发药不止于发出药

对患者不易掌握的用药情况进行详细的说明有些药品、制剂说明书或者并发签上,只说明了每天服用的克数和次数,对于每次所服用的具体片数并未作出详细的说明,造成患者没有办法准确地掌握制剂的用量;有些药品或制剂的用量还与患者的体重、年龄等有关。鉴于此,药剂人员在发药时,应将简单的计算方式介绍给患者,由于病情不同,当剂量和说明书所注明的内容存在一定的差距时,应解释清楚。在用药中,药物给药途径不同,其吸收以及所产生的效应也会存在一定的差异,如健胃药通常于饭后服用、利福平应在空腹的状态下服用等。

雾化吸入不同剂量辛伐他汀对哮喘模型小鼠气道炎症的影响

他汀类药物对哮喘模型小鼠气道炎症的多效性目前尚不明确,其抗炎活性机制与本类药物降低胆固醇作用不同。口服高剂量辛伐他汀(simvastatin,Sim)可见毒副反应,若设计成雾化吸入剂,其毒性反应则明显减轻。本研究分为:空白对照组(NS-vehicle)、模型组[ovalbumim(OVA)-vehicle]、Sim治疗组和地塞米松(dexamethasone,DXM)阳性对照组。假设Sim经雾化吸入给予具有生物学意义的抗炎活性。BALB/c雌性小鼠以卵白蛋白(ovalbumim,OVA)致敏、攻击制作哮喘模型,分别运用Sim雾化吸入(5 mg·m L^(-1),ih,15 min)、腹腔注射(40 mg·kg^(-1),ip)和灌胃(40 mg·kg^(-1),ig)等途径干预。结果表明,不同途径给予Sim均可显著降低哮喘模型小鼠肺泡灌洗液(alveolar lavage fluid,BALF)中白细胞总数(P<0.01)和嗜酸性粒细胞数(eosinophils number,EOS)(P<0.05);Sim不同剂量(1、5和20 mg·mL^(-1),ih)预处理均可不同程度减少BALF白细胞总数、EOS数(P<0.01或P<0.05)。随着剂量增加,抑制炎症细胞作用增强,Sim(5和20 mg·mL^(-1),h)作用强度与DXM相近;不同剂量Sim(5和20 mg·mL^(-1),ih)预处理可降低小鼠肺组织白细胞介素-4(interleukin-4,IL-4)和白细胞介素-5(interleukin-5,IL-5)mRNA表达(P<0.01或P<0.05),小鼠BALF中IL-4和IL-5水平显著减弱(P<0.01);Sim(1 mg·mL^(-1))预处理组小鼠BALF的IL-4水平略有下降但差异无显著性,IL-5水平下降幅度低于Sim(5和20 mg·m L^(-1))组。上述结果表明雾化吸入不同剂量Sim均可抑制气道炎症反应,为他汀类药物在哮喘等炎症性疾病中的应用提供实验依据。

Influence of intranasal medication on the structure of the nasal mucosa

OBJECTIVE: To study the influence of intranasal medication on the structure, pathology and reversibility of the nasal mucosa to provide a basis for the feasibility of intranasal route of drug administration. METHODS: Nasal drops of gentamicin were placed in the nasal cavity of rabbits for 3, 5, 7, 14 and 28 days. After that, the drops were stopped and drugs protecting the nasomucosa were used for one and three weeks. After being sacrificed over time, the nasomucosa of the rabbit was observed under optical and electron microscopes. RESULTS: Damage to the nasal mucosa appeared to different extents with prolonged use of nasal drops. Within 3 - 7 days of applying the drug, damages to the nasal mucosa gradually appeared, and after two and four weeks, were most serious. After stopping the drug, the nasal mucosa was gradually restored. CONCLUSION: Damages of drugs to the nasal mucosa could be restored. The intranasal route of drug administration would be feasible and clinically applicable.