Adverse Drug Reactions Journal

Objective To understand the current status of medication errors(ME) report in Beijing area and improve the ME monitor and report system.Methods ME cases which were reported by pharmacy departments of 22 hospitals in Beijing in 2012 were collected and analyzed.Analysis projects included category,classification,and triggering factor of ME and the number and proportion of persons who triggered or detected ME.Category A is potential error.Category B,C,and D are mild ME which did not harm patients.Category E,F,G,H,and I are severe ME which cause harm to patients even death.Results One thousand one hundred and sixty-five cases of ME were totally reported by 22 hospitals in Beijing.Proportion of ME of category A,B,C,D,E,and F were respectively 5.9%(69 cases),71.9%(837 cases),19.3%(225 cases),2.2%(26 cases),0.5%(6 cases),and0.2%(2 cases).ME of category G,H,and I have not been reported.In 1165 reports of ME,1220 errors of classification were noted.Therein,the error of kinds of medications was the highest proportion which reached 27.2%(332 errors).The errors of administration route,dosage,and time respectively accounted for 12.0%(147 errors),14.3%(175 errors),and 7.1%(86 errors).The content of unreasonable drug use was contained in the errors of kinds of medications,administration route and time.In 1165 reports of ME,1183 triggering factors were noted.The top three factors were sound alike,prescribing errors,and look alike,whose proportions were 19.1%(226 errors),14.0%(166 errors),and 8.3%(98 errors),respectively.In terms of the persons that triggered ME,the proportions of doctors,pharmacists,nurses,and patients or families were respectively 66.0%,30.6%,1.1%,and 2.3%.In terms of the persons who detected ME,doctors,pharmacists,nurses,and patients or family members respectively accounted for1.4%,88.8%,4.6%,and S.2%.Conclusions The report system of ME in Beijing had tended to be mature gradually.The operation model could be used for reference for national systems of ME monitor and report.

LI Xiao-lin

Yaowu buliang fanying zazhi

Analysis of 1165 cases of medication errors in 22 hospitals in Beijing

北京市22家医院1165例用药错误分析

Objective To explore the correlation between UDP-glucuronosyltransferases 1 family polypeptide A(UGT1A) gene polymorphism and the adverse reactions induced by antineoplastic agent irinotecan,in order to provide a reference of individual therapy for patients with tumor.Methods The subjects were 233 healthy volunteers and 196 patients with tumor received irinotecan.The healthy volunteers comprised 169 male and 64 female with mean age of(25±5) years.Of the 196 patients with tumor,92 had carcinoma of rectum,45 had cervical carcinoma,and 59 had epithelial ovarian cancer.They comprised 54 male and 142 female with a mean age of(61±19) years.The gene polymorphism of UGT1 A1*6,UGT1A1 *28,UGT1 A3*1,UGT1A3*2,UGT1A3*3,UGT1A3*4,and UGT1A9*22 were detected by pyrosequencing.The genotypic mutation frequency of UGT1A in subjects between the 2 groups were compared.The incidences of delayed diarrhea and neutropenia in patients with different UGT1A genotypes were compared.The risk factors of adverse reactions due to irinotecan were analyzed by Logistic regression analysis.The results were represented by odds ratio(OR) and 95%confidence interval(CI).Results The UGT1 A3*2 genotypic mutation frequency in the patients with tumor was significantly lower than that in the healthy volunteers(50.3%vs.68.5%,P=0.014),and the UGT1A3*3 genotypic mutation frequency in the patients with tumor was significantly higher than that in the healthy volunteers(26.0%vs.6.2%, P=0.001).The incidences of level Ⅱ-Ⅳ and Ⅲ-Ⅳ delayed diarrhea,and the neutropenia were 48.5%(95 cases),11.2%(22 cases),and 49.0%(96 cases) in 196 patients with tumor,respectively.The incidences of level Ⅱ-Ⅳ and Ⅲ-Ⅳ delayed diarrhea in UGT1A1*28 wild type(WW) carriers were significantly lower than those in the mutant heterozygote(WM) + homozygous mutant(MM) genotype carriers[Ⅱ-Ⅳ:40.4%(57/141) vs.69.1%(38/55),P=0.006;Ⅲ-Ⅳ:5.7%(8/141) vs.25.5%(14/55),P=0.001].The incidences of level Ⅱ-Ⅳ delayed diarrhea in UGT1A9*22(WW) carriers were significantly lower than those in the WM and MM carriers[26.2%(17/65) as.47.6%(40/84),P= 0.006;26.2%(17/65) vs.51.1%(24/47)P=0.0057].There were no statistical differences in incidences of level Ⅲ-Ⅳ neutropenia among the patients with different genotypes.Logistic regression analysis showed that UGT1A genotype was related to the delayed diarrhea(OR=5.657,95%CI:4.782-7.245,P=0.039). Conclusion UGT1A1*28 and UGT1A9*22 gene polymorphism may Increase the risk of delayed diarrhea induced by irinotecan.

