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28 February 2024, Volume 22 Issue 2
    

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  • Research progress of brivaracetam in the treatment of epilepsy
    LIU Cheng-yu, LIU Dai-hua, LI Jun-ming, ZENG Kun, QIN Yu
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 1-5. https://doi.org/10.3969/j.issn.1672-3384.2024.02.001
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    Pharmacotherapy is the mainstay treatment of epilepsy； however， the significant adverse reactions and poor tolerance associated with traditional antiepileptic drugs limit their clinical application. Brivaracetam， as the third-generation new antiepileptic drug， is mainly indicated for adjunctive therapy and monotherapy for patients with focal epilepsy， and presents a potential option for the treatment of generalized epilepsy and status epilepticus. Compared to the traditional antiepileptic drugs， brivaracetam offers higher safety and tolerability. This article reviews the mechanism of action， pharmacokinetic characteristics， efficacy and safety of brivaracetam， aiming to provide more effective choices for the treatment of epilepsy.
  • Research progress of mitomycin C combined with internal urethrotomy in the treatment of urethral stricture
    WANG Cheng, QIN Qi-qi
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 6-8. https://doi.org/10.3969/j.issn.1672-3384.2024.02.002
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    Direct vision urethral incision is currently one of the main methods for treating urethral stricture. Due to postoperative scar formation， the recurrence rate of stricture is high， and most patients need to repeat multiple surgeries. Mitomycin C can reduce granulation tissue and scar formation by inhibiting fibroblast proliferation. Studies have found mitomycin combined with internal urethrotomy for urethral stricture can greatly reduce the recurrence rate of treating urethral stricture. This article summarizes the medication， safety， efficacy， and limitations of internal urethrotomy combined with mitomycin C through a systematic literature review， to provide reference for clinical practice.
    • Comment of New Drug
  • A novel long-acting glucagon-like peptide-1 receptor agonist for the treatment of diabetes mellitus type 2: ecnoglutide
    WANG Yue, FENG Dong-mei, LIU Yang, LIU Dan
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 9-13. https://doi.org/10.3969/j.issn.1672-3384.2024.02.003
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    Glucagon-like peptide-1 （GLP-1） is a class of hormone that plays a role in stimulating insulin secretion and lowering blood glucose. Ecnoglutide （research code： XW003） is a novel long-acting GLP-1 receptor agonist. The phase Ⅰ and Ⅱ clinical trials have been completed， showing that ecnoglutide has a good safety and efficacy profile in treating type Ⅱ diabetes and obesity. Furthermore， the administration of the first subject has been completed in phase Ⅲ for the treatment of diabetes mellitus type 2. This article provides an overview of the ecnoglutide's basic information， mechanism of action， preclinical research， and clinical trials.
  • A novel drug for postpartum depression:zuranolone
    WANG Yu-ran, SUN Xue-lin, ZHENG Li
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 14-17. https://doi.org/10.3969/j.issn.1672-3384.2024.02.004
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    Zuranolone is a neuroactive steroid that acts as a positive allosteric modulator of gamma-aminobutyric acid （GABA）-A receptors. Zuranolone was approved by the FDA as the first oral medication globally for the treatment of postpartum depression on August 4， 2023. It reduced depression symptoms more significantly than placebo in women with severe postpartum depression. Zuranolone causes somnolence， dizziness， and sedation， therefore must be monitored throughout the therapy. This review summarizes the mechanism of action， pharmacokinetics， and clinical studies of zuranolone.
