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Ethnopharmacological relevance Asthma is a chronic inflammatory disease, characterized by airway inflammation, hyperresponsiveness, and bronchial smooth muscle contraction. Qingfei Xiaoyan Wan (QFXYW), a traditional Chinese formula, has been shown to exert anti-asthma effects and immune response in multiple diseases. Aim of this study In this study, we evaluated the therapeutic mechanism of QFXYW in the suppression of allergic asthma by integrating of transcriptomics and system pharmacology. Materials and methods BALB/c mice were sensitized with ovalbumin (OVA) to establish the allergic asthma model, and its success was confirmed with behavioral observations. Lung histopathological analysis, inflammatory pathology scores, transcription factors were used to evaluate the effects of QFXYW on allergic asthma. The therapeutic mechanism of QFXYW in treating allergic asthma through integrated transcriptomics and system pharmacology was then determined: hub genes were screened out by topological analysis and functional enrichment analysis were performed to identify key signaling pathway. Subsequently, quantitative RP-PCR and protein array were performed to detect the mRNA of hub genes and to predict the key pathway in OVA-induced allergic asthma, respectively. Results Our results demonstrated that QFXYW could significantly attenuate inflammatory cell infiltration, mucus secretion, and epithelial damage. The transcriptomics analysis found the six hub genes with the highest values- CXCL10, CXCL2, CXCL1, IL-6, CCL-5, and CCL-4 were screened out. Functional enrichment analysis showed that the differentially expressed genes (DEGs) were mainly enriched in the inflammatory response and cytokine signaling pathway. Moreover, the quantitative RT-PCR verification experiment found the CXCL2 and CXCL1 were significantly suppressed after treatment with QFXYW. The results of protein array showed that QFXYW inhibited the multi-cytokines of OVA-induced allergic asthma via cytokine signaling pathway. Conclusions QFXYW may have mediated OVA-induced allergic asthma mainly through the hub genes CXCL2, CXCL1, and the cytokine signaling pathway. This finding will offer a novel strategy to explore effective and safe mechanism of Traditional Chinese Medicine (TCM) formula to treat allergic asthma.

Children are more susceptible to medication errors because of differences in pharmacokinetics and pharmacodynamics compared to adults. Weight changes are common with growth in children and computer systems frequently are not updated with current information, which result in inaccurate weight-based dosing and thus harm children. This study evaluated the impact of a Computerized Physician Order Entry system with standardized pediatric dosing decision support (PDDS) function on reducing pediatric dosing errors. Outpatient prescriptions were analyzed from January to March during 2010 and 2011. The total number of pediatric prescriptions was 72,431 and 80,532 prior to and after system implementation, respectively. Out of 72,431 prescriptions, 1617 (2.23%) dosing errors were retrospectively detected by the system, whereas 15 dosing errors (0.02%) were detected by pharmacists prior to system implementation. Incorporating the system into practice resulted in a total of 210 successfully blocked dosing near misses, including 14 potentially fatal and 11 serious near misses. The final dosing error rate was significantly reduced from 2.23% to 0.66% (p

Objectives Obtaining an accurate medication history upon admission to the hospital can be challenging and time-consuming. This study evaluated the efficacy of a medication reconciliation program, conducted by pharmacists, with the assistance of medication usage data from the Taiwan National Health Insurance (NHI). Characteristics of patients at high risk for drug discrepancies were also determined. Methods Patients admitted between May 2008 and September 2009 were recruited. The type and class of medication discrepancies reported by pharmacists, the medication discrepancy rate, physician acceptance rate, and time taken for the intervention were studied. The degree of harm that could have resulted from the discrepancies was independently evaluated by four pharmacists. The association between selected variables and the occurrence of drug discrepancies was analyzed. Results Among 3013 patients interviewed, the pharmacists identified 243 patients (8%) with at least one medication discrepancy between the patient's medication history and admission orders. There were 576 discrepancies identified. About 19% of the errors prevented could have potentially caused moderate to severe harm. The average time for one intervention was 18 ± 9.8 min. The number of preadmission medications, age, frequency of outpatient visits within 3 months prior to this hospital admission, and the number of specialist outpatient clinics the patient had visited within 3 months before the admission were determined to be risk factors for drug discrepancies. Conclusions This medication reconciliation program, conducted by pharmacists, was made more efficient by medication usage data from the Taiwan NHI. Pharmacists can reconcile medications more effectively by selecting patients at high risk for unintentional drug discrepancies.

Background The administration interval and dosage of the drugs must be adjusted properly according to patients’ renal functions to diminish adverse effects. The computerized monitoring system was established to modify drug dosing for patients with impaired renal function. The Renal Dosing Monitoring (RDM) system was officially operated in April 2007. Only one pharmacist was assigned to assess the reports and to offer the appropriate recommendations in the beginning of operation. The duties have been taken up by the individual pharmacist in each ward since January 2008. Purpose A retrospective analysis of the annual outcomes of applying the RDM system was conducted in March 2008. The goal of the study was to assess the outcome of the application of the RDM system. Method The computerized RDM system was established and applied for screening patients with renal dysfunction. Recommendations for frequency and dosage adjustments were made according to the renal function evaluated. Ranks of the drugs, physicians’ acceptance rates, and time to modify prescriptions were assessed by reviewing the documentation of pharmacy interventions. The savings of medication cost was also calculated. Results The physicians accepted 173 (86%) of the 202 recommendations provided by the pharmacists. Most of the recommendations were related to antibiotics, and gentamicin was the most frequently involved drug. The durations for the physicians to modify their prescriptions were as follows: 142 cases were accomplished within 0–1 day (82%), 26 cases were modified within 2–3 days (15%), and five cases were done after more than 3 days (3%). The total saving was US$5377. The physicians declined the pharmacists’ recommendations in 29 cases because of serious infectious conditions in 14 cases (48%), the advice of infection specialists was followed in six cases (21%), and the rest of the cases (31%) had other reasons, such as unwilling to change patients’ long-term medications. Conclusion The study showed that the RDM system could be an aid for pharmacists to evaluate the appropriateness and safety of medication more precisely and effectively.