导读:药学论文开题报告要怎么写?开题报告有哪几点?药学开题报告都包括哪些?下面是小编为大家整理的药学开题报告的撰写方法,可提供给大家参考。
药学毕业论文开题报告
1、选题意义和背景:
万古霉素(Vancomycin,VCM)是糖肽类抗生素,1958年被美国FDA批准上市。万古霉素通过干扰细菌细胞壁合成而发挥杀菌作用。本品主要对革兰阳性(G+)菌具有强大的杀菌活性,特别是耐甲氧西林金黄色葡萄球菌(Methicillin-resistantstaphylococcusaureus,MRSA)以及耐甲氧西林凝固酶阴性葡萄球菌(Methicillinresistantcoagulasenegativestaphylococcus,MRCNS).根据XX年中国CHINET细菌耐药性监测,MRSA和MRCNS检出率分别平均为%和%.由于医院内上述耐药菌感染日趋严重,万古霉素越来越多地被应用于临床。然而,万古霉素具有肾、耳毒性,严重者可导致肾衰竭或听力丧失,这些不良反应在老年人中更易出现。因此,安全有效的应用该药物,最大程度减少药物对患者的损害,并发挥药物的最佳疗效,引起临床高度关注。
2、论文综述/研究基础:
近年来,国内外关于万古霉素群体药动学(Populationpharmacokinetics,PPK)研究涉及新生儿、成年人、肥胖患者、肾功能不全患者等人群。Sanchez等在141例应用万古霉素的患者中发现,老年人(≥65岁,n=40)清除率(Clearancerate,CL)和表观分布容积(Apparentvolumeofdistribution,V)分别为(±)L·h-1和(±)L,而年轻人(福建医科大学附属第一医院药学部课题组前期已建立成年患者万古霉素PPK模型,可以为临床制定万古霉素给药方案提供参考依据。为了进一步完善这一体系,本研究拟建立老年患者万古霉素PPK模型,辅助临床实现个体化给药。
3、参考文献:
WorldHealthOrganization.Men,ageingandhealth:Achievinghealthacrossthelifespan.XX.
RybakMJ.Thepharmacokineticandpharmacodynamicpropertiesofvancomycin.ClinInfectDis,XX,42Suppl1:S35-39.
汪复,朱德妹,胡付品,等。XX年中国CHINET细菌耐药性监测.中国感染与化疗杂志,XX,13(5):321-330.
SanchezJ,DominguezA,LaneJ,etal.Populationpharmacokineticsofvancomycininadultandgeriatricpatients:comparisonofelevenapproaches.Internationaljournalofclinicalpharmacologyandtherapeutics,XX,48(8):525-533.
肖永红,陈佰义,何礼贤,等。万古霉素临床应用剂量中国专家共识.中华传染病杂志,XX,30(11):641-646.
陈佰义,管向东,何礼贤。万古霉素临床应用中国专家共识(XX版).中国新药与临床杂志,XX,30(8):561-573.
AndersonRC,WorthHM,HarrisPN,etal.Vancomycin,anewantibiotic.IV.Pharmacologicandtoxicologicstudies.AntibiotAnnu,1956:75-81.
PfallerM,KrogstadD,GranichG,etal.Laboratoryevaluationoffiveassaymethodsforvancomycin:bioassay,high-pressureliquidchromatography,fluorescencepolarizationimmunoassay,radioimmunoassay,andfluorescenceimmunoassay.Journalofclinicalmicrobiology,1984,20(3):311-316.
LiL,MilesMV,HallW,etal.Animprovedmicromethodforvancomycindeterminationbyhigh-performanceliquidchromatography.Therapeuticdrugmonitoring,1995,17(4):366-370.
SaundersNJ,WantSV,AdamsDJ.AssayofvancomycinbyfluorescencepolarisationimmunoassayandEMITinpatientswithrenalfailure.JournalofAntimicrobialChemotherapy,1995,36(2):411-415.
PeckmanHJ,DupuisRE,SawyerWT,etal.Vancomycinserumconcentrationsinpatientswithrenaldysfunction:acomparisonoffluorescencepolarizationimmunoassayandtheenzyme-multipliedimmunoassaytechnique.Therapeuticdrugmonitoring,1996,18(6):647-653.
FarinD,PivaGA,GozlanI,etal.AmodifiedHPLCmethodforthedeterminationofvancomycininplasmaandtissuesandcomparisontoFPIA(TDX).Journalofpharmaceuticalandbiomedicalanalysis,1998,18(3):367-372.
