2012 Volume 14 Issue 5 Published: 28 October 2012

  

• Select all
  |

论著

• Select
  论著

  Clinical analysis of hospitalized patients due to adverse drug reactions in endocrine wards

  TANG Zhi-hui;WANG Bo;GUO Dai-hong;ZHU Man;CHEN Chao

  2012, 14(5): 273-4.

  Abstract ( ) PDF ( )

  Objective To analyze the clinical data of hospitalized patients due to adverse drug reactions (ADR) in endocrine ward in order to provide the basis for safe drug use in clinical practice. Methods The clinical data of discharged patients’medical records in Chinese PLA General Hospital endocrine ward from January 2011 to June 2012 were collected. The hospitalized patients due to ADR were diagnosed according to the clinical manifestations and the ADR evaluation criterion. The type of ADR, drugs associated with adverse reactions, duration of hospitalization, cost of hospitalization and outcome of patients were retrospectively analyzed. ResultsA total of 3187 patients’medical records were collected. Of them, 15 patients (0.47%) were hospitalized due to ADR. They comprised 7 males and 8 females with an average age of (59±16) years, an average duration of hospitalization of (13.5±9.7) days, and an average cost of (9182±4258) yuan. Of them, four patients (27%) were diagnosed with drug-related adverse reactions on admission, six (40%) were diagnosed with drug-related adverse reactions on discharging from hospital, and the other five patients (33%) were diagnosed with drug-related adverse reactions by analyzing the medical records. Six patients had drug or food allergic history. The type of ADR included hypoglycaemia, hypokalemia, renal tubule acidosis，liver enzyme elevations, electrolyte disturbances, and hypothyroidism. The symptoms were similar to those of the endocrine system diseases. Fifteen patients improved and discharged after drug withdrawal and symptomatic treatment. The drugs related to adverse reactions included hypoglycemic drugs, hypoglycemic Chinese patent medicine and health products, methimazole, and adefovir. ConclusionThe drugs that cause adverse reactions in this study are commonly used medications in the endocrine ward. The clinicians should closely monitor the signs and symptoms of adverse reactions when using above-mentioned drugs, and should be aware of the methods of diagnosis, differential diagnosis, and management.
• Select
  论著

  Efficacy and safety of combination therapy with saxagliptin and metformin in patients with type 2 diabetes: a meta-analysis

  WANG Ying-zheng;LU Min;ZHOU Ying;CUI Yi-min

  2012, 14(5): 277-5.

  Abstract ( ) PDF ( )

  ObjectiveTo evaluate the efficacy and safety of combination therapy with saxagliptin and metformin in patients with type 2 diabetes. Methods “saxagliptin” and “metformin” were selected as keywords and PubMed and EMbase were searched. All randomized controlled trials (RCTs) of saxagliptin therapy in patients with type 2 diabetes were selected. According to the inclusion criteria, the articles were selected, evaluated, and meta-analyzed with RevMan 5.1 software. The levels of glycosylated haemoglobin (HbA1c) and fasting plasma glucose (FPG), the incidence of hypoglycemia after the treatment with saxagliptin + metformin (the saxagliptin group), placebo + metformin (the placebo control group) and other hypoglycemic drugs + metformin (the positive drug control group) were compared in patients with type 2 diabetes and their results were presented in mean difference (MD) or relative risk (RR) with 95% confidence interval (CI). ResultsA total of 5 RCTs were entered. The results of meta-analysis were as follows: the treatment effect of decrease in HbA1c levels in the saxagliptin group was better than that in the placebo control group ( MD=-0.59, 95%CI:-0.87 to -0.32, P=0.00) and the positive drug control group (MD=-0.36, 95%CI:-0.73 to -054, P=0.00); the treatment effect of decrease in FPG levels in the saxagliptin group was better than that in the placebo control group (MD=-1627，95%CI:-21.64 to -10.91, P=0.00); however, the difference in treatment effect of decrease in FPG levels between the saxagliptin group and the positive drug control group was not statistically significant (MD=-2.75, 95%CI:-22.52 to 17.01, P =0.78); there was no significant difference in the incidence of hypoglycemia between the saxagliptin group and the placebo control group or the positive drug control group (RR=0.55，95%CI:0.15 to 2.09, P=0.38). ConclusionThe combination therapy with saxagliptin and metformin is effective to decrease the HbA1c and FPG levels in patients with type 2 diabetes. It also has a good safety profile.
• Select
  论著