    • Original Article
  • Efficacy of sivelestat sodium in acute respiratory distress syndrome in adults: a systematic review and meta-analysis
    WANG Zhi-zhou, HUA Yi-ming, DONG Xian-zhe, JIANG Dan, SONG Zai-wei, WANG Ke, XING Xiao-xuan, ZHAO Rong-sheng, ZHANG Lan
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 18-25. https://doi.org/10.3969/j.issn.1672-3384.2024.02.005
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    Objective To systematically evaluate the clinical efficacy of sivelestat sodium in the treatment of adult patients with acute respiratory distress syndrome （ARDS）. Methods A comprehensive search of PubMed， Embase， the Cochrane Library， CNKI， SinoMed， and Wanfang Databases were conducted to gather RCTs and cohort studies of sivelestat sodium in the treatment of adult ARDS from the inception of the databases to May 31， 2023. Data were extracted from the literature that met the inclusion and exclusion criteria. The risk of bias in RCTs （RoB 2.0） and risk of bias in non-randomized studies of intervention （ROBINS-I） were employed to assess the quality of the studies. RevMan 5.4 and Stata 17.0 software were utilized for meta-analysis. Results A total of 16 studies involving 9202 patients were included， including 7 RCTs and 9 cohort studies. Meta-analysis revealed that sivelestat sodium had no impact on 28-day or 30-days mortality of ARDS patients in RCTs study （RR=0.95， 95%CI： 0.74 to 1.21， P=0.68）， but in the cohort study， sivelestat sodium treatment could decrease the 28~30 d mortality of ARDS patients （RR=0.86， 95%CI： 0.81 to 0.92， P<0.0001）. Sivelestat sodium treatment could significantly enhance the oxygenation index in ARDS patients （in RCTs study， MD=33.08， 95%CI： 15.43 to 50.74， P<0.000 01； in cohort study， MD=39.74， 95%CI： 29.81 to 49.68， P<0.000 01）. Sivelestat sodium treatment could abbreviate the duration of mechanical ventilation in patients with mild to moderate ARDS （MD=-2.48， 95%CI： -2.91 to -2.05， P<0.000 01）. Egger's test showed that there was no publication bias in the included studies （P<0.05）. Conclusion Sivelestat sodium can improve oxygenation index and shorten the duration of mechanical ventilation in patients with mild-to-moderate ARDS. The effect of sivelestat sodium on 28-day or 30-day mortality needs further study to verify.
  • Comparative analysis of efficacy and safety of different dosage forms of paliperidone palmitate in the treatment of schizophrenia
    JIA Fei, ZANG Yan-nan, BAO Shuang, NIU Meng-xi, LIU Shan-shan, ZHUANG Hong-yan, ZHENG Nan
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 26-30. https://doi.org/10.3969/j.issn.1672-3384.2024.02.006
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    Objective To compare the difference in efficacy and safety between paliperidone palmitate 1-month （PP1M） and paliperidone palmitate 3-month （PP3M）. Methods A systematic review of the literature on the efficacy and safety of PP1M and PP3M in relevant Chinese and English databases from CNKI， Wanfang Data， PubMed， Embase， the Cochrane Library and so on， from the inception of the database until November， 2023. Results A total of 10 literatures were further screened to meet the exclusion criteria. The subjects of the included literature were all adult schizophrenia patients with a study period ranging from 7 months to 24 months. The results showed that PP1M and PP3M improved the symptoms of patients with schizophrenia to a similar extent. PP3M was more effective than PP1M in reducing the rate of hospitalization for psychiatric disorders and the risk of relapse. The risk of extrapyramidal symptoms （EPS） and weight gain was lower with PP3M than with PP1M， and there was no significant difference in other safety indexes between the two groups. Conclusion The efficacy and safety of PP1M and PP3M were comparable， and the medication compliance of PP3M was better.
