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Pulmonary hypertension (PH) is a rare and life-threatening disease. Over past two decades, rapid advancements in treatment techniques have significantly improved the prognosis of two major subgroups of PH entities: pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Given the underlying pathological feature of in situ thrombosis of small arteries, anti-coagulation was previously considered to be a supportive therapy for PAH to improve prognosis. However, due to a lack of robust evidence, it is not recommended by the current guidelines. In contrast, lifelong anticoagulation is recommended for CTEPH patients to prevent thrombus recurrence and in situ thrombosis, based on the thromboembolic etiology. Furthermore, with the advent of direct oral anticoagulants, there are now more options for anti-coagulation therapy in PH. Nevertheless, due to the complexity of PH etiology and the heterogeneity of treatment approaches, anti-coagulation management remains challenging. This article reviews and evaluates the current status and safety issue of anti-coagulation therapy for PH patients, providing guidance and insights for clinical practice and research in this field. [ABSTRACT FROM AUTHOR]

With the wide application of traditional Chinese medicine (TCM)globally and combined drug use in clinical practice, there have been significant increases in herb-induced liver injury (HILI) events and drug safety events, bringing great challenges to the research and development of new TCM drugs and the development of the TCM industry. At present, there are still shortcomings in systematically summarizing the effect of combined drug use on HILI and analyzing its clinical features, pathogenesis and interaction mechanism, especially the research on pharmacodynamics and pharmacotoxicology processes after the combination of TCM and Western drugs. It is urgently needed to further construct an integrated research system, especially in the aspects of target molecules, intercellular communication, tissue crosstalk, and in vivo toxicity assessment. Based on the basic research combining clinical and fundamental studies, it is necessary to put forward HILI prevention and control strategies in accordance with TCM theory and application rules, which will provide fundamental support and reliable evidence for improving the level of combined use of TCM and Western drugs in the context of diseases and syndromes. [ABSTRACT FROM AUTHOR]

Pulmonary hypertension (PH) is a rare and life-threatening disease. Over past two decades, rapid advancements in treatment techniques have significantly improved the prognosis of two major subgroups of PH entities: pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Given the underlying pathological feature of in situ thrombosis of small arteries, anti-coagulation was previously considered to be a supportive therapy for PAH to improve prognosis. However, due to a lack of robust evidence, it is not recommended by the current guidelines. In contrast, lifelong anticoagulation is recommended for CTEPH patients to prevent thrombus recurrence and in situ thrombosis, based on the thromboembolic etiology. Furthermore, with the advent of direct oral anticoagulants, there are now more options for anti-coagulation therapy in PH. Nevertheless, due to the complexity of PH etiology and the heterogeneity of treatment approaches, anti-coagulation management remains challenging. This article reviews and evaluates the current status and safety issue of anti-coagulation therapy for PH patients, providing guidance and insights for clinical practice and research in this field.

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: To analyze the combination in patients treated with the novel antiviral drug nirmatrelvir/ ritonavir, and to explore the key points of clinical pharmaceutical care of nirmatrelvir/ ritonavir. METHODS: General information and drug use of 203 patients with nirmatrelvir/ ritonavir in the hospital from Dec. 2022 to Feb. 2023 were analyzed, and the key points of pharmaceutical care were discussed from the aspects of adverse drug reactions, drug interactions and the combined application of Chinese and Western medicines. RESULTS: Among the 203 patients treated with nirmatrelvir/ ritonavir, 110 patients were treated with Western medicines interacting with nirmatrelvir/ ritonavie, 129 patients additionally received Chinese patent medicines, and 64 patients received combination therapy of Western and Chinese patent medicines. Among the patients with drug combination, 18 cases had adverse drug reactions, including 9 cases of nirmatrelvir/ ritonavir combined with atorvastatin, showing abnormal liver enzymes, 6 cases of which were combined with Chinese patent medicines. Abnormal blood potassium levels were observed in 4 cases of nirmatrelvir/ ritonavir combined with tolvaptan, 2 of which were combined with Chinese patent medicines. CONCLUSIONS: Nirmatrelvir/ ritonavir interacts with a variety of drugs and may increase the risk of adverse drug reactions when applied in combination. Combination therapy with Chinese and Western medicines requires an overall assessment of drug interactions, individualized adjustment of treatment regimens, and enhanced pharmacological monitoring. [ABSTRACT FROM AUTHOR]

Copyright of Practical Oncology Journal is the property of Journal of Practical Oncology Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Because its ability to treat COVID-19, Paxlovid, the leader of “Paxlovid” antiviral team, was interviewed by the Medication TV station and its interactions with other drugs in the SARS-CoV-2 treatment were discussed. [ABSTRACT FROM AUTHOR]