  Preliminary pharmacokinetic and pharmacodynamic studies and safety evaluation of homemade bivalirudin in 10 healthy male subjects

  ANG Ke-xu;LIN Yang;LIU Wen-fang;LI Jing;SUO Wei;WU Wei;QIU Qi;DU Hai-yan;ZHOU Zi-jie;ZHAO Gui-ping;WANG Yun-long;PAN Yu;YAN Xiu-juan;JIA Xiao-xin

  2012, 14(5): 282-4.

  Abstract ( ) PDF ( )

  ObjectiveTo study pharmacokinetic and pharmacodynamic characteristics of homemade bivalirudin in healthy male subjects and evaluate its safety preliminarily in order to provide the scientific basis for a phase Ⅱ/Ⅲ clinical trial and clinical use of the drug. Methods Healthy male subjects were collected and received a single intravenous bolus injection of bivalirudin 0.75 mg/kg. Plasma concentrations of bivalirudin within 180 min after injection were determined by liquid chromatography-tandem mass spectrometric (LC-MS/MS) method for pharmacokinetic analysis. The activated clotting time were measured for pharmacodynamic analysis. At the same time, the vital signs and safety evaluation indexes were observed in all subjects before and after medication. ResultsTen healthy male subjects were entered. Their age, height, weight, and body mass index were (29.5±3.4) years, (1707±5.5) cm, (66±7) kg, and (22.2±1.7) kg/m2, respectively. The pharmacokinetic parameters were as follows: peak concentration (Cmax) (8347±1586) μg/L, peak time (Tmax) 5 min, elimination half-life (T1/2z)(41.6±9.0) min, area under the curve (AUC0-t)1240 (98.4-182.3) min·μg/L, area under the curve (AUC0-∞)(131.9±26.8) min·μg/L，mean retention time (MRT0-t)(25.6±31) min, volume of distribution (Vz) (354.8±103.9) ml/kg, clearance (CL)(5.9±1.1)ml/(min·kg). The pharmacodynamic parameters were as follows: basic effect (E0)(146±17) s，concentration for 50% of maximal effect (EC50)2225 (799-42 008) μg/L，maximal effect (Emax)(4072±294) s. No changes in X-ray, cranial CT, 12-lead ECG and laboratory examination (routine blood and urine tests, blood biochemical tests, immunological tests, 5 tests of coagulation) were observed after the trail. No adverse drug reaction occurred during the trial. ConclusionHomemade bivalirudin seems to have the characteristics of rapid onset of action and shorter half-life and might be used as a safer anticoagulant in patients undergoing percutaneous coronary intervention.
• Select
  论著

  Effects of half hemolytic dose detection on alerting hemolytic reactions caused by saponin-containing traditional Chinese medicine compound injection

  LIU Xia;XIANG Zheng;XIAO Hang;ZHANG Jian-feng;LI De-wei;DOU De-qiang

  2012, 14(5): 285-4.

  Abstract ( ) PDF ( )

