Application of network composite module analysis and verification to explore the bidirectional immunomodulatory effect of Zukamu granules on Th1 / Th2 cytokines in lung injury.

ETHNOPHARMACOLOGICAL RELEVANCE: Zukamu granules (ZKMG), as the preferred drug for the treatment of colds in Uygur medical theory, has been used for 1500 years. It is also widely used in China and included in the National Essential Drugs List (2018 edition). It has unique anti-inflammatory, antitussive and analgesic effects. AIM OF THE STUDY: Aiming at the research of traditional Chinese medicine (TCM) with the characteristics of overall regulation of body diseases and the immune regulation mechanism with the concept of integrity, this paper put forward the integrated application of network composite module analysis and animal experiment verification to study the immune regulation mechanism of TCM. MATERIALS AND METHODS: The active components and targets of ZKMG were predicted, and network module analysis was performed to explore their potential immunomodulatory mechanisms. Then acute lung injury (ALI) mice and idiopathic pulmonary fibrosis (IPF) rats were used as pathological models to observe the effects of ZKMG on the pathological conditions of infected ALI and IPF rats, determine the contents of Th1, Th2 characteristic cytokines and immunoglobulins, and study the intervention of GATA3/STAT6 signal pathway. RESULTS: The results of network composite module analysis showed that ZKMG contained 173 pharmacodynamic components and 249 potential targets, and four key modules were obtained. The immunomodulatory effects of ZKMG were related to T cell receptor signaling pathway. The validation results of bioeffects that ZKMG could carry out bidirectional immune regulation on Th1/Th2 cytokines in the stage of ALI and IPF, so as to play the role of regulating immune homeostasis and organ protection. CONCLUSIONS: The network composite module analysis and verification method is an exploration to study the immune regulation mechanism of TCM by combining the network module prediction analysis with animal experiments, which provides a reference for subsequent research.

Trends analysis for drug utilization in county public hospitals: a sample study of the pilot area of health care reform in China.

BACKGROUND: Changes in the national drug policy always have impact on the drug utilization. In the context of China health care reform, what changes had happened in the trend of drug utilization in public hospitals? Has this change met the expectations of policy design? This study was conducted to explore the trend of medicine consumption in county public hospitals before and after health care reform, and to provide real-world evidence to help assess the effectiveness of national drug policy. METHODS: A cross-sectional study was performed to investigate the drug utilization trends of 6 county public hospitals in Anhui Province, which is the first pilot area of China health care reform. Data were collected before and after the implementation of the China National Essential Medicine Policy (NEMP) to analyse the drug utilization indicators, such as the drug utilization constituent ratio, the rate of essential medicine usage and the rate of antibiotic consumption. RESULTS: Chemicals are used most frequently and account for 60%~ 70%, followed by oral agents of proprietary Chinese medicine. The results also show increased consumption of Chinese medicine injections (χ2 = 28.428, P < 0.01). The top 3 chemical medicines consumed were anti-infective drugs (12.92%), cardiovascular system drugs (11.61%), and digestive system drugs (8.42%). For Chinese traditional medicine, the top 3 drugs consumed were internal medicine drugs (66.03%), surgical drugs (8.45%), and gynaecological drugs (7.70%). The total sales amounts of drugs covered by medical insurance are at a high level (all above 80%), whereas essential medicines are less than 50% at almost all county-level medical institutions. CONCLUSIONS: This study uncovered the changing tendency of medicine usage under the implementation of the reform. Chinese medicine injections and anti-infective drugs have always been a sustained concern of pharmacovigilance. It is noteworthy that although essential medicines are advocated for as a priority for use in the government-run hospital, the consumption proportion of these medicines is lower than expected.

La política nacional de medicamentos en el contexto de América Latina / The National Drugs Policy in the context of Latin America

Introducción: Una Política Nacional de Medicamentos es un recurso formal que permite ordenar, priorizar, planificar, controlar y evaluar; los aspectos más relevantes del ciclo de los medicamentos en un país. Objetivo: Revisar documentación concerniente al tema de Política Nacional de Medicamentos en América Latina. Fuente de datos: Documentos disponibles en la web referidos con el tópico. Síntesis de los datos: Una política surge a partir de un proceso consultivo complejo con la pretensión de lograr beneficios para la población a partir de la toma de decisiones basadas en la evidencia científica, lo que impone que los diversos aspectos relacionados con la gestión de la política deben estar actualizados, para responder a las necesidades y los cambios que experimenta una sociedad. En América Latina algunos países disponen de una política nacional de medicamentos; sin embargo, otros solo disponen de listas de medicamentos esenciales. Conclusiones: Existen en América Latina, experiencias positivas en la construcción de las Políticas Nacionales de Medicamentos y oportunidades de mejora en varios países. A pesar de los avances logrados en la construcción e implementación de esas políticas, todavía hay personas sin acceso a medicamentos en algunas regiones y se requiere incluir aspectos relacionados con la medicina tradicional, herbolarios, fitofármacos y biotecnológicos; también se deben mejora la promoción científica y los estudios poscomercialización de los medicamentos. En el caso particular de Costa Rica, se tiene una larga tradición de utilización de una política de medicamentos esenciales en la Seguridad Social, pero se carece de la consecuente política nacional(AU)