  • Comprehensive clinical evaluation of semaglutide injection for the treatment of diabetes mellitus type 2 in adults
    HE Lan-zhi, ZHOU Peng-xiang, QIN Yong-jie, LIN Chun-yan, OU Yan-ting, HE Ying, LI Gui-de, ZHOU Gan-ping
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 31-36. https://doi.org/10.3969/j.issn.1672-3384.2024.02.007
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    Objective Comprehensive clinical evaluation of semaglutide injection was conducted to provide a reference for clinical decision-making and rational use of this drug. Methods A systematic literature review and questionnaire surveys were used， to perform a qualitative and quantitative analysis of the efficacy， safety， economy， innovation， suitability， and accessibility of the drugs. Results In terms of efficacy and safety， semaglutide significantly reduces glycated hemoglobin A1c（HbA1c） levels， fasting blood glucose， and body weight， while also improving the achievement rate of HbA1c targets. The overall safety of semaglutide injection was good， with a low risk of hypoglycemia， although the risk of gastrointestinal adverse reactions was higher or similar to other antidiabetic drugs. In terms of economy， semaglutide injection demonstrates greater economic advantages compared to dulaglutide and loxenatide. With good clinical innovation， semaglutide injection was recommended by clinical guidelines both domestically and internationally. In terms of dosing convenience and compliance， it exhibits good suitability for use. Semaglutide injection exhibits good affordability， but the number of bid-winning areas and the rate of medical institution distribution were relatively low， leading to shortages. Conclusion Semaglutide injection demonstrates good efficacy， safety， economy， innovation， suitability， and affordability. However， its availability needs to be further improved.
  • Effects of different administration methods of octreotide on intestinal mucosal permeability and hemorheology in patients with acute pancreatitis
    ZHAO Jin-hua, LIU Yao-gang, CAO Ya, TU Cheng-zhi, CHENG Xiang-chao
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 37-40. https://doi.org/10.3969/j.issn.1672-3384.2024.02.008
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    Objective To explore the effects of different administration methods of octreotide on intestinal mucosal permeability and hemorheology in patients with acute pancreatitis. Methods Patients with acute pancreatitis in the Henan Province Third People's Hospital from February 2021 to October 2022 were selected as the study objects and were randomly divided into the control group and the observation group， both receiving octreotide treatment. The control group received a routine intravenous drip， while the observation group received an intravenous micropump. The efficacy and the adverse reactions between the two groups and compared the changes in intestinal mucosal functional indicators，hemorheological indicators， and inflammatory factors，between the two groups before and after treatment were observed. Results A total of 106 patients were included， with 53 in each group. After treatment， the levels of diamine oxidase （DAO）， D-lactate， lactulose/mannitol（L/M） ratio ［（4.56±0.78）U/mL， （5.04±0.46）mg/L，0.24±0.04］ ， hemorheology indexes such as whole blood viscosity （high shear） value， platelet adhesion rate， the ratio of viscosity and hematocrit ［（4.96±0.32）map/s， 36.73%±3.54%， 1.75%±0.14%，40.35%±3.47%］， C-reactive protein（CRP）， IL-17， and IL-6［（52.62±3.72）mg/L， （6.56±0.57）ng/L， （5.06±0.45）ng/L］ in the observation group were lower than those in the control group［（7.04±0.86） U/mL， （6.23±0.57）mg/L，0.51±0.06］， ［（5.67±0.45）map/s， 52.96%±3.62%， 1.97%±0.12%， 44.24%±3.52%］，［（68.34±3.94）mg/L， （8.25±0.78）ng/L， （7.74±0.63）ng/L］， and the differences were statistically significant （P<0.05）. Conclusion Micro intravenous infusion of octreotide in the treatment of acute pancreatitis can effectively improve intestinal mucosal function， and reduce inflammatory factor expression levels.