Poly ADP-ribose polymerase inhibitors (PARPi), which approved in recent years, are recommended for ovarian cancer, breast cancer, pancreatic cancer, prostate cancer and other cancers by The National Comprehensive Cancer Network (NCCN) and Chinese Society of Clinical Oncology (CSCO) guidelines. Because most of PARPi are metabolized by cytochrome P450 enzyme system, there are extensive interactions with other drugs commonly used in cancer patients. By setting up a consensus working group including pharmaceutical experts, clinical experts and methodology experts, this paper forms a consensus according to the following steps: determine clinical problems, data retrieval and evaluation, Delphi method to form recommendations, finally formation expert opinion on PARPi interaction management. This paper will provide practical reference for clinical medical staff. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare foreign criteria of potentially clinically significant drug-drug interaction (csDDI), so as to provide reference for the identification of potential csDDI during drug therapy for the elderly in China. METHODS: Relevant information of common screening lists containing csDDI criteria for the elderly in foreign countries was extracted and compared with basic information, coverage content, interaction risk, interaction type and disposal suggestions. RESULTS: A total of five criteria were enrolled, including the Beers criteria, STOPP criteria, NORGEP-NH criteria, GheOP 3 S tool and the international consensus list of potential csDDI in the elderly. All criteria covered a total of 80 categories of csDDI, of which 2 categories were covered by 5 criteria, 2 categories were covered by 4 criteria, 13 categories were covered by 3 criteria, and 12 categories were covered by 2 criteria. The items’ number of STOPP criteria was the least (6 items), yet the repetition rate wad the highest (100%). International consensus list had the most comprehensive coverage (66 items). CONCLUSIONS: There are some similarities and differences in these five potential csDDIs criteria for the elderly. Currently, there is a lack of criteria for potential csDDIs in the drug treatment for the elderly in China and the study of actual csDDIs. Enriching relevant studies can provide more evidence for China’s rational drug use among the elderly. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Chongqing University of Technology (Natural Science) is the property of Chongqing University of Technology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: To construct a risk prediction model of prolonged length of stay (LOS) in patients with cardiovascular disease (CVD) based on potential drug-drug interactions (pDDIs) and other factors. METHODS: The demographic data, related examinations, pDDIs and other information of CVD inpatients in the First Affiliated Hospital of Chongqing Medical University from Oct. 2019 to Oct. 2021 were collected, and univariate and multivariate logistic regression was used to analyze the risk factors for prolonged LOS in CVD patients, and a nomogram prediction model was constructed, the receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the model. RESULTS: A total of 599 inpatients with CVD were included, of which 566 cases (94. 49%) had at least one pDDIs. Multivariate Logistic regression analysis showed that contraindicated pDDIs, body mass index and total number of medications were independent risk factors for prolonged LOS in CVD patients (P<0. 05). The area under the ROC curve of the model was 0. 821 (95%CI = 0. 787-0. 850), and the predicted value of the calibration curve was basically consistent with the actual value. CONCLUSIONS: The incidence of pDDIs in CVD patients is high, and the risk prediction model of prolonged LOS in CVD patients based on pDDIs and other factors has effective predictive performance and can provide relevant reference for clinical decision-making. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate whether olanzapine combined with sertraline can affect the blood concentration of olanzapine in vivo. METHODS: Drug monitoring results of olanzapine in a hospital from 2020 to 2021 were retrospectively reviewed. According to whether sertraline was used or not, all patients were divided into the combined group(68 cases) and control group(117 cases), and the blood concentration of olanzapine was compared between two groups. RESULTS: The blood concentrations of olanzapine in the combined group and control group were respectively (31. 68 ± 18. 58) ng/mL and (49. 86 ± 25. 63) ng/mL, the dose-adjusted blood concentrations were respectively (2. 08 ± 0. 88) ng·d/(mL·mg) and (2. 69 ± 1. 21) ng·d/( mL·mg), the combined group was significantly lower than the control group, with statistically significant differences ( P<0. 05 ). The ratio of concentrations below the lower limit of the therapeutic range in the combined group and control group were respectively 32. 35% (22/68) and 7. 69% (9/117), the combined group was significantly higher than the control group, and the difference was statistically significant (P<0. 05). CONCLUSIONS: Olanzapine combined with sertraline can decrease the blood concentration of olanzapine. When the two drugs are combined, it is recommended to monitor the changes in the blood concentration of olanzapine, and it may be necessary to increase the dose appropriately according to the clinical situation. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the situation of drug consultation in the outpatient drug consultation center of the hospital, and to provide reference for improving the quality of drug consultation service, promoting rational drug use and improving the level of comprehensive pharmaceutical service. METHODS: A total of 45 485 drug consultation records from outpatient drug consultation center of the hospital from 2014 to Jun. 2022 were screened, and the content of consultation questions, consultation methods and composition of counselors were analyzed. RESULTS: Among the 45 485 cases of pharmacy consultation records, there were 34 089 cases (74. 95%) for western medicine consultation, 11 396 cases (25. 05%) for traditional Chinese medicine problems. Among the 39 589 drug consultation records with the gender of the counsellor recorded, 22 357 cases ( 56. 47%) were females and 17 232 cases ( 43. 53%) were males. The consultation method of 45 485 drug consultation records was mainly on-site consultation (37 660 cases, 82. 80%), followed by phone-call consultation ( 7 825 cases, 17. 20%). In terms of the types of consultation questions, professional pharmaceutical questions included usage and dosage, adverse drug reactions, drug interactions, empirical medication, pharmacological effects, guidance of special dosage forms, and medication for special populations. General questions included drug information, medical insurance, medical treatment process and price. CONCLUSIONS: The professional pharmaceutical services provided by pharmacists through the outpatient drug consultation center are conducive to ensuring the medication safety of patients and promoting rational drug use. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the application of Danhong injection in inpatient prescriptions of the hospital, and to provide reference for clinical medication, so as to improve the quality of prescription and safety and effectiveness of medication. METHODS: From Jan. 2018 to Feb. 2022, 68 211 inpatient prescriptions of Danhong injection were extracted from the information system of the hospital. The prescription analysis system PA 2. 1 independently developed by the hospital was used to perform special review on basic prescription information, clinical diagnosis and drug combination. RESULTS: Of the 68 211 prescriptions of Danhong injection, there were 3 038 inappropriate prescriptions (4. 45%), mainly for repeated medication prescriptions (3 018 prescriptions, 4. 42%) and incompatible prescriptions (20 prescriptions, 0. 03%). There were 5 097 potential risk prescriptions (7. 47%), mainly reflected in potential drug interactions. CONCLUSIONS: The application of Danhong injection in the hospital is basically reasonable, yet the problems such as repeated medication and incompatibility should be prevented. Meanwhile, attention should be paid to the pharmaceutical care when Danhong injection is used in combination with high-risk drugs to promote rational drug use. [ABSTRACT FROM AUTHOR]

