Importance/Objective: Adverse Drug Reactions (ADRs) are unavoidable, but recognizing and addressing ADRs early can improve wellness and prevent permanent injury. We suggest that available medical information and digit...Importance/Objective: Adverse Drug Reactions (ADRs) are unavoidable, but recognizing and addressing ADRs early can improve wellness and prevent permanent injury. We suggest that available medical information and digital/electronic methods could be used to manage this major healthcare problem for individual patients in real time. Methods: We searched the available digital applications and three literature databases using the medical subject heading terms, adverse drug reaction reporting systems or management, filtered by clinical trial or systemic reviews, to detect publications with data about ADR identification and management approaches. We reviewed the reports that had abstract or summary data or proposed or implemented methods or systems with potential to identify or manage ADRs in clinical settings. Results: The vast majority of the 481 reports used retrospectively collected data for groups of patients or were limited to surveying one population group or class of medication. The reports showed potential and definite associations of ADRs for specific drugs and problems, mostly, but not exclusively, for patients in hospitals and nursing homes. No reports described complete methods to collect comprehensive data on ADRs for individual patients in a healthcare system. The digital applications have ADR information, but all are too cumbersome or incomplete for use in active clinical settings. Several studies suggested that providing information about potential ADRs to clinicians can reduce these problems. Conclusion and Relevance: Although investigators and government agencies agree with the need, there is no comprehensive ADR management program in current use. Informing the patient’s healthcare practitioners of potential ADRs at the point of service has the potential for reduction of these complications, which should improve healthcare and reduce unneeded costs.展开更多
Objective:In general hospitals,pharmaceutical care was carried out to reduce the incidence of adverse drug reactions(ADR),and this effect was significant.It can significantly reduce the incidence of adverse drug react...Objective:In general hospitals,pharmaceutical care was carried out to reduce the incidence of adverse drug reactions(ADR),and this effect was significant.It can significantly reduce the incidence of adverse drug reactions and improve the safety of drug therapy.The Joint Surgery Department and the Department of Neurology of Changle County People's Hospital in Shandong province were investigated for the effect of pharmaceutical care on reducing adverse drug reactions.Methods:120 patients were selected from the Department of Joint Surgery and Neurology,Changle County People's Hospital,Shandong Province from May 2015 to May 2020.According to the random table method,the patients were divided into experimental group(60 cases)and control group(60 cases).Control group:routine drug therapy.Experimental group:pharmaceutical care treatment was carried out jointly,and the incidence of adverse reactions was compared between the two groups.Results:The incidence of adverse reactions in experimental group was lower than that in control group.Conclusion:In general hospitals,pharmaceutical care is effective in reducing adverse drug reactions,which can significantly reduce the incidence of adverse drug reactions.At the same time,this improves the safety of drug treatment,which is worthy of clinical promotion.展开更多
Gastrodin(4-hydroxymethylphenyl-β-d-glucopyranoside)is an active ingredient with high content,which is isolated from the rhizome of Gastrodia elata.Gastrodin injections,tablets and capsules are currently the main gas...Gastrodin(4-hydroxymethylphenyl-β-d-glucopyranoside)is an active ingredient with high content,which is isolated from the rhizome of Gastrodia elata.Gastrodin injections,tablets and capsules are currently the main gastrodin-related preparations in clinical practice,and gastrodin injections are the most widely used.This article will summarize pharmacology and adverse reactions of gastrodin to evaluate its safety,effectiveness and quality control.Gastrodin has pharmacological effects on central nervous system(vertigo,headache,insomnia,neurasthenia,convulsions and epilepsy,etc.),cardiovascular system and other diseases(osteoporosis,osteoarthritis and bone injury,etc.),but we still need to pay attention to its clinical adverse reactions(some patients may have dry mouth and nose,dizziness and stomach discomfort).In addition,further research is needed in other fields,such as health products,food,cosmetics,etc.We also need to further develop and explore the new pharmacological effects of gastrodin and expand its medicinal value.展开更多
Objective:To observe the clinical efficacy of point application with De Huang(Rhizome Rhei Crude)powder at Shenque(CV 8)plus moxa-salt hot compress on the umbilicus for preventing gastrointestinal adverse reactions af...Objective:To observe the clinical efficacy of point application with De Huang(Rhizome Rhei Crude)powder at Shenque(CV 8)plus moxa-salt hot compress on the umbilicus for preventing gastrointestinal adverse reactions after chemotherapy for non-Hodgkin lymphoma(NHL).Methods:A total of 60 cases with NHL under chemotherapy were divided into two groups by hospitalization order,with 30 cases in each group.The control group was treated with routine nursing and the observation group was additionally given point application with Da Hueng(Rhizome Rhei Crude)powder plus moxa-salt hot compress on the umbilicus,to compare the effect in preventing gastrointestinal adverse reactions after chemotherapy between the two groups.Results:The occurrence rates of constipation,nausea,vomiting and poor appetite on the second day and fifth day after chemotherapy were obviously lower in the observation group than those in the control group,with statistically significant differences between the two groups(all P〈0.05).Conclusion;The point application with De Hueng(Rhizome Rhei Crude)powder at Shenque(CV 8)plus maxa-salt hot compress on the umbilicus can produce more significant efficacy in preventing the gastrointestinal adverse reactions after chemotherapy for NHL than routine nursing.Moreover,it is simple and easy to be used and popularized.展开更多