  • Effect of sodium tanshinone ⅡA sulfonate combined with aspirin on cardiac function in patients with angina pectoris of coronary heart disease
    MA Xiao-min, LIU Zi-shuang, DU Ge, ZHANG Xin-feng, CHEN Shan-shan, YANG Kai
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 41-45. https://doi.org/10.3969/j.issn.1672-3384.2024.02.009
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    Objective To investigate the clinical effect of sodium tanshinone ⅡA sulfonate combined with aspirin on patients with angina pectoris of coronary heart disease and its influence on cardiac function. Methods Patients with angina pectoris from Beijing Rehabilitation Hospital Affiliated to Capital Medical University from June 2021 to June 2023 were selected and divided into group A and group B by random number table method. Group A was treated with tanshinone ⅡA sulfonate combined with aspirin， and group B was treated with aspirin monotherapy. Both groups were treated for 2 weeks. The clinical efficacy of the two groups was compared， and the changes in angina pectoris attack， myocardial enzyme level and hemorheology indexes before and after treatment were observed， and safety analysis was conducted. Results A total of 120 patients were included， 60 patients in group A and 60 patients in group B. After 2 weeks of treatment， the total clinical response rate of group A was higher than that of group B， and the frequency， duration， and the levels of creatine kinase， creatine kinase isoenzyme， lactate dehydrogenase， alpha-hydroxybutyrate dehydrogenase， fibrinogen， plasma viscosity and whole blood viscosity of angina pectoris were lower than those of group B with statistical significance （P<0.05）. There was no significant difference in the total incidence of adverse reactions between the two groups （P>0.05）. Conclusion Sodium tanshinone ⅡA sulfonate combined with aspirin has a good effect and safety in patients with coronary heart disease and angina pectoris， which can alleviate clinical symptoms， improve cardiac function and hemorheology.
  • Biologics for treatment of moderately to severely ulcerative colitis: a network meta-analysis on the effectiveness and safety of maintenance therapy
    CAI Gai-qiang, LIANG Yao-wen, LI Jian-rong, WEN Yong-ping, CHEN Ping-juan
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 46-54. https://doi.org/10.3969/j.issn.1672-3384.2024.02.010
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    Objective To employ a network meta-analysis comparing the effectiveness and safety of different biologic agents in patients with moderately to severely ulcerative colitis during the maintenance therapy period. Methods RCTs were searched in CNKI， Wanfang Data， VIP， China Biology Medicine disc， PubMed， the Cochrane Library， and Embase databases from their inception to July， 2023. Relevant studies on biologics for the treatment of ulcerative colitis were collected. A network meta-analysis was performed using RevMan 5.3 and Stata 16.0 software after screening the literature according to the inclusion and exclusion criteria， evaluating the quality of the studies and extracting data. Results A total of 1374 articles were retrieved from various databases and 17 articles were included with 18 RCTs and totaled sample size of 5939 cases. There was a total of 10 intervention methods， including 7 medications. They were as follows： placebo， infliximab intravenous injection， adalimumab subcutaneous injection， vedolizumab intravenous injection， vedolizumab subcutaneous injection， golimumab subcutaneous injection， ustekinumab subcutaneous injection once every 8 weeks， ustekinumab subcutaneous injection once every 12 weeks， etrolizumab subcutaneous injection， mirikizumab subcutaneous injection. The meta results showed that different medication regimens had different performances in terms of efficacy indicators. Considering endoscopic mucosal healing and overall adverse events， it was found that vedolizumab subcutaneous injection not only provided good mucosal healing efficacy but also had the least incidence of adverse events followed by vedolizumab intravenous injection and mirikizumab subcutaneous injection. Conclusion There are three main pathways of biologics for the treatment of ulcerative colitis， of which the integrin antagonist vedolizumab excels in efficacy and safety and is available in both subcutaneous and intravenous dosage forms for clinical selection. The interleukin inhibitor mirikizumab can be used as a second choice.