Mutations in the epithelial growth factor receptor (EGFR) is a driving factor that causes non-small cell lung carcinoma (NSCLC). The epithelial growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) is a crucial discovery in the treatment of lung cancer, particularly the efficacy of EGFR-TKIs is superior to that of the standard chemotherapy for patients with EGFR mutation-positive advanced NSCLC. Patients with NSCLC use EGFR-TKIs and other medications simultaneously is commonly seen, especially among those with comorbidities, which increases the risk of drug-drug interactions (DDIs) of EGFR-TKIs. The most common mechanisms underlying the DDIs of EGFR-TKIs are modulations of cytochrome P450 (CYP) and drug transporters [including P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP)], as well as gastrointestinal acid-inhibitory drugs [proton pump inhibitors (PPIs) and H2 receptor antagonists (H2RA)]. Inhibitors or inducers of CYP enzymes and drug transporters can inhibit or accelerate the metabolism of EGFR-TKIs, which increase or reduce the exposure of EGFR-TKIs, thereby affect the efficacy and safety of EGFR-TKIs. In addition, PPIs or H2RA can decrease the solubility, bioavailability and efficacy of EGFR-TKIs. This review summarizes the mechanisms of DDIs of gefitinib, erlotinib, icotinib, afatinib, dacomitinib and osimertinib; the management recommendations for DDIs of those EGFR-TKIs from the Chinese and global guideline, as well as from the recent pre-clinical and clinical studies, which provide the reference and evidence for managing the combination therapies of EGFR-TKIs and other medications in clinics. [ABSTRACT FROM AUTHOR]

Drug combination therapy has important application value in the cancer treatment. Predicting drug synergistic combinations through computational methods can provide targeted guidance for biological research, thereby improving research efficiency and reducing experimental costs. This paper proposed a multi-view graph neural network for drug synergy prediction to solve the problem of existing algorithms lack effective drug interaction modeling methods and could not consider the relationship between cell lines. Firstly, the algorithm used variational graph auto-encoder to learn the drug embedding of a specific cell line . Then, the algorithm integrated the drug information of other cell lines in the same tissue through a multi-view framework to improve the reliability of the drug embedding. Finally, the algorithm used the known drug combination scores as a supervisory signal to supervised training of the model to achieve reliable prediction of drug synergy effects. The experimental results on the DrugComb dataset demonstrate the effectiveness of the method. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the application of statins in patients with primary nephrotic syndrome in this hospital, and to probe into the possible drug interactions between various types of statins and cyclosporine, so as to provide reference for rational clinical drug selection. METHODS: The application of statins in patients diagnosed with primary nephrotic syndrome in outpatient department in this hospital from Jan. to Jun. 2022 was retrospectively analyzed; the categories of statins used and their possible drug interactions with cyclosporine were compared and analyzed by using the Lexicomp drug interaction database and dispensatory. RESULTS: From Jan. to Jun. 2022, the main statins used by patients with primary nephrotic syndrome in this hospital included pravastatin, fluvastatin, simvastatin, atorvastatin and rosuvastatin; among them, simvastatin and rosuvastatin were definitely prohibited in combination with cyclosporine in the “contraindications” of the dispensatory. In the Lexicomp database, the drugs with D-class interactions with cyclosporine were pravastatin, fluvastatin and resulvastatin; the drugs with X-class interaction with cyclosporine were simvastatin and atorvastatin. CONCLUSIONS: In the treatment of primary nephrotic syndrome, there are interactions between cyclosporine and statins, and the literature reports do not fully agree with the dispensatory; physicians need to take a comprehensive consideration when making decisions, choosing pravastatin and fluvastatin may be more desirable. [ABSTRACT FROM AUTHOR]