  ObjectiveTo explore the effects of half hemolytic degree (HD50) detection on alerting hemolytic reactions caused by saponin-containing traditional Chinese medicine compound injection. Methods The red cell suspension (volume fraction 11%) was prepared with blood taken from the ear edge vein of rabbits and physiological saline solution. The red cell suspension was added into the saponin-containing traditional Chinese medicine compound injection (Shenmai injection or Shengmai injection) with different batch numbers and different concentrations produced by different pharmaceutical factories. The HD50 was detected using spectrophotometry, the concentration-hemolytic degree curve was performed by Sigmaplot 10.0 software and HD50 was calculated. The contents of total phenols and tannins in the two kinds of above-mentioned injections were measured according to the method in Chinese Pharmacopoeia. The correlation between contents of total phenols, tannins and HD50 was analyzed using SPSS 19.0 software. ResultsThe differences in HD50 were significant among six batches of Shenmai injection produced by Hebei Shenwei pharmaceutical factory. Among them, two batches of injection failed to reach the half hemolysis at the highest concentration, and the HD50 of other four batches of injection (0116, 0.147, 0.182 and 0.236 ml/ml ) were lower than those of two batches of injection (0.333, 0.363 ml/ml) produced by Sichuan Shenghe pharmaceutical factory. The Shenmai injections with lower HD50 had higher content of tannins. The hemolytic activity, the contents of total phenols and tannins in Shengmai injection produced by Shanxi Taihang pharmaceutical factory were higher than those in Shengmai injection produced by Sichuan Yibin pharmaceutical factory(the former were 0.066 ml/ml, 1.298 mg/ml and 0.361 mg/ml, the latter were 0.079 ml/ml, 0.221 mg/ml, and 0.029 mg/ml, respectively). HD50 and content of total phenols in Shenmai injection showed a significant negative correlation (r=-0.936, P=0.009). ConclusionHD50 detection could reflect the hemolytic activity of saponin-containing traditional Chinese medicine compound injection and might use in alerting the hemolysis caused by the drugs.

药源性疾病

• Select
  药源性疾病

  Drug-induced microscopic colitis and its prevention and treatment

  WEN Jian-bo;LEI Zhao-bao

  2012, 14(5): 290-4.

  Abstract ( ) PDF ( )

  Clinical manifestations of drug-induced microscopic colitis (DIMC) are mainly chronic (continuous or intermittent) non-bloody watery diarrhea, a normal or almost normal endoscopic examination, and special histopathological characteristics. The drugs which cause DIMC mainly include nonsteroidal anti-inflammatory drugs, proton pump inhibitors, selective serotonin reuptake inhibitors, and others. The mechanism is associated with abnormal immunization. Risk factors for DIMC are middle-aged and elderly people, female, and combination therapy. The measures for treatment and prevention are as follows: the causative drugs should be discontinued; the patients with mild symptoms of DIMC could be treated with loperamide; the patients with severe symptoms of DIMC could be treated with budesonide; if drug treatment is ineffective, patients might undergo surgery; the drugs known to induce DIMC should be used with caution in patients with allergic diathesis, autoimmune disease, and allergic disease.

安全用药

• Select
  安全用药

  Linezolid-induced hematologic toxicity and its prevention

  ZHAO Wen-yan;ZHANG Jian

  2012, 14(5): 294-5.

  Abstract ( ) PDF ( )

  Linezolid is an oxazolidinone antibiotic and has potent antibacterial activity against most Gram-positive bacteria. The most common serious adverse reactions caused by linezolid is hematologic toxicity, such as anemia and thrombocytopenia. The possible mechanism of linezolid-associated hematologic toxicity is bone marrow suppression and immune mediation. The risk factors for linezolid-associated hematologic toxicity include advanced age, long-term treatment, lower baseline blood cell counts, hepatorenal dysfunction and so on. The measures of prevention and treatment are as follows: linezolid should be only used for labeled indications; prolonged use of linezolid should be avoided; a combination of linezolid and drugs that cause bone marrow depression should be avoided; linezolid concentrations should be monitored in patients with advanced age and/or severe hepatorenal failure; routine blood tests should be performed during treatment. If cytopenia occur, linezolid should be discontinued immediately, and blood transfusions should be given in patients with severe symptoms.
• Select
  安全用药

  Progress in studies on prevention and treatment of hypersensitivity induced by oxaliplatin

  HAN Yong-peng

  2012, 14(5): 299-3.

  Abstract ( ) PDF ( )

  Clinical presentations of oxaliplatin-induced anaphylactic reaction are respiratory tract symptoms, skin symptoms and other systemic symptoms. Hypersensitivity induced by oxaliplatin usually occurs after multiple treatment courses. The mechanisms of oxaliplatin-induced anaphylactic reaction may be associated with a high cytokine release. The risk and severity of oxaliplatin-induced anaphylactic reaction can be reduced by using allergy skin test, a slower infusion rate, a conditioning regimen and desensitization therapy.

