.2019.070102
A. L. Abiola, Adebayo Muritala Ayofe, A. Adedoyin
Aim: An earlier study has demonstrated the in-vivo antidepressant effect of methanol stem bark extract of Adansonia digitata, using soxhlet extraction protocol, but there is a lack of scientific data on its neurobehavioural mechanism of action. This study, therefore, investigated its antidepressant potentials, using cold maceration method, and determined the probable neurobehavioural mechanism of its antidepressant-like effect. Methodology: The antidepressant-like effect of the extract was evaluated in tail suspension test, at graded doses in mice. Subsequently, the probable neurobehavioural mechanism of the antidepressant-like effect of the extract was investigated by intraperitoneal pretreatment with adrenergic, serotonergic, dopaminergic, and muscarinic cholinergic receptor antagonists; GABA agonist; nitric oxide precursor and inhibitors; and using a putative neuromodulator at NMDA receptors prior to the extract administration. Results and discussion: The extract at all the doses used, significantly (p 0.05) alteration on locomotor behaviour in mice. However, the anti-immobility potential of the extract was significantly (p<0.05) reversed by prazosin, yohimbine, sulpiride, methylene blue, L-arginine and baclofen, suggesting the involvement of adrenergic, dopaminergic, GABAerargic and nitergic pathways. Conclusion: This study, therefore, concluded that the extract may possess antidepressant effect and its mechanism may involve multiple pathways.
目的:早前有研究表明,采用索氏提取方案,荆芥甲醇茎皮提取物具有体内抗抑郁作用,但其神经行为作用机制缺乏科学数据。因此,本研究采用冷浸法研究其抗抑郁潜能,并确定其抗抑郁样作用的可能神经行为机制。方法:采用小鼠尾悬液分级剂量试验,评价其抗抑郁样作用。随后,通过肾上腺素能、血清素能、多巴胺能和毒蕈碱能受体拮抗剂腹腔预处理,研究了该提取物抗抑郁样作用的可能神经行为机制;GABA受体激动剂;一氧化氮前体和抑制剂;并在提取物施用之前在NMDA受体上使用假定的神经调节剂。结果与讨论:各剂量提取物对小鼠运动行为的影响均显著(p < 0.05)。然而,普拉唑嗪、育亨宾、舒必利、亚甲基蓝、l -精氨酸和巴氯芬显著(p<0.05)逆转了提取物的抗静止电位,提示其参与了肾上腺素能、多巴胺能、gabaarargic和氮能途径。结论:该提取物可能具有抗抑郁作用,其作用机制可能涉及多个途径。
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引用次数: 2
Anti-infective Assessment of Dichrostachys cinerea Root Bark, an Ivorian Anti-asthmatic Herbal 象牙海岸平喘草本植物灰根皮的抗感染评价
IF 0.1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2018-09-01 DOI: 10.13189/app.2018.060302
N. Geneviève, Z. N. Yessé, Dj Anderson, K. Landry, K. S. Landry, A. A. Leon, Djobo Adjé Wilfried
Dichrostachys cinerea root bark is used in Ivorian folk to manage asthma attack. As asthma is often accompanied with secondary infections, this study aimed to assess its potential effects of this medicine against microorganisms. An aqueous-alcoholic extract was obtained from Dichrostachys cinerea root bark. The growth of bacteria in the presence of the extract was measured by the method of dilution in microplate. The antiparasitic potent of the extract was determined on cell culture in microplate with determination of the parasitic viability by reading the optical density of wells in optical microscope. The antifungal activity of the extract was measured by the method of dilution in tube. At 200; 100; 50; 25; 12.5; 6.25 and 3.125 mg/mL the extract did not inhibit growth of Staphylococcus aureus, Escherichia coli, Bacillus sp, Pseudomonas aeruginosa and Enterococcus faecalis. IC90 of the plant extract on Trypanosoma brucei brucei, Caenorhabditis elegans and Aspergillus fumigatus was superior to 125 µg/mL and on average 50 µg/mL on Leishmania donovani and Candida albicans. In conclusion, the extract did not exert any significant anti-infective effect towards the studied microorganisms, supposing that Dichrostachys cinerea root bark would be effective only to delete bronchospasm, the main characteristic of asthma attack.
象牙海岸的人们用白蜡树皮来治疗哮喘。由于哮喘常伴有继发性感染,本研究旨在评估该药对微生物的潜在作用。研究了一种水醇提取液的制备方法。用微孔板稀释法测定提取液存在下细菌的生长情况。在微孔板细胞培养上测定提取液的抗寄生能力,在光学显微镜下通过读取孔的光密度测定寄生活力。用试管稀释法测定提取物的抑菌活性。在200年;100;50;25;12.5;6.25和3.125 mg/mL提取物对金黄色葡萄球菌、大肠杆菌、芽孢杆菌、铜绿假单胞菌和粪肠球菌的生长均无抑制作用。该植物提取物对布氏锥虫、秀丽隐杆线虫和烟曲霉的IC90均优于125µg/mL,对多诺瓦利什曼原虫和白色念珠菌的IC90均优于50µg/mL。综上所述,该提取物对所研究的微生物没有明显的抗感染作用,推测其仅对哮喘发作的主要特征支气管痉挛有效。
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引用次数: 1
Antinociceptive Activity of Methanol Extract of Dioscorea Pentaphylla Linn. Leaves in Mice 薯蓣甲醇提取物的抗伤活性研究。老鼠体内的叶子
IF 0.1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2018-09-01 DOI: 10.13189/APP.2018.060301
T. Islam, A. Begum, Shahed-Al-Mahmud
Background: Dioscorea pentaphylla L. a common plant of Dioscorea family commonly called five leaves in Bangladesh. The plant contains the alkaloid, carbohydrate, tannin, gum protein, steroid, glycoside, flavonoids. It is used as an analgesic, anti-inflammatory, and Powder of plant extract given orally in abdominal pain after delivery. The aim of the study: The present study was designed to evaluate chemical constituents and to investigate the antinociceptive activity of methanol extracts of Dioscorea pentaphylla (MEDP). Methods: The antinociceptive activity of MEDP was investigated using heat-induced (hot-plate and tail-immersion test) and chemical-induced (acetic acid, Formalin-induced) nociception models in mice at 200 & 400mg/kg doses. Result: Oral administration of the methanolic extract of leaves of Dioscorea pentaphylla L. (200 & 400 kg/mg) dose-dependently reduced nociceptive response to acute pain in acetic acid induced writhing. For acetic acid-induced writhing test highest inhibition (55.40 %) was found in case of highest dose (400 mg/kg) for leaf extract. Whereas standard drug diclofenac sodium causes (46.93%) writhing inhibition. Formalin-induced nociception test showed the significant effect in (200 and 400 mg/kg) for both dosages. On the other hand, MEDP showed the significant effect in hot plate, tail immersion test, at high dose (400mg/kg). Conclusion: MEDP showed significant antinociceptive activity via a multifactorial mechanism of action, indicating that the extract may be useful in the development of a new analgesic drug.