BACKGROUND Despite the popularity of immune checkpoint inhibitors(ICIs)in the treatment of advanced cancer,patients often develop gastrointestinal(GI)and non-GI immune-related adverse events(irAEs).The clinical charac...BACKGROUND Despite the popularity of immune checkpoint inhibitors(ICIs)in the treatment of advanced cancer,patients often develop gastrointestinal(GI)and non-GI immune-related adverse events(irAEs).The clinical characteristics and survival outcomes of GI-irAEs have not been fully elucidated in previous reports.This necessitates the evaluation of the impact of GI-irAEs on patients receiving ICI treatment.AIM To evaluate the clinical characteristics of GI-irAEs and their impact on survival in patients treated with ICIs.METHODS In this single-center,retrospective,observational study,we reviewed the records of 661 patients who received ICIs for various cancers at Nagoya University Hospital from September 2014 to August 2020.We analyzed the clinical characteristics of patients who received ICI treatment.We also evaluated the correlation between GI-irAE development and prognosis in non-small cell lung cancer(LC)and malignant melanoma(MM).Kaplan-Meier analysis was used to compare the median overall survival(OS).Multivariate Cox proportional hazards models were used to identify prognostic factors.A P value<0.05 was considered statistically significant.RESULTS GI-irAEs occurred in 34 of 605 patients(5.6%)treated with an anti-programmed cell death-1/programmed death-ligand 1(anti-PD-1/PD-L1)antibody alone and in nine of 56 patients(16.1%)treated with an anti-cytotoxic T-lymphocyte antigen 4(CTLA-4)antibody alone or a combination of anti-PD-1 and anti-CTLA-4 antibodies.The cumulative incidence and median daily diarrhea frequency were significantly higher in patients receiving anti-CTLA-4 antibodies(P<0.05).In 130 patients with MM,OS was significantly prolonged in the group that continued ICI treatment despite the development of GI-irAEs compared to the group that did not experience GI-irAEs(P=0.035).In contrast,in 209 patients with non-small cell LC,there was no significant difference in OS between the groups.The multivariate analyses showed that a performance status of 2-3(hazard ratio:2.406;95%confidence interval:1.125–5.147;P=0.024)was an independent predictive factor for OS in patients with MM.CONCLUSION Patients receiving anti-CTLA-4 antibodies develop GI-irAEs more frequently and with higher severity than those receiving anti-PD-1/PD-L1 antibodies.Continuing ICI treatment in patients with MM with GI-irAEs have better OS.展开更多
BACKGROUND Although norepinephrine injection is commonly used in emergency situations,it is associated with risks for elderly patients with spasmodic liver pain.This study explores the safety and effectiveness of mebe...BACKGROUND Although norepinephrine injection is commonly used in emergency situations,it is associated with risks for elderly patients with spasmodic liver pain.This study explores the safety and effectiveness of mebendazole injection,an alternative treatment option,for the emergency management of spasmodic abdominal pain,while minimizing adverse reactions,in elderly patients.AIM To explore the development of norepinephrine injection and the adverse reactions of this drug in emergency elderly patients with spasmodic liver pain.METHODS The control group consisted of 56 elderly patients visiting our hospital from January 2021 to December 2021.After hospital admission,the control group was intravenously administered tolopin.The experimental group consisted of 56 emergency patients with spasmodic abdominal pain who visited our hospital until June 2022.After hospital admission,the experimental group was intravenously administered toloxazole.The two groups were treated for 3 d.The disappearance of clinical symptoms was observed before and after the treatment,and the difference in adverse reactions between the two groups was compared.RESULTS The pain of the wife,fire,diarrhea,drowning,and surrounding time disappeared in the experimental group.No statistical difference was observed between the experimental and control groups in visual pain analog scale(VAS)scores before and after the treatment(P>0.05).The VAS scores of abdominal pain severity after 0.5 h,1.0 h,and after 6.0 h of treatment were significantly lower for the experimental group than for the control group.After the treatment,the therapeutic effect in the experimental group was higher and statistically significant than that in the control group(P<0.05).The probability of adverse reactions before the treatment was lower in the experimental group than in the control group.CONCLUSION During emergency,mebendazole injection exhibited a good therapeutic value when used for the clinical treatment of elderly patients with spasmodic stomach pain.It accelerated the disappearance of clinical symptoms such as stomach pain,reduced the stomach weight,and improved clinical activity.Reducing and promoting the frequency of high treatment safety with mebendazole injection is worthwhile.展开更多