  • Rapid health technology evaluation of entecavir for the treatment of chronic hepatitis B
    KONG Ying, XIAO Jin-na, HU Zhi, HE Li-biao, LIU Li-li, WAN Lu, HU Jin-fang, ZHOU Ying
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 55-62. https://doi.org/10.3969/j.issn.1672-3384.2024.02.011
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    Objective To evaluate the effectiveness， safety， and economics of entecavir in the treatment of chronic hepatitis B. Methods The Cochrane Library， Science Direct， PubMed， Embase， SinoMed， CNKI， Wanfang Data， VIP databases， and health technology assessment websites were searched by computer. The literature on entecavir for the treatment of chronic HBV infection was collected and analyzed from the inception of the database until August， 2023. Two researchers evaluated the quality according to the corresponding criteria and conducted a comprehensive analysis of the obtained results. Results A total amount of 33 literature entries were included in this study， including 1 HTA report， 25 systematic reviews/meta-analyses， and 7 pharmacoeconomic studies. In terms of effectiveness， the HBV-DNA negative conversion rate and ALT normalization rate of entecavir were better than those of adefovir， and entecavir had an excellent effect on preventing HBV reactivation. In terms of safety， the adverse reactions of entecavir were generally mild， and the overall incidence were low， there existed no significant difference compared with other drugs such as lamivudine and adefovir. In terms of pharmacoeconomics， compared with patients without antiviral drug treatment， oral entecavir had a better cost performance， and entecavir monotherapy had more economic advantages compared with combination with other therapeutic drugs. Conclusion For chronic hepatitis B treatment， entecavir can achieve excellent outcomes with a low safety risk and decent cost-effectiveness.
  • Data mining of adverse drug event signals for tenofovir alafenamide based on the FDA adverse event reporting system database
    WANG Meng, LIU Hui, WANG Shuo, ZHAN Han-qiu
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 63-68. https://doi.org/10.3969/j.issn.1672-3384.2024.02.012
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    Objective To analyze the adverse drug event signals of tenofovir alafenamide， to provide a reference for the rational and safe clinical use of tenofovir alafenamide. Methods The OpenVigil 2.1 data platform was used to retrieve the FDA adverse event reporting system （FAERS） database. The reporting odds ratio （ROR） method was used to analyze all the adverse events reported as primarily suspected to be related to tenofovir alafenamide from January 1， 2017 to September 30， 2022. For all the selected adverse events， the characteristics of the population， the number of reports， the distribution of positive signals， and signal strength were analyzed. Results A total of 9025 cases of tenofovir alafenamide-related adverse events were identified， including 6203 males， 2271 females， and 551 unspecified. The largest age groups were 45 to 64 and 18 to 44 years. The United States had the highest number of reports， with Japan being the only country in the top five. Among the severe outcomes， hospitalization accounted for the largest proportion， with 410 suspected deaths due to tenofovir alafenamide. A total of 196 positive signals were detected mapping to 21 system/organ classifications， mainly involving various examinations， gastrointestinal system， psychiatric disorders， various surgical and medical procedures， systemic diseases and reactions of drug delivery sites， skin and subcutaneous tissues， infections and infestations， renal and urinary system diseases， etc. Positive signals of adverse events not included in the package insert included various examinations （CD4 lymphocyte decrease/abnormal/increase）， endocrine system （diffuse goiter）， nervous system （Guillain-Barre syndrome）， pregnancy， perinatal period， puerperal period （placenta previa， fetal death） diseases， etc. Conclusion In addition to the adverse events listed in the manual， clinicians should be vigilant about the impact of tenofovir alafenamide on various examinations， the endocrine system， and the nervous system to ensure its safe use in clinical practice.