Song Li-xu

Correlation between UDP-glucuronosyltransferase 1 gene polymorphism and the adverse reactions due to irinotecan

UDP-葡萄糖醛酸基转移酶1基因多态性与伊立替康不良反应的相关性

Objective To evaluate anesthetic effect and safety of lumbar anesthesia combined with intravenous dexmedetomidine(DMT) in elderly patients.Methods The elderly patients(aged 65 to 75 years) undergoing prostate electrocision through urethra from January 2012 to May 2013 in Logistics College Hospital of Chinese People's Armed Police Forces were enrolled into this study and were divided into DMT group and control group using a random number table.The patients in the two groups received bupivacaine(5.0 mg/ml) 2.0 ml for lumbar anesthesia.The patients in the DMT group received a slow intravenous bolus of DMT(0.5 μg/kg) before anesthesia and pumped DMT continuously at a rate of 0.5 μg/(kg ? h) until the end of operation.The patients in the control group received the same volume of 0.9%sodium chloride solution for injection at the same rate.The anesthetic effects(maximal sensory block plane and regression time,sedation score),adverse reactions and the residence time in post anesthesia care uint were compared between the two groups.Results A total of 86 patients were enrolled into this study.DMT group comprised 43 cases with the average age of(69±5) years and the control group comprised 43 cases with the average age of(71±6) years.There were no significant differences in the systolic pressure, diastolic pressure,heart rate,pulse oxygen saturation(SpO_2) and maximal sensory block plane of patients during the operation between the two groups.The differences of regression time of maximal sensory block plane,sedation score during operation,incidence of hypotension,incidence of bradycardia,and the residence time in post anesthesia care unit between DMT group and the control group were(223±38) min vs.(155±26) min,(4.2±1.9) vs.(2.1±1.3),20.9%(9 cases) vs.2.3%(1 case),44.2%(19 cases) vs.4.7%(2 cases),and(245±43)min vs.(195±38) min,respectively.The differences were statistically significant(all P0.05).The difference in incidence of excessive sedation between DMT group and the control group[9.3%(4 cases) vs.0]was not statistically significant,the incidence of low pulse oxygen saturation[14.0%(6 cases) vs 0]was statistically significant(P0.05).The patients who developed hypotension,bradycardia and low pulse oxygen saturation received ephedrine,atropine and oxygen,respectively.The patients' above-mentioned symptoms were improved after the treatment. Conclusions Lumbar anesthesia combined with intravenously DMT may enhance the effects of analgesia and sedation,and is relatively safe for elderly patients.The clinician should pay attention to the adverse reactions such as hypotension,bradycardia and low pulse oxygen saturation.The monitoring of adverse reactions should be intensified.Once adverse[reactions develop,the symptomatic treatment should be given.

Chu Jin

Anaesthetic effect and safety of lumbar anesthesia combined with intravenous dexmedetomidine in elderly patients

老年患者腰麻联合静脉输注右美托咪定的麻醉效果及安全性

A 56-year-old man with acute myocardial infarction underwent coronary arteriongraphy and percutaneous coronary intervention(PCI)after receiving regular treatment with oral aspirin and clopidogrel for 2 months.His platelet count was 185×10~9/L before PCI.Unfractionated heparin was given during the operation and an continuousⅣinfusion of tirofiban[0.1μg/(kg·min)]was given for 36 hours via a micropump after PCI.About 12 hours after starting tirofiban,the patient presented with sporadic ecchymoses on both upper extremities and the platelet count decreased to 5×10~9/L.Tirofiban,aspirin,and clopidogrel were withdrawn immediately and dexamethasone was given.On day 4 after PCI,clopidogrel was given again.On day 5 after PCI,aspirin was resumed.On day 6 after PCI,his ecchymoses disappeared and the platelet count returned to normal level.The patient's severe thrombocytopenia was considered to be induced by tirofiban.