Copyright of Journal Of Sichuan University (Natural Sciences Division) / Sichuan Daxue Xuebao-Ziran Kexueban is the property of Editorial Department of Journal of Sichuan University Natural Science Edition and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To develop prescription-checking rules of cough medication regimen with expectorant and antitussive Chinese patent medicine, so as to provide reference for prescription review. Methods: By referring to such professional documents as Expert consensus on the diagnosis and treatment of cough with traditional Chinese medicine (2011 edition)" and "Instructions for clinical medication in Chinese pharmacopoeia", expectorant and antitussive Chinese patent drugs classified in the National Catelogue of Medical Insurance (2020 edition) were used as traditional Chinese medicines for treatment of cough and for prescription-checking rules and prescription review. Take the Tongxuan Lifei pill as an example. Initial investigations were made from the standpoints of traditional Chinese medicine diagnosis, application and dosage, special population, drug interactions, repeated medication, contraindication, pharmceutical care of medication, key points of patient propaganda and education and so on. Results and Conclusion: The prescription-checking rules for cough medication regimen were successfully developed with expectorant and antitussive Chinese patent medicine as an example, and it was absolutely necessary for assurance of safe and rational medication in clinic. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the clinical application characteristics of donepezil in inpatients, so as to provide reference for standardizing rational drug use in clinic. METHODS: A total of 170 inpatients with donepezil in People’s Hospital, Peking University from 2018 to 2019 were extracted for statistical analysis of the general conditions, clinical characteristics and drug combination. RESULTS: Among the 170 patients,91 were males and 79 were females, the average age was (78. 44±8. 67) years, the average length of stay was (12. 65±6. 93) d. There were 32 patients with previous allergic history. Totally 165 patients (97. 06%) had the diagnosis related to the administration of donepezil and 5 patients (2. 94%) lacked the corresponding diagnosis. The dosage of donepezil was mainly 5 mg, qd, and 10 mg, qd, 149 cases in total, accounting for 87. 65%. And 12. 35% of patients (21 cases might have inappropriate dosage. In some patients, donepezil was combined with citalopram, sertraline, paroxetine, risperidone, tolterodine and other drugs, which might lead to potential drug risks due to drug interactions. Meanwhile, 7 patients (4. 12%) had adverse drug reactions. CONCLUSIONS: The use of donepezil in inpatients has irregular diagnosis, improper usage and dosage, and potential medication risks, which should attract clinical attention; meanwhile, pharmacists should pay attention to the phenomenon in pharmaceutical care. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the discharge prescription with drugs in the Tenth People's Hospital Affiliated to Tongji University (hereinafter referred to as "our hospital"), to identify problems and study countermeasures,so as to promote the rational drug application for discharged patients. METHODS: Totally 6 000 discharge prescription with drugs in our hospital from Mar. 2019 to Feb. 2020 were extracted for prescription review,the irrational drug application and potential drug interaction were analyzed. RESULTS: Among the 6 000 discharge prescription,there were 105 irrational prescriptions,accounted for 1. 75% of the total prescriptions; there were 237 prescriptions with potential drug interactions,accounting for 3. 95% of the total prescriptions. The main problems were unreasonable dosage, inappropriate usage, super-therapeutic use, improper drug combination and potential drug interaction. CONCLUSIONS: Dispensing pharmacists and clinical pharmacists should strengthen cooperation, and dispensing pharmacists should timely intervene the prescriptions to reduce the occurrence of irrational prescriptions; clinical pharmacists should carry out discharge medication education to ensure safe and effective medication for discharged patients. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To optimize the type and matching of faropenem (FP) and biexpenem (BP) combined with lactamase inhibitors, so as to screen out the composition with the strongest anti-tuberculous activity. METHODS: The microplate alamar blue assay (MABA) was adopted to determine the type and matching of FP and BP combined with lactamase inhibitors by measuring the minimum inhibitory concentration (MIC) of mycobacterium tuberculosis standard strain H37Rv, and the anti-tuberculosis activity of the drug combinations was verified by clinical isolated strains; the MIC of drug combination in two-drug combinations with six anti-tuberculous drugs were determined by MABA method, and the in vitro drug interactions was evaluated by calculating the fractionated inhibition concentration (FIC). RESULTS: The MIC of FP and BP combined with potassium clavulanate (CLV) in fixed CLV concentration of 2. 5 μg/ml against H37Rv were respectively 2 μg/ml and 1 μg/ml; for the MIC of clinical isolated strains, the FP/CLV were 2-4 times lower than FP in 88% of strains, and the BP/CLV were 4-8 times lower than BP in 92% of strains; FP/CLV was synergistic with sodium aminosalicylate and protionamide, BP/CLV was synergistic with capromycin, sodium aminosalicylate and protionamide, BP/CLV was partially synergistic with linezolid and levofloxacin, BP/CLV and clofazimine had additive effect, and other combinations were unrelated. CONCLUSIONS: FP/CLV and BP/CLV have good anti-tuberculous activity, BP/CLV is more active and has a good combination with commonly used second-line anti-tuberculous drugs. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of pre-prescription review system, so as to provide reference for rational use of drugs in clinic. Methods: The prescriptions in the outpatient department of Henan Provincial People's Hospital from January to June in 2018 (without the on-line pre-prescription review system) and the prescriptions from January to June in 2019 and 2020 (with the on-line pre-prescription review system) were collected, and the rate of reasonable prescriptions and the changes of unreasonable prescription types were analyzed during the above-mentioned time spans. Results: The rate of reasonable prescriptions from January to June in 2019 and 2020 in the outpatient department significantly increased as compared with that of the time span of 2018. The rates of unreasonable prescriptions including-prescriptions without clinical diagnosis or with incomplete clinical diagnosis", "prescriptions with unsuitable drugs", "pre script io ns with unsuitable dosage forms or routes of adm inis t ratio and "prescriptions with unsuitable applications or dosages" reduced significantly during the time spans from January to June in 2019 and 2020 compared with the time span from January to June in 2018. At the same time, such problems as "prescriptions with unsuitable indications" and "adverse drug interactions" appeared more frequently with the improvement of the review system. Conclusion: The establishment of the pre-prescription review system significantly improved the rate and quality of reasonable prescriptions in the outpatient department of the hospital. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the rationality and influence factors of nasogastric dosing, and propose rational suggestion, so as to promote the rationality and normalization of nasogastric dosing in primary hospitals. METHODS: Retrospective analysis was adopted to inspect the nasogastric dosing on inpatients in Xiaolan Hospital Affiliated to Southern Medical University during 2017-2018, HIS and Excel software were used for the classification, summarizing and analysis on case numbers, distribution of dosage form, drug combination and irrational medication of nasogastric dosing. RESULTS: Totally 1 268 patients with nasogastric dosing was inspected, involving 303 categories of drugs, and the application frequency reached 23 920; the number of drug varieties administered simultaneously was up to 15; there were 131 case-times of adverse drug interactions; there were 3 689 case-times of inappropriate choice of dosage forms for nasogastric dosing, with the irrational medication rate was 15. 42%(3 689/23 920). CONCLUSIONS: There are irrational application of nasogastric dosing in primary hospitals, clinical pharmacists should give full play to their professional expertise to implement prior intervention to improve the rationality and normalizing of nasogastric dosing, and promote medication safety. [ABSTRACT FROM AUTHOR]