病例报告

• Select
  病例报告

  Blood ammonia elevation due to concomitant use of valproate sodium and ketogenic diet for treating epilepsy

  PENG Hui;QI Xiao-lian

  2012, 14(5): 302-3.

  Abstract ( ) PDF ( )

  A 3-year-old girl with epilepsy received valproate sodium 180 mg once per 12 hours, but due to poor response, ketogenic diet therapy was added to her regimen. Before giving ketogenic diet therapy, her blood ammonia level was 64 μmol/L. On days 1-3 of ketogenic diet therapy, the ratio of fat and carbohydrate to protein in her diet was gradually increased from 1 ∶ 1 to 3 ∶ 1. On day 4, the ratio was adjusted to 4 ∶ 1 and her blood ammonia level was 63 μmol/L. On day 7 of ketogenic diet therapy, her blood ammonia level rose to 95 μmol/L, and then valproate sodium was changed to 120 mg once per 12 hours orally. On day 10 of ketogenic diet therapy, valproate sodium was decreased to 60 mg once per 12 hours orally and, on day 11, her blood ammonia level was 68 μmol/L. On day 13 of ketogenic diet therapy, she continued to receive valproate sodium at a decreased dosage. During ketogenic diet therapy, her epileptic condition was well controlled.
• Select
  病例报告

  Exfoliative dermatitis caused by risedronate sodium

  HU Xiao-lei;LIU Rui;WANG Yu;HE Ju-ying

  2012, 14(5): 304-2.

  Abstract ( ) PDF ( )

  An 82-year-old woman received risedronate sodium 5 mg once daily for severe osteoporosis. On day 2, she developed diffuse red erythema involving her entire body with pruritus and partial confluent plaques. On day 4, some blisters ruptured along with purulent secretions on her partial skin. Risedronate sodium was stopped immediately, and an IV infusion of dexamethasone and an IV infusion of hydrocortisone sodium succinate were given; levocetirizine hydrochloride and ketotifen fumarate were given by mouth; zinc oxide lotion was given for external application; and at the same time, symptomatic treatments, such as acid suppression, potassium supplement, were given. After 12 days of treatment, the patient’s rash on her entire body gradually subsided.
• Select
  病例报告

  Respiratory failure and death from lorazepam in a patient with uremia receiving citalopram hydrobromide and various other medications

  ZENG Yan;FU Wen-jing;WANG Yu-qin

  2012, 14(5): 306-2.

  Abstract ( ) PDF ( )

  A 65-year-old man with uremia, hypertension, miliary tuberculosis, depression and other diseases received multiple drug therapy. He was given oral citalopram hydrobromide 30 mg at bedtime and oral lorazepam 0.5 mg in the next morning for anxiety. Two hours later, the patient developed mental fatigue, hypopnea, absent breath sounds in bilateral lungs, hyperhidrosis. Blood gas analysis showed the following levels: pH 7.16, PaCO2 80 mm Hg, PaO2 134 mm Hg. The patient was given nikethamide, lobeline, and flumazenil and underwent hemodialysis, hemoperfusion, and assisted mechanical ventilation. He had no improvement in symptoms despite a 3-day resuscitation attempts and died from respiratory and circulatory failure on the fourth day.
• Select
  病例报告

  Leukopenia following piperacillin sodium/tazobactam sodium administration

  HE Zhong-fang;ZHENG Mao-hua;WU Xin-an;XU Ji-guang;LUO Yi-cheng

  2012, 14(5): 308-2.