文摘Importance/Objective: Adverse Drug Reactions (ADRs) are unavoidable, but recognizing and addressing ADRs early can improve wellness and prevent permanent injury. We suggest that available medical information and digital/electronic methods could be used to manage this major healthcare problem for individual patients in real time. Methods: We searched the available digital applications and three literature databases using the medical subject heading terms, adverse drug reaction reporting systems or management, filtered by clinical trial or systemic reviews, to detect publications with data about ADR identification and management approaches. We reviewed the reports that had abstract or summary data or proposed or implemented methods or systems with potential to identify or manage ADRs in clinical settings. Results: The vast majority of the 481 reports used retrospectively collected data for groups of patients or were limited to surveying one population group or class of medication. The reports showed potential and definite associations of ADRs for specific drugs and problems, mostly, but not exclusively, for patients in hospitals and nursing homes. No reports described complete methods to collect comprehensive data on ADRs for individual patients in a healthcare system. The digital applications have ADR information, but all are too cumbersome or incomplete for use in active clinical settings. Several studies suggested that providing information about potential ADRs to clinicians can reduce these problems. Conclusion and Relevance: Although investigators and government agencies agree with the need, there is no comprehensive ADR management program in current use. Informing the patient’s healthcare practitioners of potential ADRs at the point of service has the potential for reduction of these complications, which should improve healthcare and reduce unneeded costs.
基金Key Research Project of Scientific and Educational Innovation in the Institute of Educational Science,Chinese Academy of Management Sciences(Grant No:KJCX5406).
文摘Objective:In general hospitals,pharmaceutical care was carried out to reduce the incidence of adverse drug reactions(ADR),and this effect was significant.It can significantly reduce the incidence of adverse drug reactions and improve the safety of drug therapy.The Joint Surgery Department and the Department of Neurology of Changle County People's Hospital in Shandong province were investigated for the effect of pharmaceutical care on reducing adverse drug reactions.Methods:120 patients were selected from the Department of Joint Surgery and Neurology,Changle County People's Hospital,Shandong Province from May 2015 to May 2020.According to the random table method,the patients were divided into experimental group(60 cases)and control group(60 cases).Control group:routine drug therapy.Experimental group:pharmaceutical care treatment was carried out jointly,and the incidence of adverse reactions was compared between the two groups.Results:The incidence of adverse reactions in experimental group was lower than that in control group.Conclusion:In general hospitals,pharmaceutical care is effective in reducing adverse drug reactions,which can significantly reduce the incidence of adverse drug reactions.At the same time,this improves the safety of drug treatment,which is worthy of clinical promotion.
文摘Gastrodin(4-hydroxymethylphenyl-β-d-glucopyranoside)is an active ingredient with high content,which is isolated from the rhizome of Gastrodia elata.Gastrodin injections,tablets and capsules are currently the main gastrodin-related preparations in clinical practice,and gastrodin injections are the most widely used.This article will summarize pharmacology and adverse reactions of gastrodin to evaluate its safety,effectiveness and quality control.Gastrodin has pharmacological effects on central nervous system(vertigo,headache,insomnia,neurasthenia,convulsions and epilepsy,etc.),cardiovascular system and other diseases(osteoporosis,osteoarthritis and bone injury,etc.),but we still need to pay attention to its clinical adverse reactions(some patients may have dry mouth and nose,dizziness and stomach discomfort).In addition,further research is needed in other fields,such as health products,food,cosmetics,etc.We also need to further develop and explore the new pharmacological effects of gastrodin and expand its medicinal value.
文摘Objective:To observe the clinical efficacy of point application with De Huang(Rhizome Rhei Crude)powder at Shenque(CV 8)plus moxa-salt hot compress on the umbilicus for preventing gastrointestinal adverse reactions after chemotherapy for non-Hodgkin lymphoma(NHL).Methods:A total of 60 cases with NHL under chemotherapy were divided into two groups by hospitalization order,with 30 cases in each group.The control group was treated with routine nursing and the observation group was additionally given point application with Da Hueng(Rhizome Rhei Crude)powder plus moxa-salt hot compress on the umbilicus,to compare the effect in preventing gastrointestinal adverse reactions after chemotherapy between the two groups.Results:The occurrence rates of constipation,nausea,vomiting and poor appetite on the second day and fifth day after chemotherapy were obviously lower in the observation group than those in the control group,with statistically significant differences between the two groups(all P〈0.05).Conclusion;The point application with De Hueng(Rhizome Rhei Crude)powder at Shenque(CV 8)plus maxa-salt hot compress on the umbilicus can produce more significant efficacy in preventing the gastrointestinal adverse reactions after chemotherapy for NHL than routine nursing.Moreover,it is simple and easy to be used and popularized.