Organic cation transporter, organic anion transporter, P glycoprotein, multidrug resistance protein and nucleoside transporter are transporters that are closely related to transport and elimination of nucleoside antivirals in the body. By mediating the flux and efflux of drugs, transporters can regulate the concentration of antivirals in vivo, thus affecting the pharmacokinetic and pharmacodynamic behavior of drugs in vivo. This thesis reviews the related literature of nucleoside antivirals and body transporters, and explores the interaction between transporter-mediated nucleoside antivirals in combination with other drugs, so as to provide references for rational drug use in clinic. [ABSTRACT FROM AUTHOR]

To analyze the typical cases of irrational use of immunosuppressants in the review of outpatient prescriptions and inpatient medical orders, so as to improve rational use of drugs in the hospital. Methods: By referring to drug instructions, relevant guidelines and literature, typical cases found in outpatient prescriptions and inpatient medical orders concerning irrational use of immunosuppressants were analyzed in detail. Results: The main problems identified in the review of outpatient prescriptions and inpatient medical orders of immunosuppressant drugs were the interactions between calcineurin inhibitors and statins, macrolide antibacterials, proton pump inhibitors, rifampin, Wuzhi capsules and azole antifungal agents. Conclusion: The clinical interactions between calcineurin inhibitors and a variety of drugs are common problems in irrational prescription of immunosuppressants and should be the focus of pharmacists when they review prescriptions and medical orders. [ABSTRACT FROM AUTHOR]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To analyze possible drug interactions in the treatment of chronic diseases in elderly patients, so as to reduce adverse drug reactions (ADRs) and complications, and also to guide rational use of drugs in clinic. Methods: Case information of 180 patients with cardio-cerebral vascular diseases, diabetes and chronic respiratory diseases were screened from Jiuquan People's Hospital of Gansu Province from January 2017 to May 2017 in a retrospective study. The drug utilization was summarized and potential drug interactions were analyzed. Results: In the comprehensive treatment of chronic diseases, the highest percentage of drug combination involved 6-10 drugs, accounting for 4CM, the least used combination drugs were related with 2 drugs, and the most frequently used combination drugs were as many as 16 drugs. There were 116 cases of drug interactions, with a percentage as high as 64 .4%, of which the highest percentage of drug interactions involved 2 drugs, accounting for 40 .0% . 8 cases of ADRs were recorded and reported in the course of disease. Drug interactions that occurred between classical or commonly-used drugs were quite frequent • Conclusion: In the treatment of chronic diseases, drug interactions are commonly seen. Pharmacists should clearly know the mechanism and regularity of common drug interactions，assist physicians to optimize treatment profiles and minimize the kinds of drugs used, so as to avoid or reduce adverse reactions between drugs and ensure safe clinical medication. [ABSTRACT FROM AUTHOR]

Objective: To explore the key points of pharmaceutical care for angiotensin receptor-neprilysin inhibitor (ARNI) drugs in patients with dilated cardiomyopathy by clinical pharmacists. Methods: The clinical pharmacists offered pharmaceutical care to a patient with dilated cardiomyopathy from the perspectives of heart failure and anti-infection. In the course of treatment, attention was paid to the indications, application, dosage and adverse drug reactions of ARNI drugs, and at the same time, medication education and pharmaceutical care were provided to the patient. Results: In accordance with the features of the drugs, adverse drug reactions and drug interactions, the clinical pharmacist provided valuable advice for the physicians to adjust treatment regimen, and offered pharmaceutical monitoring for the patient. In the application of ARNI drugs, the blood pressure of the patient was relatively low, with normal renal function and normal blood potassium level, and symptoms of heart failure were obviously controlled. Conclusion: Individualized pharmaceutical care by clinical pharmacists for the patient with dilated cardiomyopathy treated with ARNI drugs could effectively avoid drug interactions and adverse drug reactions, and more importantly could improve therapeutic effects. [ABSTRACT FROM AUTHOR]

Objective: To discuss the application value of big data in pharmaceutical care. Methods: Literature on the application of big data in drug therapy, adverse drug reactions (ADRs) monitoring, drug interaction prevention, precision medicine was reviewed and the significance of big data in pharmaceutical care was also analyzed. Results: Big data technology plays an important role in the improvement of drug safety, the construction of smart pharmaceutical platform and the exploitation of the value of traditional Chinese medicines. Conclusion: Big data is a valuable tool for the development of pharmaceutical care. Rational use of big data technology can effectively improve the quality of pharmaceutical care. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the pharmaceutical practice for treatment of neutropenic fever with infection after chemotherapy in patients with fallopian tube cancer by clinical pharmacists. METHODS: For a patient with neutropenic fever and infection after chemotherapy for fallopian tube cancer, the clinical pharmacists participated into the anti-infective treatment, assisted the clinicians in analyzing the risk factors, preventing the selection of drugs, and assessing the risk and drug resistance of the patient. According to the initial experience of antibiotic treatment, after the experience and treatment, according to the results of microbiological examination and changes in the condition, the application of antibacterial drugs was adjusted with several times. RESULTS: The patient received effective and quality treatment and the prognosis was improved. CONCLUSIONS: In the process of pharmaceutical care, clinical pharmacists should make full use of their own professional advantages, fully understand the particularity of patients with agranulocytosis, investigate the pathogenic characteristics of the disease, comprehensively analyze the pharmacokinetic/pharmacodynamic characteristics of the drugs, the pathophysiological status of the patient and drug interactions, so as to assist the clinicians in the development of individualized treatment programs to ensure the safe and effective medication in patients. [ABSTRACT FROM AUTHOR]