  • Analysis of factors influencing the efficacy of methylprednisolone in the treatment of henoch-sch?nlein purpura and construction of Nomogram prediction model
    JIAO Liang, XIANG Hao-yu, FENG Huan
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 69-74. https://doi.org/10.3969/j.issn.1672-3384.2024.02.013
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    Objective To investigate the factors influencing the efficacy of methylprednisolone in the treatment of henoch-sch?nlein purpura （HSP） and to construct a Nomogram prediction model. Methods The data of children with severe HSP admitted to Suining Central Hospital from May 2021 to April 2023 were retrospectively selected and divided into the group with good efficacy and the group with poor efficacy according to the efficacy of methylprednisolone in treating HSP. Clinical data of the children were collected， and the optimal cut-off values of each factor were obtained through the analysis of subjects' work characteristics （ROC） curves. A logistic multiple regression model was used to analyze the risk factors affecting the efficacy of methylprednisolone in treating HSP. A Nomogram prediction model was constructed， and the internal validation and prediction efficacy were evaluated by the calibration curve and the decision curve respectively. Results A total of 227 patients with severe HSP were included in this study， including 176 patients in the group with good efficacy and 51 patients in the group with poor efficacy. The age of the group with good efficacy， the inducing factors of infection ratio， previous HSP history ratio， HSP family history ratio， neutrophil to lymphocyte ratio （NLR）， platelet to lymphocyte ratio （PLR）， and systemic immunoinflammatory index （SII） were all higher than those of the group with good efficacy. Dietary intervention ratio and IgG level were lower than those of the group with good efficacy with statistically significant differences （P<0.05）. ROC results showed that the optimal cut-off values of age， IgG， NLR， PLR， and SII were 7 years old， 9.34 g/L， 3.58， 215.45， and 726.75， respectively. Logistic multivariate regression showed that age， previous HSP history， family history of HSP， NLR， PLR， and SII were the risk factors affecting the therapeutic effect of methylprednone on HSP， and dietary intervention was the protective factor （P<0.05）. Internal verification results showed that the C-index of the Nomogram model was 0.925 （0.881 to 0.970）， and the actual and predicted values were basically consistent. The Nomogram model threshold was greater than 0.08， indicating that the model provided significant clinical net benefits. Conclusion The Nomogram prediction model constructed based on age， previous history of HSP， family history of HSP， NLR， PLR， and SII has good predictive value for the efficacy of methylprednisolone in the treatment of HSP， which may provide a basis for improving the efficacy of HSP.
  • A survey of application status of macrolides in the treatment of chronic rhinosinusitis
    SONG Zhi-hui, HUANG Zhen-xiao, XU Shan-shan, LI Yi-man, ZHOU Bing
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 75-79. https://doi.org/10.3969/j.issn.1672-3384.2024.02.014
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    Objective To understand the current status of macrolides used in the treatment of chronic rhinosinusitis （CRS）， and to provide a basis for the rationality and safety of macrolides for CRS. Methods A questionnaire survey was conducted among Chinese otolaryngologists to assess attitudes， prescribing habits， and safety concerns about prescribing macrolides to patients with CRS. Results A total of 478 questionnaires were returned， with a validity rate of 100.0%. Most of the respondents believed that they would prescribe macrolides to patients with CRS when necessary， and "Sometimes"， "often" and "infrequently" prescribed macrolides 38.7%， 31.0%， and 20.1%， respectively. Clarithromycin dominated， and was followed by roxithromycin， they were usually given in regular dosage， and about 97.7% of the otolaryngologists opted for a shorter course of treatment （less than 3 months）， with a greater tendency to prefer 2 to 4 weeks and 1 to 2 weeks. 42.7%， 17.8%， 45.8%， and 37.4% of the respondents had never undergone blood routine tests， IgE level tests， allergen， and drug sensitivity tests before prescribing macrolides， respectively. 41.4% of the respondents had never paid attention to the interactions of macrolides with other drugs； for special populations， 1.5%， 4.2%， and 47.9% of respondents prescribed macrolides for chronic CRS patients during pregnancy， lactation， and children. Conclusion Most otolaryngologists follow relevant domestic and international guidelines to use macrolides， but there are still gaps in the applicable population， dosage， and course of treatment. At the same time， more attention should be paid to the combination of drugs to reduce the risk of serious adverse events.
