Drug Interactions Involving Antifungal Drugs: Time Course and Clinical Significance

The antifungal armamentarium has expanded greatly over the past two decades. This expansion, along with the pharmacologically complex therapeutic regimens used in treating many patients with systemic fungal disease, enhances the risk of clinically significant drug–drug interactions. This review examines the drug–drug interaction potential of antifungal agents by pharmacologic class and attempts to provide perspective on the time course and clinical significance of these events.     

Comparison of Adrenergic Beta-blocking Drugs in Angina Pectoris

The symptomatic, electrocardiographic, and haemodynamic effects of two adrenergic beta-blocking drugs, oxprenolol and propranolol, have been compared in equipotent intravenous doses in six patients with uncomplicated angina pectoris during treadmill exercise. The method of comparison included double-blind assessment and analysis with placebo control and randomized serial comparison in each patient. Both drugs produced an equal amelioration in symptoms in most of the patients. This was closely correlated with improvement in the electrocardiographic changes and a significant reduction in the exercising heart rate and systemic arterial pressure. This method of double-blind combined subjective and objective assessment carries distinct advantages in the comparative assessment of drug treatments in angina pectoris.     

Hemorrhage During Long-Term Anticoagulant Drug Therapy—Part IV: Selection and Management of Patients

Most serious hemorrhages that occur during long-term anticoagulant drug therapy are due either to poor patient selection or to poor management of the patient, or both.In each patient being considered for treatment, the risk of bleeding must be evaluated and classified as high, moderate or low.The clinician must especially assess the risk of intracranial hemorrhage in hypertensive patients, and must screen all patients for potential sources of gastrointestinal bleeding. There is ample time for such investigations, since initiating long-term anticoagulant therapy is not an emergency procedure.The desired level of prothrombin activity must be adjusted to the risks determined for each individual patient. There is no single “therapeutic range” applicable to all patients with their varying hemorrhagenic risks.Proper management includes sufficient laboratory testing to maintain the desired prothrombin level, and continued vigilance to detect signs of early bleeding.Preventable hemorrhage cannot be cited as evidence against the value of anticoagulant drug therapy.     

Long-term Anticoagulant Therapy after Myocardial Infarction in Women

A multicentre trial from five medical departments in Oslo has been carried out to determine the value in women patients of one year''s long-term anticoagulant therapy. Follow-up long-term laboratory control and anticoagulant dosage were performed at one centre (the Rikshospitalet). One hundred and fifty-nine patients were assigned randomly into two similar well-matched groups (control and treatment). Dosage was controlled by Thrombotest, aiming at 10–20% levels, and 50% of the tests were less than 14%. Compared with the control group, the treatment group showed a significant reduction in mortality and in reinfarction rate. No serious bleeding complications occurred. It is concluded that women benefit as much as men from long-term anticoagulant therapy.     

Growth Inhibition of Crithidia fasciculata by Serotoninergic and Adrenergic Drugs

SYNOPSIS. Growth of Crithidia fasciculata , a trypanosomatid flagellate known to contain epinephrine and serotonin, is sensitively inhibited by several adrenergically and serotoninergically reactive drugs such as dichloroisoproterenol, desipramine, and cyproheptidine. The pattern of sensitivity of Crithidia to these drugs is contrasted to the pattern of sensitivity of the ciliate Tetrahymena pyriformis.     

Prevalent Drug Resistance Among Oral Yeasts from Asymptomatic Patients in Hainan,China

The oral cavity is a significant niche of the human microbiome and a gateway for the microbiota in many other human body sites. As a result, understanding the oral microbiota has broad implications for the prevention and management of human infectious diseases. Opportunistic yeast infections are among the most prevalent fungal infections of humans, and most opportunistic yeast pathogens are common residents of the oral mucosa. However, relatively little is known about the drug susceptibility profiles of oral yeasts. Here, we report the species distribution and patterns of antifungal susceptibility profiles among 313 yeasts isolated from the oral cavities of 301 asymptomatic hospitalized patients in Hainan Province in southern China. These yeasts were tested for their susceptibilities to the following five drugs: amphotericin B, fluconazole, itraconazole, ketoconazole, and fluorocytosine. Since none of the sampled hosts had taken any antifungal drugs at least 3 months before samples were taken, we hypothesized that little or no drug resistance should be observed. Contrary to our expectations, our analyses identified that 29 % (91/313) of the isolates were resistant to at least one drug and 14.3 % (45/313) were resistant to two or more of the five common drugs. The potential sources of the observed resistance were discussed.     