WalkerCA,KoppB.Sensitivebioassayforvancomycin.Antimicrobialagentsandchemotherapy,1978,13(1):30-33.
FongKL,HoDH,BogerdL,etal.Sensitiveradioimmunoassayforvancomycin.Antimicrobialagentsandchemotherapy,1981,19(1):139-143.
JehlF,GallionC,ThierryR,etal.Determinationofvancomycininhumanserumbyhigh-pressureliquidchromatography.Antimicrobialagentsandchemotherapy,1985,27(4):503-507.
MorseGD,NairnDK,BertinoJrJS,etal.Overestimationofvancomycinconcentrationsutilizingfluorescencepolarizationimmunoassayinpatientsonperitonealdialysis.Therapeuticdrugmonitoring,1987,9(2):212-215.
Abu-ShandiKH.Determinationofvancomycininhumanplasmausinghigh-performanceliquidchromatographywithfluorescencedetection.Analyticalandbioanalyticalchemistry,XX,395(2):527-532.
YeoK-T,TraverseW,HorowitzG.ClinicalperformanceoftheEMITvancomycinassay.Clinicalchemistry,1989,35(7):1504-1507.
乔小云,朱怀军,王羽。酶放大免疫分析法监测万古霉素血药浓度的质控评估.药学与临床研究,XX,21(5):516-519.
FavettaP,GuittoJ,BleyzacN,etal.Newsensitiveassayofvancomycininhumanplasmausinghigh-performanceliquidchromatographyandelectrochemicaldetection.JournalofchromatographyB,Biomedicalsciencesandapplications,XX,751(2):377-382.
KonishiH,IgaI,NagaiK.Underestimationofratserumvancomycinconcentrationsmeasuredbyanenzyme‐multipliedimmunoassaytechniqueandthestrategyforitsavoidance.Drugtestingandanalysis,XX,6(4):350-356.
MoscatoD,NonnatoA,AdamoR,etal.Therapeuticmonitoringoftacrolimus:aberrantresultsbyanimmunoassaywithautomatedpretreatment.Clinicachimicaacta;internationaljournalofclinicalchemistry,XX,411(1-2):77-80.
RebolloN,CalvoMV,Martin-SuarezA,etal.ModificationoftheEMITimmunoassayforthemeasurementofunboundmycophenolicacidinplasma.Clinicalbiochemistry,XX,44(2-3):260-263.
吴委。万古霉素群体药动学及个体化给药研究.福建医科大学,XX.
RybakMJ,LomaestroBM,RotschaferJC,etal.Vancomycintherapeuticguidelines:asummaryofconsensusrecommendationsfromtheinfectiousdiseasesSocietyofAmerica,theAmericanSocietyofHealth-SystemPharmacists,andtheSocietyofInfectiousDiseasesPharmacists.Clinicalinfectiousdiseases:anofficialpublicationoftheInfectiousDiseasesSocietyofAmerica,XX,49(3):325-327.
FarberBF,MoelleringRC,Jr.Retrospectivestudyofthetoxicityofpreparationsofvancomycinfrom1974to1981.Antimicrobialagentsandchemotherapy,1983,23(1):138-141.
ForouzeshA,MoisePA,SakoulasG.Vancomycinototoxicity:areevaluationinaneraofincreasingdoses.Antimicrobialagentsandchemotherapy,XX,53(2):483-486.
BossoJA,NappiJ,RudisillC,etal.Relationshipbetweenvancomycintroughconcentrationsandnephrotoxicity:aprospectivemulticentertrial.Antimicrobialagentsandchemotherapy,XX,55(12):5475-5479.
SheinerLB,RosenbergB,MaratheVV.Estimationofpopulationcharacteristicsofpharmacokineticparametersfromroutineclinicaldata.Journalofpharmacokineticsandbiopharmaceutics,1977,5(5):445-479.
CockcroftDW,GaultMH.Predictionofcreatinineclearancefromserumcreatinine.Nephron,1976,16(1):31-41.
EtteEI,WilliamsPJ,KimYH,etal.Modelappropriatenessandpopulationpharmacokineticmodeling.Journalofclinicalpharmacology,XX,43(6):610-623.
叶红波。NONMEM法群体药代动力学研究的自举法验证及其应用.医学研究生学报,XX,23(12)。
BrendelK,CometsE,LaffontC,etal.Metricsforexternalmodelevaluationwithanapplicationtothepopulationpharmacokineticsofgliclazide.Pharmaceuticalresearch,XX,23(9):2036-2049.