背景:五叶薯蓣(Dioscorea pentaphylla L.)是孟加拉国薯蓣科的一种常见植物,俗称五叶薯蓣。该植物含有生物碱、碳水化合物、单宁、树胶蛋白、类固醇、糖苷、类黄酮。它是一种镇痛药,抗炎药和植物提取物粉末,在分娩后腹痛时口服。本研究旨在评价五葡萄薯蓣(Dioscorea pentaphylla, MEDP)甲醇提取物的化学成分并研究其抗伤活性。方法:采用热诱导(热板和尾浸试验)和化学诱导(醋酸、福尔马林诱导)伤害模型,分别在200和400mg/kg剂量下观察MEDP的抗伤害感受活性。结果:口服薯蓣叶甲醇提取物(200和400 kg/mg)剂量依赖性地降低醋酸扭体急性疼痛的伤害性反应。在乙酸诱导扭体试验中,叶提取物在最高剂量(400 mg/kg)时抑制率最高,达到55.40%。而标准药物双氯芬酸钠引起扭体抑制(46.93%)。福尔马林致痛觉试验显示,两种剂量(200和400 mg/kg)均有显著效果。另一方面,MEDP在高剂量(400mg/kg)的热板、尾浸试验中表现出显著的效果。结论:MEDP具有明显的抗痛觉活性,其作用机制可能是多因素的,可用于开发一种新型镇痛药物。
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引用次数: 3
Pharmacological Test Confirming the Diagnosis: Responding to Stimulants Neuropsychiatric ADHD 确认诊断的药理学试验:对兴奋剂的反应神经精神ADHD
IF 0.1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2014-07-01 DOI: 10.13189/app.2014.020402
Klaus Martin Beckmann
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引用次数: 0
Correlation of Treatment Dose Enoxaparin with Anti-Xa Concentrations in Adult Hemodialysis Inpatients 成人血液透析住院患者依诺肝素治疗剂量与抗xa浓度的相关性
IF 0.1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2014-07-01 DOI: 10.13189/APP.2014.020401
Paul E. Brumley, Miroslav A. Anguelov, Jason P. Hecht, Dane L. Shiltz
Enoxaparin, a low-molecular-weight-heparin, is being used in hemodialysis patients despite a lack of guideline or manufacturer dose recommendations. Due to enoxaparin's renal excretion, the possibility of accumulating anti-Xa concentrations in hemodialysis patients using enoxaparin creates a hemorrhagic risk, calling for more research. The objectives of this study are to determine the correlation between treatment dose enoxaparin use and anti-Xa concentrations within the defined therapeutic range in patients receiving chronic, scheduled hemodialysis to determine the degree of change in anti-Xa concentrations in those cases where a concentration was obtained before and after a specific hemodialysis session, and to determine if there is evidence of enoxaparin accumulation over the course of treatment. This was a retrospective cohort study. Patients that were admitted to Indiana University Health facilities in a two-year period were identified from a Cerner query for inclusion eligibility. Inclusion criteria involved patients that received therapeutic dose enoxaparin based on actual body weight on a once daily basis, maintained a scheduled hemodialysis regimen, and had an anti-Xa concentration obtained after at least one enoxaparin dose. Despite lacking statistical significance, the data collected from this study depicts trends which can be utilized to guide future studies. The results of this study suggest that hemodialysis does not effectively remove enoxaparin.
依诺肝素是一种低分子量肝素,尽管缺乏指南或制造商剂量推荐,但仍被用于血液透析患者。由于依诺肝素的肾脏排泄,在使用依诺肝素的血液透析患者中积累抗xa浓度的可能性产生出血风险,需要更多的研究。本研究的目的是确定慢性有计划血液透析患者治疗范围内依诺肝素使用剂量与抗xa浓度之间的相关性,以确定在特定血液透析之前和之后获得浓度的病例中抗xa浓度的变化程度,并确定在治疗过程中是否有依诺肝素积累的证据。这是一项回顾性队列研究。通过Cerner查询确定纳入资格,确定两年内入住印第安纳大学卫生设施的患者。纳入标准包括每日一次根据实际体重接受依诺肝素治疗剂量,维持预定的血液透析方案,并在至少一次依诺肝素剂量后获得抗xa浓度的患者。尽管缺乏统计意义,但本研究收集的数据描绘了可以用来指导未来研究的趋势。本研究结果提示血液透析不能有效去除依诺肝素。
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引用次数: 1
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Advances in Pharmacology and Pharmacy
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