  • A retrospective analysis of the effectiveness and safety of amphotericin B in the treatment of acquired immune deficiency syndrome with deep fungal infection
    SUN Na, LIU Hui, ZHAN Han-qiu
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 80-83. https://doi.org/10.3969/j.issn.1672-3384.2024.02.015
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    Objective To retrospectively analyze the effectiveness and safety of amphotericin B in AIDS patients with deep fungal infection. Methods A retrospective review was conducted on the medical records of AIDS patients treated with amphotericin B for deep fungal infections at Beijing Ditan Hospital， Capital Medical University， from January 1， 2019， to May 31， 2023. The effectiveness and safety indicators during the treatment period were monitored and analyzed. Results A total of 25 patients were included. The overall effectiveness rate was 84.0% and the symptom improvement rate was 68.0%； 22 cases experienced adverse reactions， and 12 cases experienced serious adverse reactions. The most common types of adverse reactions were hypokalemia， bone marrow suppression， renal impairment， and liver function abnormality. Conclusion Amphotericin B demonstrates great clinical efficacy in treating deep fungal infections in AIDS patients. However， due to its high rate of adverse reactions， close monitoring is required during clinical use.
    • Case Research
  • Pharmaceutical care of a chronic renal insufficiency patient with severe multisystem damage caused by medication error with low-dose methotrexate
    YE Jia-dan, ZHANG Chun-yan, HUANG Jing, REN Xiao-lei, ZHANG Xiao-hong
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 84-86. https://doi.org/10.3969/j.issn.1672-3384.2024.02.016
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    This article reports a case of a 61-year-old female patient with a previous diagnosis of sarcoidosis and chronic renal disease who developed severe oral ulcers， severe rash， acute kidney injury， and severe myelosuppression after mistakenly taking methotrexate at 2.5 mg once daily. After hospitalization， the clinical pharmacist assisted the physician develop an individualized dosing regimen and provided pharmaceutical care， which included discontinuing methotrexate， administering folic acid for detoxification， alkalinizing the urine to promote methotrexate excretion， and symptomatic treatment for each adverse reaction. The patient improved and was discharged from the hospital.
  • Isavuconazole in the treatment of pulmonary mucormycosis in children undergoing hematopoietic stem cell transplantation: a case report
    CUI Ying, ZHONG Xu-li, LIU Bi-qing, ZHANG Yi-zhi, GUO Mao-wen, LIN Ai-hua, ZHANG Jian-min
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 87-89. https://doi.org/10.3969/j.issn.1672-3384.2024.02.017
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    This paper reports a case of clinical practice of using isavuconazole to treat pulmonary mucormycosis in a child with acute lymphocytic leukemia during the perioperative period of hematopoietic stem cell transplantation. Clinical pharmacists participated in consultations and suggested the use of isavuconazole to treat pulmonary mucormycosis based on the patient's condition， determined the medication dosage for children， and monitored safety and effectiveness during treatment. After treatment， the pulmonary lesions in the child improved. As a new drug， there was limited experience of isavuconazole in children's use. Clinical pharmacists have consulted literature， formulated medication plans， and implemented pharmaceutical monitoring to ensure the rational and safe use of medication in children.
  • Pharmaceutical care for a case of pulmonary mucormycosis with myelodysplastic syndrome
    LIANG Liang, WANG Ting, FENG Ru, JIN Peng-fei
    CLINICAL MEDICATION JOURNAL. 2024, 22(2): 90-92. https://doi.org/10.3969/j.issn.1672-3384.2024.02.018
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    Treatment course of mucormycosis would last for a long time and there may be a lot of ADRs and drug interactions. Pharmaceutical care is helpful in promoting rational clinical drug use and ensuring the medication safety of patients. Clinical pharmacists gave pharmaceutical care to a pulmonary mucormycosis patient with myelodysplastic syndrome （MDS）. The advice was suggested to prevent from drug interactions and adverse effects. The most suitable regimen was selected through individualized drug therapy. Moreover， drug interactions were avoided through individualized drug therapy.
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