Introduction: A National Drugs Policy is a formal resource that allows ordering, prioritizing, planning, controlling and evaluating the most relevant aspects of the medicines cycle in a country. Objective: To review documentation concerning the topic of National Drugs Policy in Latin America. Data sources: Documents available on the web referring to the topic. Data synthesis: A policy arises from a complex consultative process with the aim of achieving benefits for the population from the decision making based on scientific evidence, which requires that the various aspects related to the management of the policy should be updated to respond to the needs and changes that a society experiences. In Latin America, some countries have a national drugs policy; however, others only have lists of essential medicines. Conclusions: There are positive experiences in Latin America in the construction of National Drugs Policies and opportunities for improvement in several countries. Despite the progress made in the construction and implementation of these policies, there are still people without access to medicines in some regions and it is necessary to include aspects related to traditional medicine, herbalists, phytopharmaceuticals and biotechnology. Scientific promotion and post-marketing studies of medicines should also be improved. In the particular case of Costa Rica, there is a long tradition of using an essential medicines policy in Social Security, but they lack of the consequent national policy(AU)

La política nacional de medicamentos en el contexto de América Latina / The National Drugs Policy in the context of Latin America

Introducción: Una Política Nacional de Medicamentos es un recurso formal que permite ordenar, priorizar, planificar, controlar y evaluar; los aspectos más relevantes del ciclo de los medicamentos en un país. Objetivo: Revisar documentación concerniente al tema de Política Nacional de Medicamentos en América Latina. Fuente de datos: Documentos disponibles en la web referidos con el tópico. Síntesis de los datos: Una política surge a partir de un proceso consultivo complejo con la pretensión de lograr beneficios para la población a partir de la toma de decisiones basadas en la evidencia científica, lo que impone que los diversos aspectos relacionados con la gestión de la política deben estar actualizados, para responder a las necesidades y los cambios que experimenta una sociedad. En América Latina algunos países disponen de una política nacional de medicamentos; sin embargo, otros solo disponen de listas de medicamentos esenciales. Conclusiones: Existen en América Latina, experiencias positivas en la construcción de las Políticas Nacionales de Medicamentos y oportunidades de mejora en varios países. A pesar de los avances logrados en la construcción e implementación de esas políticas, todavía hay personas sin acceso a medicamentos en algunas regiones y se requiere incluir aspectos relacionados con la medicina tradicional, herbolarios, fitofármacos y biotecnológicos; también se deben mejora la promoción científica y los estudios poscomercialización de los medicamentos. En el caso particular de Costa Rica, se tiene una larga tradición de utilización de una política de medicamentos esenciales en la Seguridad Social, pero se carece de la consecuente política nacional(AU)

Introduction: A National Drugs Policy is a formal resource that allows ordering, prioritizing, planning, controlling and evaluating the most relevant aspects of the medicines cycle in a country. Objective: To review documentation concerning the topic of National Drugs Policy in Latin America. Data sources: Documents available on the web referring to the topic. Data synthesis: A policy arises from a complex consultative process with the aim of achieving benefits for the population from the decision making based on scientific evidence, which requires that the various aspects related to the management of the policy should be updated to respond to the needs and changes that a society experiences. In Latin America, some countries have a national drugs policy; however, others only have lists of essential medicines. Conclusions: There are positive experiences in Latin America in the construction of National Drugs Policies and opportunities for improvement in several countries. Despite the progress made in the construction and implementation of these policies, there are still people without access to medicines in some regions and it is necessary to include aspects related to traditional medicine, herbalists, phytopharmaceuticals and biotechnology. Scientific promotion and post-marketing studies of medicines should also be improved. In the particular case of Costa Rica, there is a long tradition of using an essential medicines policy in Social Security, but they lack of the consequent national policy(AU)

Principles for constructing a tuberculosis treatment regimen: the role and definition of core and companion drugs.