  Abstract ( ) PDF ( )

  A 46-year-old woman received an IV infusion of piperacillin sodium/tazobactam sodium 4.5g every 8 hours for postoperative intracranial infection . Her WBC count decreased from 10.61×109/L before treatment to 1.79×109/L on day 13 of treatment and 1.00×109/L on day 15 of treatment, respectively. Piperacillin/tazobactam was withdrawn immediately and switched to other antibacterial drugs, and then hypodermic recombinant human granulocyte macrophage colony stimulating factor(rhGM-CSF)150 μg once daily was given. Four days after the treatment changes, her WBC count increased to 6.95×109/L. Six days after the treatment changes, her cerebrospinal fluid WBC count increased from 8×106/L(15 days after the first administration) to 56×106/L, she was readministered an IV infusion of piperacillin /tazobactam 4.5 g every 8 hours and her rhGM-CSF dosage remained unchanged. After a 6-day treatment, her intracranial infection was cured, antibacterial drugs were stopped.On days 2 and 5 of treatment, her WBC count was 2.67×109/L and 1.65×109/L, respectively. On day 8, rhGM-CS was withdrawn and WBC count was 5.75×109/L. On day 15, WBC count was 4.56×109/L.
• Select
  病例报告

  Dysphagia and severe hyponatremia due to flupentixol and melitracen tablets in an elderly patient

  HOU Xiao-ping;ZHOU Yun-fei

  2012, 14(5): 310-3.

  Abstract ( ) PDF ( )

  An 86-year-old man received one flupentixol and melitracen tablet once daily for suspected anxiety disorder. After starting treatment, he gradually developed listlessness, somnolence, weakness, and anorexia. On days 19, he developed nausea. On days 28, his symptoms progressed to dysphagia, inability to stand or walk, slow response. Serum electrolyte test showed the followed levels: potassium 40 mmol/L, sodium 121 mmol/L, chlorine 84 mmol/L. Hyponatremia and hypochloremia were diagnosed. Flupentixol and melitracen tablets decreased to 1/2 tablet once daily. The next day, his mental status and appetite improved remarkably. One week later, flupentixol and melitracen tablets decreased to 1/4 tablet once daily. Two weeks later, flupentixol and melitracen tablets was discontinued. The patient returned to normal. A repeat serum electrolyte test showed a potassium level of 4.3 mmol/L, a sodium level of 135 mmol/L, and a chlorine level of 98 mmol/L.
• Select
  病例报告

  Exfoliative dermatitis attributed to oral moxifloxacin

  YU Xiao-ling

  2012, 14(5): 312-2.

  Abstract ( ) PDF ( )

  A 37-year-old woman with HIV received IV cefoperazone sodium and sulbactam sodium 3.0 g once daily via a pump for pulmonary infection. On day 21, the drug therapy was changed to oral moxifloxacin 400 mg once daily. On day 3 of oral moxifloxacin therapy, the patient developed skin pruritus. On day 7, her face and entire body developed numerous red papules and skin pruritus with red swelling. Drug eruption was suspected. Moxifloxacin was stopped. Anti-allergic drugs such as calcium gluconate, dexamethasone, and loratadine were given. Two days later, she presented with diffuse dark red patch, scaly skin, generalized swelling and difficulty keeping eye open, and edema in her lower extremities. After 8 days, she had exfoliative desquamation on her face and trunk, and her pruritus gradually subsided.
• Select
  病例报告

  Electrolyte abnormalities associated with pituitrin

  XU Zhi-ying;CAO Ying

  2012, 14(5): 314-2.

  Abstract ( ) PDF ( )

  A 19-year-old man with tuberculosis was hospitalized due to massive hemoptysis. On the day of admission, examination of the patient showed blood electrolyte concentrations as follows: potassium 3.5 mmol/L, sodium 137 mmol/L, and chlorine 104 mmol/L. Phentolamine mesilate 20 mg and pituitrin 24 U in 0.9% sodium chloride 50 ml was continuously infused at a rate of 5 ml/h via pump every day. At the same time, he was given anti-TB treatment including isoniazid aminosalicylate, levofloxacin, and amikacin. On day 5 of admission, the patient developed weak and headache. Electrolyte tests showed the following levels: potassium 3.1 mmol/L, sodium 122 mmol/L, chlorine 88 mmol/L, phosphorus 0.65 mmol/L. Pituitrin was reduced to 18 U once every 12 hours. Meanwhile electrolyte supplementation was given and other medications remained unchanged. On day 6, electrolyte tests revealed a potassium level of 2.8 mmol/L, a sodium level of 117 mmol/L, a chlorine level of 83 mmol/L, a phosphorus level of 0.54 mmol/L, and a calcium level of 1.99 mmol/L. Pituitrin was stopped and electrolyte supplementation was given. On day 10 of admission, laboratory tests showed the above-mentioned electrolyte levels returned to normal range as follows: potassium 4.3 mmol/L, sodium 136 mmol/L, chlorine 101 mmol/L，calcium 2.17 mmol/L, and phosphorus 0.82 mmol/L.
• Select
  病例报告