Poly ADP-ribose polymerase inhibitors (PARPi), which approved in recent years, are recommended for ovarian cancer, breast cancer, pancreatic cancer, prostate cancer and other cancers by The National Comprehensive Cancer Network (NCCN) and Chinese Society of Clinical Oncology (CSCO) guidelines. Because most of PARPi are metabolized by cytochrome P450 enzyme system, there are extensive interactions with other drugs commonly used in cancer patients. By setting up a consensus working group including pharmaceutical experts, clinical experts and methodology experts, this paper forms a consensus according to the following steps: determine clinical problems, data retrieval and evaluation, Delphi method to form recommendations, finally formation expert opinion on PARPi interaction management. This paper will provide practical reference for clinical medical staff.

OBJECTIVE: By participating in pharmaceutical practice for individualized medication for patients after lung transplantation, the clinical pharmacists discusses the application of therapeutic drug monitoring during treatment of immunosuppressive therapy after lung transplantation. METHODS: The clinical pharmacists went into the clinic, performed routine tacrolimus blood concentration monitoring on one patient after lung transplantation, adjusted the medication regimen according to patient’s clinical manifestations, drug combination and auxiliary examination results, and then analyzed the causes of large fluctuation of tacrolimus concentration in the patient, so as to provided individualized treatment for the patient. RESULTS: Due to the drug interactions between tacrolimus and voriconazole, the instability of blood concentration of tacrolimus in patients increased the risk of rejection and adverse drug reactions in patients. The clinical pharmacists monitored the blood drug concentration of tacrolimus closely, adjusted the dose, and finally maintained it within the effective therapeutic ranges. There was no significant renal toxicity. CONCLUSIONS:Although the application of therapeutic drug monitoring in organ transplant patients has certain limitations, it is still the best way to ensure the effectiveness and safety of immunosuppressive therapy after organ transplantation. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

With the successful application of direct - acting antivirals (DAAs) in the treatment of hepatitis C, clinical management of drug - drug interaction (DD1) has become a lot topic in this field. Most DAAs develop DD1 with other drugs administered at the same time via cytochrome P450 or transporters in the liver and/or the intestine. At present, European Association for the Study of the Liver has published the recommendations on DD1 of DAAs in the treatment of chronic hepatitis C, which covers HIV antiretrovirals, lipid - lowering drugs, cardiovascular drugs, immunosuppressants, and addictive drugs for the central nervous system. When developing the regimens for DAA treatment, clinicians should closely assess and monitor the risk of DD1, in order to reduce or avoid treatment failure or adverse reactions during antiviral therapy. [ABSTRACT FROM AUTHOR]

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OBJECTIVE:To probe into the pharmaceutical care for one patient with intestinal tuberculosis after renal transplantion in anti tuberculosis treatment by clinical pharmacists. METHODS:Through participating into the formulation of anti tuberculosis treatment and pharmaceutical care for one patient with intestinal tuberculosis after renal transplantion, the clinical pharmacists analyzed the rationality of medication treatment from the aspects of drug selection, interaction and adverse drug reactions, etc. RESULTS:Different departments, clinicians and clinical pharmacists cooperated with each other, formulated and improve continuously patient`s anti tuberculosis treatment, the patient was getting better in the fifteenth day after hospitalization. According to laboratory test results in the sixteenth day, the kidney condition was poor and blood creatinine did not decrease, yet the patient refused to be treated for hemodialysis. And in the nineteenth day, the patient`s abdomen was generally good, the blood drug peak concentration of tacrolimus was 4.4 ng/ml, the patient and the family members refused to increase the dosage of tacrolimus. In the twenty-third day, with the disease mutations, the patient received casespositive rescue treatment. In the twenty-fourth day, the patient`s condition was still unrelieved after active treatment, the patient and the family members refused to be sent into intensive care unit and then gave up treatment for automatic discharge. CONCLUSIONS:It necessary to consider patient`s basic conditions in patient with intestinal tuberculosis after renal transplantion in anti tuberculosis treatment, especially for the aspects of antibacterial activity of drugs, interactions and adverse drug reactions. The clinical pharmacists actively participate into the clinical medication treatment, assist the clinicians to formulate and improve individualized treatment program, which promote the rational drug application in clinic. [ABSTRACT FROM AUTHOR]