Current World Health Organization guidelines for the formulation of treatment regimens for multidrug-resistant tuberculosis (MDR-TB) pay too little attention to the microbiological activity of anti-tuberculosis drugs. Here, we draw lessons from the pioneering work done on shorter MDR-TB treatment regimens and the current knowledge of the bactericidal and sterilizing properties of the drugs to inform the composition of treatment regimens for MDR-TB. We propose to reserve the term 'core drug' for the one drug in a regimen that contributes most to relapse-free cure. The core drug has both moderate to high bactericidal and sterilizing activity, is given throughout treatment, is well tolerated, and has no cross-resistance with the core drug used in the previous regimen. Currently used core drugs include rifampicin in the first-line 6-month regimen, and fourth-generation fluoroquinolones and bedaquiline in regimens for drug-resistant TB. All other drugs are 'companion drugs', used to avert treatment failure due to acquired drug resistance against the core drug. Some also help further reduce the risk of relapse. Moreover, toxic drugs should be avoided if there is an alternative. A regimen must always include the core drug, plus at least one companion drug with high bactericidal activity, a second bactericidal companion drug, plus two sterilizing companion drugs.

Los aceites esenciales como agentes antiparasitarios / Essential oils as anti-parasitic agents

La aparición de parásitos resistentes a la terapia, incluyendo protozoos de géneros como Leishmania, Trypanossoma, Giardia y Plasmodium, y/o la falta de eficacia, los efectos secundarios graves y el alto costo de la terapia, hace urgente desarrollar nuevos agentes antiparasitarios. En los últimos años se ha potenciado la búsqueda de nuevos medicamentos alternativos para el tratamiento de las infecciones por parásitos, habiendo aumentado el descubrimiento de potenciales agentes terapéuticos a partir de fuentes naturales como las plantas medicinales y sus extractos, incluyendo los aceites esenciales. Aceites esenciales, tales como los de Cymbopogon citratus, Croton cajucara, Ocimum gratissimum o Thymus vulgaris, han demostrado su actividad antiparasitaria, con un amplio espectro de actividad, a menudo demostrando eficacia equivalente a la quimioterapia establecida (AU)

The emergence of parasites resistant to therapy, namely protozoa of genera Leishmania, Trypanossoma, Giardia, Plasmodium, and/or the lack of efficacy, the occurrence of serious side effects and the high cost of therapy, makes urgent the development of new anti-parasitic agents. In the last years, the search for new alternative drugs for the treatment of parasitic infections have been developed. The discovery of potential therapeutic agents from natural sources such as medicinal plants and their extracts, including essential oils, has increased. Essential oils from Cymbopogon citratus, Croton cajucara, Ocimum gratissimum and Thymus vulgaris, showed anti-parasitic activity with a broad spectrum of activities and often demonstrating equivalent effectiveness to established chemotherapy (AU)

A emergência de parasitas resistentes à terapêutica instituída, designadamente protozoários de géneros como a Leishmania, Trypanossoma, Giardia, Plasmodium, e/ou a falta de eficácia, os efeitos secundários graves e o custo elevado, torna urgente o desenvolvimento de novos agentes anti-parasitários. Nos últimos anos, a pesquisa por fármacos novos e alternativos no tratamento de infecções por parasitas, tem vindo a desenvolver-se. A descoberta de potenciais agentes terapêuticos a partir de fontes naturais como as plantas medicinais e dos seus extractos, nomeadamente os óleos essenciais, tem vindo a aumentar. Os óleos essenciais como o Cymbopogon citratus, o Croton cajucara, o Ocimum gratissimum, ou o Thymus vulgaris, têm demonstrado actividade anti-parasitária com um amplo espectro de actividades evidenciando, muitas vezes, eficácia equivalente à quimioterapia padrão (AU)

Evaluation of availability, accessibility and prescribing pattern of medicines in the Islamic Republic of Iran.

Prescribing, dispensing, availability and affordability of drugs were evaluated in 100 primary health care centres in 5 provinces of the Islamic Republic of Iran using WHO indicators. On average, 92% of the 12 essential drugs monitored were available in the health centre pharmacies and 95% of the drugs prescribed by the physician were dispensed by the health centre pharmacy. The stock-out duration was less than 1 month on average. A complete treatment for pneumonia cost only 2% of the lowest weekly government salary. The national average number of drugs per prescription was 3.4. Prescription of antibiotics and injectable drugs was very high (58% and 41% respectively). Although availability and affordability of essential drugs is good in this country, rational use of drugs needs to be emphasized.