  Acute hemolytic reactions and renal failure related to micafungin

  LI Yan;LIANG Ning-sheng

  2012, 14(5): 316-2.

  Abstract ( ) PDF ( )

  A 71-year-old male patient developed allergic skin reactions following receiving fluconazole for fungal infections of the intestinal fistula and the abdominal cavity after undergoing subtotal gastrectomy for gastric ulcer and pyloric obstructions. So the treatment was switched to an IV infusion of micafungin 50 mg dissolved in 100 ml of 0.9% sodium chloride solution once a day. After receiving the infusion about 65 ml，the patient suddenly presented with gerenalised cyanosis, short of breath, and brownish red urine. Laboratory tests showed the following values: WBC count 52.5×109/L, RBC count 2.7×1012/L, Hb 78 g/L，PLT count 118×109/L, blood urea nitrogen 21.5 mmol/L, creatinine 113 μmol/L, urine occult blood 200 cell/μl, and many red blood cells per field . The infusion was discontinued immediately and he received blood dialysis and other treatments. His conditions gradually improved and, two weeks later, his routine blood and urine tests and renal function basically normalized.
• Select
  病例报告

  Acute renal failure associated with foscarnet sodium

  LI Dan-dan;XIE Qian;WANG Yue;ZHAO Rong-sheng

  2012, 14(5): 317-3.

  Abstract ( ) PDF ( )

  A 75-year-old woman received IV infusion of foscarnet sodium 3 g once daily combined with mecobalamin, vitamin B1, Xinhuang tablets (新癀片), and aciclovir ointment for herpes zoster. On day 4, she developed extremity and facial edema accompanied with nausea, anorexia and skin pruritus. On day 10, above-mentioned drugs were stopped except aciclovir ointment. On day 12, laboratory tests showed the following levels: serum creatinine 142 μmol/L, blood urea nitrogen 8.6 mmol/L, urine specific gravity 1010. Acute renal failure and acute interstitial nephritis was considered. The woman's fluid intake was restricted, and she received a low-salt, low-fat, and a high-protein diet. Five days later, her edema subsided and pruritus disappeared. Laboratory tests showed the following results: serum creatinine 86 μmol/L, blood urea nitrogen 7.4 mmol/L, phosphorus 0.9 mmol/L.
• Select
  病例报告

  Escitalopram oxalate-induced severe liver injury

  HU Yang;WANG Lan;MEI Dan;ZHANG Bo

  2012, 14(5): 319-3.

  Abstract ( ) PDF ( )

  A 16-year-old female patient received escitalopram oxalate 10 mg once daily for anorexia nervosa. More than one month after receiving the drug, she presented to other hospital with amenorrhea. Liver function tests showed the following results: alanine aminotransferase (ALT) 222 U/L, aspartate aminotransferase (AST) 124 U/L, and albumin 45 g/L. Escitalopram oxalate was discontinued. One week later, the drug was readministered and liver-protective treatment was given at the same time. However, her liver function did not improved and she was hospitalized in Peking Union Medical College Hospital. On admission, her liver function tests showed the following results: ALT 3257 U/L, albumin 37 g/L, TBil 37.7 μmol/L, DBil 21.3 μmol/L. Escitalopram oxalate was stopped immediately and liver-protective drugs such as glutathione, S-adenosylmethionine, compound glycyrrhizin, polyene phosphatidyl choline, sodium glutamate, and potassium glutamate were given. Two months later, her liver function returned to normal, and she was discharged.
• Select
  病例报告

  Severe gastrointestinal reactions induced by azathioprine

  CUI Jin;ZHU Chong-gui;ZHU Mei;LIU Wei

  2012, 14(5): 321-2.