Liu Xiao-qi

Tirofiban-induced severe thrombocytopenia

替罗非班诱导的重度血小板减少症

Objective To evaluate the efficiency of the three molecular marker techniques for identification of plant genus in order to select the most suitable molecular technique to rapidly identify a poisonous plant at the scene of the poisoning accident.Methods Nineteen samples of leaves in 18 species of common poisonous plants of Ranunculaceae and Euphorbiaceaec were selected.Genomic DNA of these samples were extracted using improved hexadecyltrimethylammonium bromide(CTAB) method,species identification(genus level) were performed using random amplified polymorphic DNA(RAPD),intersimple sequences repeats(ISSR) and DNA barcoding,cluster analysis were performed using NYSTS,SPSS, PAUP,and MEGA software.Accuracy,reliability,timeliness,and operability were compared between the 3 molecular marker techniques.Results Accuracy:genus level of samples failed to be identified using RAPD;and the accuracy rates in genus level of identification using ISSR and DNA barcoding were 68%and 100%,respectively.Reliability:the subjective influence rates and the repetitive rates in RAPD and ISSR were 47%and 26%as well as 47%and 45%,respectively;the success rates of amplification and sequencing of trnH-psbA fragment using DNA barcoding both were 100%.Timeliness:the time from extraction of DNA to accomplishment of identification in the 3 molecular marker techniques were 8.5,9.0, and 42.2 h,respectively.Operability:species identification using RAPD and ISSR could be done in a common laboratory;special sequencing equipment was needed when using DNA barcoding technique in the identification of poisonous plants.Conclusion The preliminary study results show that DNA barcoding is a molecular identification technique more suitable for rapid determination of the poisonous plant at the scene of the sudden poisoning accident.

Long Xin

Evaluation of efficiency of three molecular marker techniques for identifying poisonous plants

三种分子标记技术识别有毒植物效率的评估

The coronavirus disease 2019 (COVID-19) epidemic is facing the most critical situation As of January 11, 2021, there have been nearly 90 million confirmed cases worldwide and nearly 2 million deaths The local epidemic situation in China is sporadic and locally clustered, and the situation of epidemic prevention is difficult and complicated In this situation, there are many problems in medication safety of patients, such as safety issues in off-label medication and compassionate medication of COVID-19 treatment, safety problems in the combination use of drugs for COVID-19 and drugs for other diseases, monitoring of adverse drug reactions in COVID-19 treatment, the safety issues in self-purchased drugs for prevention and treatment of COVID-19, and the medication safety in patients with other diseases during the epidemic Therefore, it is necessary to pay more attention to the medication safety of patients to fight the epidemic scientifically and to win a greater victory in the fight against the COVID-19 epidemic at a smaller price © 2021 Chinese Medical Association

Publication Information	Publisher: Chinese Medical Journals Publishing House Co.Ltd，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2020，Proportion of original research papers: 0.00%，Self Citation Rate:N.A.， Gold OA Rate: 0.00%

Adverse Drug Reactions Journal

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Analysis of 1165 cases of medication errors in 22 hospitals in Beijing

Correlation between UDP-glucuronosyltransferase 1 gene polymorphism and the adverse reactions due to irinotecan

Anaesthetic effect and safety of lumbar anesthesia combined with intravenous dexmedetomidine in elderly patients

Tirofiban-induced severe thrombocytopenia

Evaluation of efficiency of three molecular marker techniques for identifying poisonous plants

Pay attention to the medication safety of patients during the period of coronavirus disease 2019 epidemic prevention

Pay attention to the medication safety of patients during the period of coronavirus disease 2019 epidemic prevention

Pay attention to the medication safety of patients during the period of coronavirus disease 2019 epidemic prevention

Pay attention to the medication safety of patients during the period of coronavirus disease 2019 epidemic prevention

Pay attention to the medication safety of patients during the period of coronavirus disease 2019 epidemic prevention

ISSN	1008-5734
h-index	4