RenYP,DengCH,WangXP,etal.Comparisonstudyofmodelevaluationmethods:normalizedpredictiondistributionerrorsvs.visualpredictivecheck.YaoXueXueBao,XX,46(9):1123-1131.
LeveyAS,BoschJP,LewisJB,etal.Amoreaccuratemethodtoestimateglomerularfiltrationratefromserumcreatinine:anewpredictionequation.ModificationofDietinRenalDiseaseStudyGroup.AnnInternMed,1999,130(6):461-470.
LeveyA,GreeneT,KusekJ,etal.Asimplifiedequationtopredictglomerularfiltrationratefromserumcreatinine.JAmSocNephrol,XX,11(Suppl2):155.
TotoRD,KirkKA,CoreshJ,etal.EvaluationofserumcreatinineforestimatingglomerularfiltrationrateinAfricanAmericanswithhypertensivenephrosclerosis:resultsfromtheAfrican-AmericanStudyofKidneyDiseaseandHypertension(AASK)PilotStudy.JAmSocNephrol,1997,8(2):279-287.
NankivellBJ,GruenewaldSM,AllenRD,etal.Predictingglomerularfiltrationrateafterkidneytransplantation.Transplantation,1995,59(12):1683-1689.
毕增祺,徐红,主理群。对几种测定老年人肾小球滤过率方法的评估.中华老年医学杂志,XX,25(1):25-28.
TanakaA,AibaT,OtsukaT,etal.PopulationpharmacokineticanalysisofvancomycinusingserumcystatinCasamarkerofrenalfunction.Antimicrobialagentsandchemotherapy,XX,54(2):778-782.
MarsotA,BoulameryA,BruguerolleB,etal.Vancomycin:areviewofpopulationpharmacokineticanalyses.ClinPharmacokinet,XX,51(1):1-13.
唐勤,葛卫红,丁义涛。万古霉素对肝移植并发腹腔感染的治疗监测及药动学研究.江苏药学与临床研究,XX,10(02):4-6.
RevillaN,Martín‐SuárezA,PérezMP,etal.Vancomycindosingassessmentinintensivecareunitpatientsbasedonapopulationpharmacokinetic/pharmacodynamicsimulation.Britishjournalofclinicalpharmacology,XX,70(2):201-212.
StaatzCE,ByrneC,ThomsonAH.Populationpharmacokineticmodellingofgentamicinandvancomycininpatientswithunstablerenalfunctionfollowingcardiothoracicsurgery.Britishjournalofclinicalpharmacology,XX,61(2):164-176.
胡瑾瑜,施耀国,张菁,等。万古霉素在健康老年人和年轻人的药代动力学.中国抗感染化疗杂志,XX,3(3):138-142.
毕明慧。老年重症感染患者使用万古霉素的疗效及安全性分析.北京医学,XX,33(06):491-493.
MizokamiF,ShibasakiM,YoshizueY,etal.Pharmacodynamicsofvancomycininelderlypatientsaged75yearsorolderwithmethicillin-resistantStaphylococcusaureushospital-acquiredpneumonia.Clinicalinterventionsinaging,XX,8:1015-1021.
YasuharaM,IgaT,ZendaH,etal.PopulationpharmacokineticsofvancomycininJapaneseadultpatients.Therapeuticdrugmonitoring,1998,20(2):139-148.
ChungJY,JinSJ,YoonJH,etal.SerumcystatinCisamajorpredictorofvancomycinclearanceinapopulationpharmacokineticanalysisofpatientswithnormalserumcreatinineconcentrations.JKoreanMedSci,XX,28(1):48-54.
Marqués‐Mi?anaMR,SaadeddinA,PerisJE.Populationpharmacokineticanalysisofvancomycininneonates.Anewproposalofinitialdosageguideline.Britishjournalofclinicalpharmacology,XX,70(5):713-720.
SeayRE,BrundageRC,JensenPD,etal.Populationpharmacokineticsofvancomycininneonates.ClinicalPharmacology&Therapeutics,1994,56(2):169-175.
4、论文提纲
第一部分万古霉素血药浓度监测
1方法学简述
2EMIT法测定万古霉素血药浓度
3讨论
4小结
第二部分老年患者万古霉素群体药动学模型的建立
1材料与方法
2结果
3讨论
4小结
5、论文的理论依据、研究方法、研究内容
本研究应用NONMEM法初步建立了老年患者万古霉素PPK模型,考察了年龄、体重、肾功能、合并用药对万古霉素清除率的影响,发现CLCr是万古霉素药动学参数的主要影响因素。模型验证结果显示,最终模型稳定、有效,具有良好的预测能力。