In recent years，direct-acting antiviral agents (DAAs) have achieved great success in the treatment of hepatitis C and have replaced interferon/ribavirin. However, since DAAs were launched not long ago, there lacks sufficient knowledge of their toxic and side effects, interactions with other drugs, and safety in patients complicated by other serious chronic diseases. The results of many large - scale clinical trials show that DAAs have good safety in different populations and serious toxic and side effects are rare, but drug interactions need to be taken seriously. The addition of ribavirin in DAA regimen or prolongation of DAA treatment does not increase patients5 benefits and may cause more adverse events. Moreover, at the same time of DAA treatment, liver injury caused by HCV cannot be neglected, and contin¬uous treatment should be given. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the application rationality of proton pump inhibitors in inpatients in department of cardiology from Affiliated Hospital of Nantong University(hereinafter referred to as "our hospital"), so as to provide reference for the rational drug application in clinic. METHODS: From the hospital information system, the medical records of 3 380 inpatients with application of proton pump inhibitors for injection in department of cardiology of our hospital from Jul. 2016 to Jun. 2018 were selected. The usage, dosage, solvent selection and treatment course of proton pump inhibitors for injection were statistically analyzed to evaluate the rationality of drug application. RESULTS: Of the 3 380 patients, 3 165 cases(93.64%) were treated with pantoprazole sodium for injection(80 mg), and 215 cases(6.36%) received esomeprazole sodium for injection(40 mg). Totally 812 cases(24.02%) were irrational drug application, mainly performed as irrational drug treatment course(430 cases, 12.72%), followed by unclear indications(277 cases, 8.20%), improper usage and dosage(63 cases, 1.86%) and drug interactions(42 cases, 1.24%). CONCLUSIONS: There are still some problems in the application of proton pump inhibitors for injection in department of cardiology of our hospital, which need to be further improved. [ABSTRACT FROM AUTHOR]

Objective: To explore the entry point of pharmaceutical care for patients with type 2 diabetes mellitus by clinical pharmacists. Methods: The entry point of pharmaceutical care for patients with type 2 diabetes mellitus by clinical pharmacist was discussed through specific cases. Results: Through the access of drug interactions，PK/PD research of local antibacterials for the treatment of the patients with diabetic foot ulcer and medication education for patients using modular approach，clinical pharmacists participated in the treatment of patients with type 2 diabetes mellitus and achieved good outcomes. Conclusion: Focus on drug interactions， diabetic foot local infection control and modularized patient education are the entry point of pharmaceutical care for the patients with type 2 diabetes mellitus by clinical pharmacists. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the common drug problems in department of endocrinology from Nanping Municipal the Second Hospital (hereinafter referred to as “our hospital”), so as to probe into the role of clinical pharmacists in promoting rational drug application.METHODS: Combined with actual cases in department of endocrinology, the clinical pharmacists provided pharmaceutical care from the aspect of optimization of treatment regimen, attention of special crowd medication, avoiding of drug interactions, monitoring and control of adverse drug reactions, etc.RESULTS: Through participating in clinical treatment, assisting the clinicians to formulate and optimize the treatment regimen, the clinical pharmacists solved the actual medication problems and improved the level of rational drug application in clinic.CONCLUSIONS: Participation of clinical pharmacists in pharmaceutical practice can improve the clinical treatment effects, and promote the rational drug application in clinic. [ABSTRACT FROM AUTHOR]

Polypharmacy is a major concern in the care of older adults. People over 65 years of age frequently have multiple medical conditions and may have cancer, which requires multiple medications for treatment. The use of multiple medications increases the risk of drug-drug interactions, non-adherence, and adverse drug reactions. Polypharmacy is a term that refers to a high number of prescribed medications, usually five and above, or the use of more medications than is clinically justified. Although medications are an important factor in improving and maintaining the quality of life of older adults, polypharmacy increases the risks of morbidity and mortality, loss of functional independence, and a multiplicity of cognitive and physical problems in this population. This article examines issues related to polypharmacy in older adults and identifies nursing strategies and interventions to detect and prevent polypharmacy. Nursing strategies discussed include: (1) increasing patient knowledge of pharmacological issues, (2) increasing patient medication management competency, (3) promoting safe patient medication practices, and (4) enhancing patient education. Nurses must be familiar with medicine regimens, understand the primary factors that affect adherence, and participate in continuing education to enhance their ability to safeguard older adult patients. [ABSTRACT FROM AUTHOR]

Mutations in the epithelial growth factor receptor (EGFR) is a driving factor that causes non-small cell lung carcinoma (NSCLC). The epithelial growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) is a crucial discovery in the treatment of lung cancer, particularly the efficacy of EGFR-TKIs is superior to that of the standard chemotherapy for patients with EGFR mutation-positive advanced NSCLC. Patients with NSCLC use EGFR-TKIs and other medications simultaneously is commonly seen, especially among those with comorbidities, which increases the risk of drug-drug interactions (DDIs) of EGFR-TKIs. The most common mechanisms underlying the DDIs of EGFR-TKIs are modulations of cytochrome P450 (CYP) and drug transporters [including P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP)], as well as gastrointestinal acid-inhibitory drugs [proton pump inhibitors (PPIs) and H(2) receptor antagonists (H(2)RA)]. Inhibitors or inducers of CYP enzymes and drug transporters can inhibit or accelerate the metabolism of EGFR-TKIs, which increase or reduce the exposure of EGFR-TKIs, thereby affect the efficacy and safety of EGFR-TKIs. In addition, PPIs or H(2)RA can decrease the solubility, bioavailability and efficacy of EGFR-TKIs. This review summarizes the mechanisms of DDIs of gefitinib, erlotinib, icotinib, afatinib, dacomitinib and osimertinib; the management recommendations for DDIs of those EGFR-TKIs from the Chinese and global guideline, as well as from the recent pre-clinical and clinical studies, which provide the reference and evidence for managing the combination therapies of EGFR-TKIs and other medications in clinics.

