临床用药不安全因素的分析及对策

目的 查找临床用药不安全的主要因素,探索针对临床用药不安全因素的对策及有效措施.方法 对本院2011 年度和2012 年度发生的各种用药错误进行整理.结果 临床用药不安全的主要风险因素为病区配药存在的安全隐患、病区备用药的安全隐患、未按照药品说明书合理用药、医嘱处理、执行医嘱过程中存在的安全隐患等其他因素.结论 从思想重视临床用药的安全性、加强临床用药管理制度及临床用药的人员培训等方面来解决目前临床用药不安全的状况,以保障临床用药的安全性.     

我院门诊处方点评及实例分析

目的通过对我院门诊2012年1～10月抽查处方的点评及实例分析,了解我院门诊处方用药的基本情况。方法采用回顾性分析,对抽查处方进行统计分析。结果全年共抽查处方6000张,平均每张处方用药品种数为1.9种,其中19.8%的患者使用了针剂,26%使用了抗菌药物,药品通用名的使用率为100%,基本药物使用率为63.8%,二联抗菌药物使用率为2.5%,三联抗菌药物使用率为0.77%,不合理用药处方占所抽查处方总数的5.05%,平均每张处方金额为86.06元。结论我院门诊处方质量基本合格,但仍需要进一步改进,不断提高合理用药水平。     

1例静脉滴注阿奇霉素患儿穿刺处皮下血肿的护理

总结1例静脉滴注阿奇霉素患儿出现穿刺处皮下血肿的护理。针对患儿具体情况,分析发生肿胀的原因,采取正确方式对患儿皮肤进行用药及护理,密切观察局部肿胀皮肤的温度、色泽、张力的变化,重点维护局部皮肤完整性及肢体正常功能。为患儿输液时,必须严格遵守技术规范,勤巡视,详尽护理告知,掌握常用药物性能、特点及使用注意事项,注重工作中每一个细节。     

Results from the single-use autoinjector for self-administration of subcutaneous interferon beta-1a in patients with relapsing multiple sclerosis (MOSAIC) study

Background: Patients with multiple sclerosis (MS) often receive long-term injectable therapy, and difficulties associated with self-injection can affect treatment adherence and efficacy.

Objective: The objective of this study was to evaluate an investigational, ready-to-use, single-use autoinjector for self-injection of subcutaneous (sc) interferon beta-1a (IFNβ-1a).

Methods: In this multicenter, open-label, single-arm study, patients with relapsing MS who were receiving IFNβ-1a sc 44 μg three times weekly for ≥ 12 weeks continued therapy using a single-use autoinjector and completed a user trial questionnaire at baseline and weeks 6 and 12. The primary endpoint was the proportion of patients rating the autoinjector as easy or very easy to use at week 12.

Results: At 12 weeks, 86% of 109 patients included in the intent-to-treat population rated the autoinjector easy or very easy to use (95% confidence interval, 80% ? 93%), and the most important perceived benefit was its overall convenience. The majority (74%) of patients reported the device as somewhat or extremely convenient to use, and most (83%) agreed or strongly agreed that the device made injections simple.

Conclusion: The single-use autoinjector was well received and supported by favorable ratings for simplified injections and convenience. The results suggest that the device may improve overall injection experience in patients with relapsing MS.     

药物不合理使用情况分析与提高患者预后相关讨论

目的:分析门诊、急诊中药组成药品使用情况并对日后用药提出指导性建议。方法:通过随机时段抽取门诊、急诊含中药成分药品处方16 098份进行分析,时段选择为2011年3月至2013年1月,于两个月后给予干预,其中包括药品归类、专业分析、治疗干预及院外指导,干预时间12个月,入选含中药成分药品处方18 900张。结果:分析表明临床诊断不规范,适应证不适宜,剂量或给药方法不适宜作为门诊、急诊中药组成药品使用最集中问题;通过阶段性干预后入选处方中不合理用药情况明显好转。结论:临床治疗中结合中药组成药品对提高患者预后具有重要意义,临床医生应对药品具有一定的认知度最终提高药品的有效使用率。     

缺血性脑血管病出院患者用药依从性现状及影响因素研究

目的 探讨缺血性脑血管病出院患者的用药依从性现状及其影响因素.方法 选取缺血性脑血管病出院患者360例.收集患者的一般资料、疾病及用药情况、用药知识水平,使用Morisky用药依从性问卷、一般自我效能、领悟社会支持表等资料,分析用药依从性现状及其影响因素.结果 缺血性脑血管病出院患者的用药依从率为23.2％.依从性好和...     

Pharmacological Profiles of Acute Myeloid Leukemia Treatments in Patient Samples by Automated Flow Cytometry: A Bridge to Individualized Medicine

BackgroundWe have evaluated the ex vivo pharmacology of single drugs and drug combinations in malignant cells of bone marrow samples from 125 patients with acute myeloid leukemia using a novel automated flow cytometry–based platform (ExviTech). We have improved previous ex vivo drug testing with 4 innovations: identifying individual leukemic cells, using intact whole blood during the incubation, using an automated platform that escalates reliably data, and performing analyses pharmacodynamic population models.Patients and MethodsSamples were sent from 24 hospitals to a central laboratory and incubated for 48 hours in whole blood, after which drug activity was measured in terms of depletion of leukemic cells.ResultsThe sensitivity of single drugs is assessed for standard efficacy (E_MAX) and potency (EC₅₀) variables, ranked as percentiles within the population. The sensitivity of drug-combination treatments is assessed for the synergism achieved in each patient sample. We found a large variability among patient samples in the dose-response curves to a single drug or combination treatment.ConclusionWe hypothesize that the use of the individual patient ex vivo pharmacological profiles may help to guide a personalized treatment selection.