  Abstract ( ) PDF ( )

  A 28-year-old woman received an IV injection of methylprednisolone 40 mg once daily for hypophysitis-induced central diabetes insipidus. Two weeks later, her regimen was changed to oral prednisone 10 mg thrice daily and azathioprine 50 mg twice daily. On day 4, the patient developed upper abdominal distension, acid regurgitation and nausea. His symptoms did not improved after symptomatic treatment. Prednisone was discontinued after 1 week. Two weeks later, the patient developed severe upper abdominal pain accompanied by vomiting. Gastroscopy revealed chronic gastritis. Azathioprine was discontinued. The gastrointestinal symptoms markedly improved after 2 days. One week later, the gastrointestinal symptoms disappeared, but her urine volume gradually increased. The patient received oral azathioprine 50 mg again. The same symptoms recurred after 1 hour. His symptoms relieved after symptomatic treatment.
• Select
  病例报告

  Mental disorders attributed to an IV infusion of fluconazole

  LIU Qing;LUO Gang;LEI Zhao-bao

  2012, 14(5): 323-2.

  Abstract ( ) PDF ( )

  An 87 year-old male patient received an IV infusion of fluconazole 0.4g once daily for chronic obstructive pulmonary disease (COPD) and Candida albicans infection. The patient experienced agitation, anxiety, delirium, and trembling of his hands at the night. On day 3, the dose of fluconazole reduced to 0.2 g once daily, and a antipsychotic medication was given. But the patient’s mental symptoms was progressively exacerbated. On the day 5, fluconazole was discontinued, and itraconazole capsules were given orally. The patient’s mental symptoms disappeared. On days 8 and 10, sputum cultures results were negative, and the symptoms of COPD was relieved. The patient’s mental symptoms did not reappear on telephone follow-up at 15 days after discharge.
• Select
  病例报告

  Convulsion due to piperacillin sodium and tazobactam sodium

  GUO Heng;XIN Hua-wen;PANG Yu-tao;FAN Xing

  2012, 14(5): 324-3.

  Abstract ( ) PDF ( )

  A 26-year-old male patient, who had undergone renal transplantation 4 years before and received hemodialysis in the past 5 months, was treated with an IV infusion of piperacillin sodium and tazobactam sodium 4.5 g in 0.9% sodium chloride 100 ml once daily for pulmonary infections. Five hours after the second infusion, the patient suddenly experienced convulsion, unconsciousness, upward deviation of the eyes, and twitching of legs. He was given IM diazepam 10 mg, followed by IV diazepam 7 mg, and then above-mentioned symptoms subsided.

中药不良反应

• Select
  中药不良反应

  Senecio chrysanthemoides-induced hepatic veno-occlusive disease and death

  ZHOU Yan-ping;SUN Li-jian;YU Shan-shan;ZHANG Shi-long;ZHOU Xu

  2012, 14(5): 327-2.

  Abstract ( ) PDF ( )

  A 62-year-old male patient self-medicated with oral senecio chrysanthemoides powder 15 g daily for injury. After half a year, the patient appeared ascites. Senecio chrysanthemoides was stopped. The hepatoprotective treatment was ineffective in the local hospital and he developed severe jaundice and hepatic encephalopathy, and then he was admitted to our hospital. Laboratory examinations showed the followed levels and values: WBC count 13×109/L, total protein 37 g/L, total bilirubin 128.9 μmol/L, direct bilirubin 103.3 μmol/L, alanine aminotransferase 104 U/L, serum creatinine 298 μmol/L, blood urea nitrogen 38.1 mmol/L, uric acid 975 μmol/L, prothrombin time 31.7 seconds, prothrombin activity 26%, C-reactive protein 16 mg/L, creatine kinase 383 U/L. Drug-induced hepatic veno-occlusive disease was diagnosed. Despite treatment with liver-protective drugs, medications used to treat jaundice, anti-infective drugs, diuretics, and nutritional support, patient progressed to multiple organ failure and eventually died.