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1例重症肺炎合并感染性心内膜炎患者的药学监护 被引量:3
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作者 向道春 程刚英 +4 位作者 赖永继 周庆 刘珏 王奕 邓艾平 《中国药物应用与监测》 CAS 2019年第4期219-222,共4页
1例23岁男性患者,因“发热咯血4 d”入院,诊断为感染性心内膜炎性赘生物,二尖瓣脱垂伴关闭不全,行二尖机械瓣置换术,术后给予维持心率、抗凝、抗感染等对症支持治疗。抗凝治疗期间患者INR升高至3.04,感染控制不佳,一度出现谵妄等精神症... 1例23岁男性患者,因“发热咯血4 d”入院,诊断为感染性心内膜炎性赘生物,二尖瓣脱垂伴关闭不全,行二尖机械瓣置换术,术后给予维持心率、抗凝、抗感染等对症支持治疗。抗凝治疗期间患者INR升高至3.04,感染控制不佳,一度出现谵妄等精神症状。临床药师查阅相关文献,发现胺碘酮、伏立康唑均通过抑制CYP2C9对华法林的代谢产生影响,遂结合患者病情,建议下调华法林剂量;考虑亚胺培南导致精神异常的可能性大,建议换用美罗培南;术后8 d感染仍未控制,建议监测万古霉素血药浓度并结合患者病理生理状态调整其剂量。经过一系列药物调整,患者恢复良好出院。 展开更多
关键词 感染性心内膜炎 抗凝 抗感染 药学监护
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临床药师参与1例脑梗死后出血转化患者的药学监护 被引量:1
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作者 向道春 周庆 +2 位作者 刘珏 王奕 邓艾平 《中国药物应用与监测》 CAS 2019年第5期271-274,共4页
1例67岁男性患者,因1h前突发言语含糊、口角歪斜入院,入院后给予阿替普酶50mg溶栓治疗,发生症状性出血转化,在住院期间并发肺部感染。临床药师从血压控制、溶栓、抗血小板药物调整、活血类中药注射剂及抗菌药物使用等方面提供合理化建... 1例67岁男性患者,因1h前突发言语含糊、口角歪斜入院,入院后给予阿替普酶50mg溶栓治疗,发生症状性出血转化,在住院期间并发肺部感染。临床药师从血压控制、溶栓、抗血小板药物调整、活血类中药注射剂及抗菌药物使用等方面提供合理化建议。患者梗死急性期血压维持在125~130/70mmHg,临床药师建议降低甘露醇用量以增加脑部血液供应;中药注射剂与抗血小板联用出血风险增加,临床药师遂建议停用血栓通和丁苯酞;同时,建议将出血风险较大的头孢哌酮舒巴坦换用为头孢他啶(2g,q12h)行抗感染治疗。经过积极治疗干预,患者出血停止,感染得到有效控制,神志清楚,肌力较前明显恢复。 展开更多
关键词 脑梗死 出血转化 肺部感染 药学监护
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Baicalin protects against 17α-ethinylestradiol-induced cholestasis via Sirt1/HNF-1α/FXR pathway
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作者 YANG Jin-yu xiang dao-chun +8 位作者 xiang Dong HE Wen-xi LIU Ya-nan LAN Lu-lu LI Guo-dong JIANG Chen REN Xiu-hua LIU Dong ZHANG Cheng-liang 《中国药理学与毒理学杂志》 CAS 北大核心 2021年第10期738-738,共1页
OECTIVE Baicalin is a major flavonoid component of Scutellaria baicalensis,and has been used in the treatment of liver diseases for many years.However,the role of baicalin in estrogen-induced cholestasis(EIC)remains t... OECTIVE Baicalin is a major flavonoid component of Scutellaria baicalensis,and has been used in the treatment of liver diseases for many years.However,the role of baicalin in estrogen-induced cholestasis(EIC)remains to be elucidated.This present study explored the protective effect of baicalin against estrogen-induced liver injury and further elucidated the mechanisms involved both in vivo and in vitro.METHODS We conducted a series of experiments using 17α-ethinylestradiol(EE)induced cholestatic rats and cultured HepG2 cells.Serum,bile,and liver samples were collected for biochemical and histological analyses.Bile acid composition in liver was analyzed by LC-MS/MS.The mechanisms underlying the hepatoprotective of baicalin were investigated by RT-PCR,Western blotting analyses and immunohistochemistry.RESULTS Baicalin showed obvious hepatoprotective effects in EIC rats by reducing serum biomarkers and increasing the bile flow rate,as well as by alleviating liver histology and restoring the abnormal composition of hepatic bile acids(BAs).In addition,baicalin protected against EE induced liver injury by up-regulation of the expression of hepatic efflux transporters and down-regulation of hepatic uptake transporters.Furthermore,baicalin increased the expression of hepatic BA synthase(CYP27A1)and metabolic enzymes(Bal,Baat and Sult2a1)in EIC rats.We showed that baicalin significantly inhibited hepatic inflammatory responses in EIC rats through reducing elevated levels of TNF-α,IL^(-1)β,IL-6 and NF-κB.Finally,we confirmed that baicalin maintains BA homeostasis and alleviates inflammation through Sirt1/HNF-1α/FXR signaling pathway.CONCLUSION Baicalin protects against estrogen-induced cholestatic liver injury,and the underlying mechanism involved is related to activation of the Sirt1/HNF-1α/FXR signaling pathway. 展开更多
关键词 baiclain CHOLESTASIS 17α-ethinylestradiol SIRT1 HNF-1α FXR
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