Chemogenomic Approaches for Revealing Drug Target Interactions in Drug Discovery

The drug discovery process has been a crucial and cost-intensive process. This cost is not only monetary but also involves risks, time, and labour that are incurred while introducing a drug in the market. In order to reduce this cost and the risks associated with the drugs that may result in severe side effects, the in silico methods have gained popularity in recent years. These methods have had a significant impact on not only drug discovery but also the related areas such as drug repositioning, drug-target interaction prediction, drug side effect prediction, personalised medicine, etc. Amongst these research areas predicting interactions between drugs and targets forms the basis for drug discovery. The availability of big data in the form of bioinformatics, genetic databases, along with computational methods, have further supported data-driven decision-making. The results obtained through these methods may be further validated using in vitro or in vivo experiments. This validation step can further justify the predictions resulting from in silico approaches, further increasing the accuracy of the overall result in subsequent stages. A variety of approaches are used in predicting drug-target interactions, including ligand-based, molecular docking based and chemogenomic-based approaches. This paper discusses the chemogenomic methods, considering drug target interaction as a classification problem on whether or not an interaction between a particular drug and target would serve as a basis for understanding drug discovery/drug repositioning. We present the advantages and disadvantages associated with their application.     

Bayesian Hierarchical Pattern Mixture Models for Comparative Effectiveness of Drugs and Drug Classes Using Healthcare Data: A Case Study Involving Antihypertensive Medications

Comparative effectiveness research aims, in part, to provide evidence most relevant to clinical decision making. One decision relevant to hypertensive patients is which therapeutic drug class is the most safe and effective. In addition, once a drug class has been chosen it would be useful to know whether there are differences in effectiveness between drugs within class. Randomized trials are unlikely to provide sufficient evidence for answering these questions. We therefore propose a modeling approach that can be used to address the questions using administrative databases. We propose a Bayesian hierarchical model, where drugs are nested within their corresponding class. We account for the type of missing data that are common in these databases using a pattern mixture model. The methodology is illustrated using data from a comparative effectiveness study of antihypertensive medications.     

抗癌药物奥沙利铂与DNA分子相互作用的研究

奥沙利铂被称为第三代铂类药物,特别对胃肠道肿瘤具有较好的疗效.目前大多数的研究表明奥沙利铂的主要作用靶点是DNA分子,但它与DNA分子形成的关键结构和作用机制仍处在探索阶段.本研究运用紫外可见吸收光谱和原子力显微镜观察探索奥沙利铂与DNA在活体外的相互作用过程,从而揭示奥沙利铂产生抗癌作用的主要分子结构基础.首先使用紫外光谱研究了较高浓度奥沙利铂与DNA的作用过程.在此基础上,进一步采用原子力显微镜在高定向热解石墨表面观察了不同浓度奥沙利铂与质粒DNA在37℃条件下作用不同时间后的结构形貌变化,分析了奥沙利铂与DNA相互作用的过程.高分辨原子力显微观察结果表明奥沙利铂与DNA作用后可导致质粒DNA的结构发生显著的变化.随着作用时间的增加,DNA分子逐渐由伸展的链状变化为相互缠绕并带有许多结点的紧密结构,最终变化为更紧密的球状结构.本研究结果表明奥沙利铂可通过化学键合作用和静电作用使质粒DNA逐渐凝集为紧密的球状结构,这种结构可能对奥沙利铂的抗癌活性和毒性产生重要影响.     