Objectives: Hypertension (HTN) is an important risk factor for cardiovascular disease, and not only is a major health threat for the general population, but is also an important public health issue. Using National Health Insurance (NHI) claims data, this research investigated the inappropriate prescription of medications to treat hypertension under NHI in Taiwan. Methods: The data for 2004 to 2008 were collected from the National Health Insurance Research Database (NHIRD) published by the National Health Research Institutes. The dataset contains information about 1,000,000 beneficiaries randomly sampled from the year 2005 Registry for Beneficiaries of the NHIRD. The NHI Pharmaceutical Subsidy Anatomical Therapeutic Chemical classification system was used to extract the pharmaceutical classification records. The study subjects were identified based on major diagnoses of ICD-9-CM codes 401.xx-405.xx. Inappropriate prescriptions were defined as duplicate medications, drug-drug interactions, or over-dosage. Results: There were 161,003 patients with hypertension and 3,988,024 prescriptions from 2004 to 2008. For inappropriate prescriptions, the frequencies of over-dosage, duplicate medications, and drug-drug interactions were 2.1%, 33.41%, and 12.39%, respectively. The incidence of inappropriate prescriptions was considered high, and most were prescribed by public and private medical facilities, male physicians, and physicians with low seniority. Conclusions: This research demonstrated the inappropriate prescription of medications to treat HTN from 2004 to 2008 under NHI in Taiwan. It may provide useful information for policy-makers to enact relevant policies to ensure prescription safety for HTN patients. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the drug-drug interactions and the tolerability of combined medication between yimitasvir phosphate capsules with sofosbuvir tablets, omeprazole magnesium enteric-coated tablets, and rosuvastatin calcium tablets in healthy volunteers. Methods: A randomized, open, and continuous administration design was used in trial 1 (yimitasvir phosphate capsules with sofosbuvir tablets). 28 subjects were randomly divided into two groups. A non-randomized, open design was used in trial 2 (yimitasvir phosphate capsules with omeprazole magnesium enteric-coated tablets), and included 42 subjects divided into three groups. The open design method was used in trial 3 (yimitasvir phosphate capsules with rosuvastatin calcium tablets), and included 14 subjects. The plasma concentrations of yimitasvir phosphate, sofosbuvir and their main metabolites GS-331007, omeprazole and rosuvastatin were validated by a liquid chromatography/tandem mass spectrometry (LC-MS/MS). The pharmacokinetic parameters were calculated by Phoenix winNonlin software. Results: (1) in trial 1, after single and co-administration, the 90% CI of sofosbuvir C(max) and AUC(0-tau) geometric mean ratio (GMR) were 152.0% (118.0% ~ 197.0%) and 230.0% (184.0% ~ 287.0%), with an increase of 52.0% and 130.0% compared to single dose of sofosbuvir, respectively. The 90% CI of GS-331007 C(max) GMR was 74.0% (67.5% ~ 81.2%) and reduced by 26% compared to single dose of sofosbuvir. (2) in trial 2, the 90% CI of C(max) GMR after yimitasvir single or co-administration at the same time, with a 4-hours interval, or with a 12- hours interval were 68.9% (44.5% ~ 106.7%) , 64.0% (43.8% ~ 93.6%) and 56.4%(38.9% ~ 81.9%), and the 90% CI of AUC(0-t) GMR were 68.6% (46.5% ~ 101.2%), 68.3% (47.6% ~ 98.0%) and 60.5% (41.8% ~ 87.5%), respectively. Compared with single dose of yimitasvir, the C(max) and AUC(0-t) were decreased by 31.1% and 31.4%, 36.0% and 31.7%, 43.6% and 39.5%, respectively. (3) In trial 3, after single and co-administration, the 90% CI of rosuvastatin C(max) and AUC(0-72) GMR were 172.4% (153.6% ~ 193.5%) and 158.0% (144.3% ~ 172.9%), respectively, with an increase of 74.9% and 60.5% compared to single dose of rosuvastatin. There were no serious adverse events and adverse events leading to withdrawal from the trial. Conclusion: Yimitasvir phosphate capsules have drug-drug interactions with sofosbuvir tablets, omeprazole magnesium enteric-coated tablets, and rosuvastatin calcium tablets.

This study is to explore the effect of Xiangdan Injection on anticoagulation of warfarin in rats. Rats were randomly divided into different groups and then administered, subsequently the blood samples were collected at a set series of time points to measure PT(prothrombin time) and APTT(activated partial thromboplastin time) values, and INR(international normalized ratio) value was calculated. The plasma concentrations of warfarin enantiomers were determined by UPLC-MS/MS technology, and pharmacokinetic parameters were calculated by DAS 2.0 software. Statistical analysis was performed to compare differences between the groups. Single-dose study of warfarin showed that Xiangdan Injection alone had no effects on PT, APTT and INR, but when co-administrated with warfarin, PT and INR values were increased(P&lt;0.01), while APTT was unaffected; after co-administration of the two drugs, C&#95;(max), AUC&#95;(0-t), and AUC&#95;(0-∞) of S-warfarin increased(P&lt;0.01), and t&#95;(1/2) prolonged(P&lt;0.01), while the pharmacokinetic parameters of R-warfarin were not changed significantly. Steady-state study of warfarin showed that after co-administration of the two drugs, the PT and INR values increased(P&lt;0.05), and the plasma concentration of S-warfarin increased(P&lt;0.01), while the plasma concentration of R-warfarin was not changed significantly. The results suggest that Xiangdan Injection itself has no effect on coagulation index, but can enhance the anticoagulant effect of warfarin by slowing metabolism of S-warfarin.