Manual de medicamentos y acciones esenciales para la atención de la madre y el recien nacido "del problema a la acción" / Manual on drugs and actions essential for care of the mother and the newborn of the problem to the action\"

Este manual"de bolsillo" ha sido, apartir del "estudio" de la Norma de Atención a la Mujer y el Recién Nacido para Puestos, Centros de Salud y Hospitales de Distrito (Norma Boliviana de Salud NBSNS-02-96), con el objeto de dar al personal de salud una rápida llegada al uso del medicamento y la acción, una vez que identifica o diagnostica la causa y/o define el procedimiento a seguir

Lista oficial de medicamentos con registro sanitario vigente / Official list of drugs wit sanitary registry in effect

Los datos que presentamos en este documento han sido sometidos a una exhaustiva revisión, evaluación y análisis. Estamos seguros que este instrumento constituirá una herramienta impresindible para los profesionales de salud, en la ejecución del Seguro Básico de Salud y toda la atención integral en la calidad de la prescripción y la dispensación. Esperamos que este listado constituya un documento de consulta para los profesionales e instituciones de salud

What have been the strategies for the registration, positioning and control of medical information for intramuscular artemether?

At the beginning of the 1990s the Chinese Authorities and Rhone-Poulenc Rorer signed an agreement to develop intramuscular (i.m.) artemether (Paluther) and to market the product in the malaria endemic countries. This accord ushered in an exemplary period of co-operation between an international pharmaceutical group and its Chinese partners, the WHO (especially TDR), the Wellcome Trust, and several university research departments. The challenge was to complement the Asian development (to Western standards of Good Manufacturing Practices, Good Laboratory Practices, and Good Clinical Practices) of a molecule which was already used on an everyday basis in East Asia and by Chinese medical missions in Africa. The implementation of Good Manufacturing Practice was the priority for Rhone-Poulenc Rorer in order to ensure the pharmaceutical quality of Paluther. New preclinical and clinical studies confirmed the importance of the drug in the curative treatment of severe malaria due to Plasmodium falciparum, or when resistance to other antimalarial drugs is suspected. The outcome of these new trials was the recognition that i.m. artemether is at least as efficient as quinine. The results of the current development of Paluther have been presented at several international congresses and the latest clinical trials were published in the New England Journal of Medicine in July 1996. The neurotoxicity observed in animals after long term administration of high and repeated dosages has never been reported in human subjects. I.m. artemether was listed in the WHO List of Essential Drugs in December 1995, and the product has now been registered in more than 40 malaria endemic countries. Authorization for use of Paluther in hospitals in France and in several other European countries was granted in 1996.

Artemisinin and its derivatives: the regulatory and policy implications for African countries.

In many African countries, the first step for introducing a new drug is its selection on the Essential Drug List (WHO) according to the need, the efficacy, the safety, and the affordability of the product. Requirements for registration of artemisinin and its derivatives are either simple notification or authorization, or full registration. Procedures may vary from country to country, depending upon the level of development of their national regulatory system. The availability of mechanisms to regulate the distribution and the use of these new antimalarials are also depending upon the availability of manpower to implement them. The only artemisinin derivative which has been evaluated clinically in Africa and registered in some African countries, for the treatment of severe and complicated malaria, is intramuscular (i.m.) artemether. The major advantage of artemether is that it is given i.m., thus can be used at peripheral facilities where treatment with intravenous infusions of quinine would not be possible. Post registration surveillance, while being a component of the drug policy of some African countries, has not yet been adequately managed.

Listado básico de medicamentos / Basic list of drugs

En el trabajo se han incluido una serie de medicamentos que permitirán a nuestra institución avanzar junto a los adelantos farmacológicos, buscando como es norma brindar al paciente una medicina de mejor calidad; del mismo modo se han retirado del listado anterior algunos medicamentos de escasa utilización por el cuerpo médico, de utilidad cuestionable o que han sido superados por otros con mayor beneficio terapéutico o con menores afectos adversos

Lista de medicamentos controlados / Controled drugs list

Esta presentación se refiere a lista de medicamentos controlados la misma que, si bien no indica registro sanitario, permite detectar cuáles productos farmacéuticos deben controlar de acuerdo a disposiciones legales vigentes, tales como el código de salud, la ley 1008 del régimen de la coca y sustancias controladas, convenios y acuerdos internacionales firmados por nuestro país. Contando con el concurso de los profesionales en salud, esta lista permitirá lograr una prescripción y dispensación racional, evitando de esta manera el uso indiscriminado de este tipo de productos farmacéuticos que pueden llevar a la farmacodependencia, incidiendo en la salud de la población en general y de la juventud en particular