常用抗癫痫药对癫痫患者血同型半胱氨酸的影响

目的:观察常用抗癫痫药对癫痫患者血同型半胱氨酸、叶酸、维生素B12浓度的影响。方法:比较45例服用单药治疗的癫痫患者(服用卡马西平11例,服用拉莫三嗪12例,服用奥卡西平9例,服用丙戊酸13例)血同型半胱氨酸、叶酸、维生素B12浓度的差异。结果:癫痫患者血同型半胱氨酸均高于正常,而叶酸和维生素B12均在正常范围内;服用拉莫三嗪的患者其血中同型半胱氨酸低于服用丙戊酸、卡马西平和奥卡西平的患者;服用卡马西平的患者血中叶酸高于服用拉莫三嗪、丙戊酸的患者(P<0.05);维生素B12在各用药组间无统计学差异。结论:长期服用抗癫痫药物可引起血中同型半胱氨酸的升高,而高同型半胱氨酸血症可增加心脑血管疾病的危险,故癫痫患者应常规给予补充叶酸、维生素B12,以使血同型半胱氨酸水平恢复正常。     

蛋白质药物口服的研究进展

蛋白质药物口服给药系统因其给药方便、顺应性好,逐渐成为一种最有前景的给药方式.从提高蛋白质药物生物利用度入手,综述采用结构修饰、吸收促进剂、酶抑制剂、结肠定位释药、脉冲式药物给药系统和受体介导靶向载体系统等方式,均可大大提高蛋白质药物的口服生物利用度和在胃肠道中的稳定性.     

Liver Hamartomas in Patients on Oral Contraceptives

Three cases are reported of tumour-like lesions of the liver in women who had been on oral contraceptives for long periods. These malformations have a prominent vascular component and may present with haemoperitoneum and shock. The possibility of an association between liver hamartomas and oral contraceptive therapy has to be considered.     

Finding Candidate Drugs for Hepatitis C Based on Chemical-Chemical and Chemical-Protein Interactions

Hepatitis C virus (HCV) is an infectious virus that can cause serious illnesses. Only a few drugs have been reported to effectively treat hepatitis C. To have greater diversity in drug choice and better treatment options, it is necessary to develop more drugs to treat the infection. However, it is time-consuming and expensive to discover candidate drugs using experimental methods, and computational methods may complement experimental approaches as a preliminary filtering process. This type of approach was proposed by using known chemical-chemical interactions to extract interactive compounds with three known drug compounds of HCV, and the probabilities of these drug compounds being able to treat hepatitis C were calculated using chemical-protein interactions between the interactive compounds and HCV target genes. Moreover, the randomization test and expectation-maximization (EM) algorithm were both employed to exclude false discoveries. Analysis of the selected compounds, including acyclovir and ganciclovir, indicated that some of these compounds had potential to treat the HCV. Hopefully, this proposed method could provide new insights into the discovery of candidate drugs for the treatment of HCV and other diseases.     

Dopamine-Beta-Hydroxylase: An Index of Adrenergic Function in Hypertensive Patients

Previous attempts to assess sympathetic nervous system activity in patients with hypertension have used a variety of physiologic, pharmacologic and biochemical techniques. Results have been conflicting and confusing. Recently, the activity in plasma of the catecholamine synthesizing enzyme, dopamine-beta-hydroxylase (DBH), has been proposed as an index of sympathetic nervous system activity. Studies of apparently healthy subjects show that high values (greater than 60 units per liter) for plasma DBH activity correlate with pronounced daily lability of blood pressure and frequent readings greater than 130/85 mm of mercury. Studies of patients referred for evaluation of established hypertension show significantly higher values for plasma DBH activity in patients with primary hypertension than in those with commonly recognized forms of secondary hypertension—that is, renovascular, renal parenchymal and adrenocortical. Therefore, the measurement of plasma DBH activity may be helpful in the study and differential diagnosis of hypertensive diseases. Measurement of DBH in plasma is inexpensive, reproducible and relatively easy to do.     

基于一致性评价导向的国家基本药物口服制剂信息集萃

初步整理了国家基本药物口服制剂信息,包括药物疾病分类、中英文通用名、剂型、规格、国产批文数量、原研公司、原研商品名、 原研剂型、原研规格、BCS分类等,旨在为仿制药一致性评价工作提供借鉴。