文摘BACKGROUND Despite the popularity of immune checkpoint inhibitors(ICIs)in the treatment of advanced cancer,patients often develop gastrointestinal(GI)and non-GI immune-related adverse events(irAEs).The clinical characteristics and survival outcomes of GI-irAEs have not been fully elucidated in previous reports.This necessitates the evaluation of the impact of GI-irAEs on patients receiving ICI treatment.AIM To evaluate the clinical characteristics of GI-irAEs and their impact on survival in patients treated with ICIs.METHODS In this single-center,retrospective,observational study,we reviewed the records of 661 patients who received ICIs for various cancers at Nagoya University Hospital from September 2014 to August 2020.We analyzed the clinical characteristics of patients who received ICI treatment.We also evaluated the correlation between GI-irAE development and prognosis in non-small cell lung cancer(LC)and malignant melanoma(MM).Kaplan-Meier analysis was used to compare the median overall survival(OS).Multivariate Cox proportional hazards models were used to identify prognostic factors.A P value<0.05 was considered statistically significant.RESULTS GI-irAEs occurred in 34 of 605 patients(5.6%)treated with an anti-programmed cell death-1/programmed death-ligand 1(anti-PD-1/PD-L1)antibody alone and in nine of 56 patients(16.1%)treated with an anti-cytotoxic T-lymphocyte antigen 4(CTLA-4)antibody alone or a combination of anti-PD-1 and anti-CTLA-4 antibodies.The cumulative incidence and median daily diarrhea frequency were significantly higher in patients receiving anti-CTLA-4 antibodies(P<0.05).In 130 patients with MM,OS was significantly prolonged in the group that continued ICI treatment despite the development of GI-irAEs compared to the group that did not experience GI-irAEs(P=0.035).In contrast,in 209 patients with non-small cell LC,there was no significant difference in OS between the groups.The multivariate analyses showed that a performance status of 2-3(hazard ratio:2.406;95%confidence interval:1.125–5.147;P=0.024)was an independent predictive factor for OS in patients with MM.CONCLUSION Patients receiving anti-CTLA-4 antibodies develop GI-irAEs more frequently and with higher severity than those receiving anti-PD-1/PD-L1 antibodies.Continuing ICI treatment in patients with MM with GI-irAEs have better OS.
文摘BACKGROUND Although norepinephrine injection is commonly used in emergency situations,it is associated with risks for elderly patients with spasmodic liver pain.This study explores the safety and effectiveness of mebendazole injection,an alternative treatment option,for the emergency management of spasmodic abdominal pain,while minimizing adverse reactions,in elderly patients.AIM To explore the development of norepinephrine injection and the adverse reactions of this drug in emergency elderly patients with spasmodic liver pain.METHODS The control group consisted of 56 elderly patients visiting our hospital from January 2021 to December 2021.After hospital admission,the control group was intravenously administered tolopin.The experimental group consisted of 56 emergency patients with spasmodic abdominal pain who visited our hospital until June 2022.After hospital admission,the experimental group was intravenously administered toloxazole.The two groups were treated for 3 d.The disappearance of clinical symptoms was observed before and after the treatment,and the difference in adverse reactions between the two groups was compared.RESULTS The pain of the wife,fire,diarrhea,drowning,and surrounding time disappeared in the experimental group.No statistical difference was observed between the experimental and control groups in visual pain analog scale(VAS)scores before and after the treatment(P>0.05).The VAS scores of abdominal pain severity after 0.5 h,1.0 h,and after 6.0 h of treatment were significantly lower for the experimental group than for the control group.After the treatment,the therapeutic effect in the experimental group was higher and statistically significant than that in the control group(P<0.05).The probability of adverse reactions before the treatment was lower in the experimental group than in the control group.CONCLUSION During emergency,mebendazole injection exhibited a good therapeutic value when used for the clinical treatment of elderly patients with spasmodic stomach pain.It accelerated the disappearance of clinical symptoms such as stomach pain,reduced the stomach weight,and improved clinical activity.Reducing and promoting the frequency of high treatment safety with mebendazole injection is worthwhile.
