A pilot study of cadre training to promote responsible self-medication in Indonesia: Which is better specific or general modules?

In 2015, the Indonesian Government initiated ‘Smart Use of Medications Movement’ (‘GeMa CerMat’) which included cadre training to promote responsible self-medication. Evaluation of a pilot training conducted across Indonesia suggested the need to improve those training modules. This study aimed to assess cadre’ knowledge gained following training with newly developed general or specific training modules. Five types of modules were developed and used to train cadres at five Community Health Centres (CHCs) in Surabaya, Indonesia: 1) Sidosermo CHC (general-drugs module), 2) Tenggilis CHC (common cold drugs module), 3) Gunung Anyar CHC (analgesic drugs module), 4) Kalirungkut CHC (anti-diarrhoeal drugs module), and 5) Jagir CHC (indigestion drugs module). Cadres’ knowledge improvements were evaluated using pre-/post-test scores and the difference scores depending on the module being tested. Multifactorial ANOVA explored the effects of the type of module on difference scores. A total of 279 cadres across five CHCs were involved in the training, giving response rates from 65% to 93%. There was an increase in the post-test scores after the training with all modules. However, significant differences were reported only for the specific-drugs module groups (all p < .001). Furthermore, the general module group had the lowest difference score (1.12; 95% CI [−0.45, 2.92]) while the common cold module group had the highest gain (5.02; 95% CI [1.95, 5.17]). Multifactorial ANOVA revealed that there was a significant main effect of the type of modules on difference scores [F (4, 263) = 8.37, p <.001]. In conclusion, this preliminary study indicated that the development of modules for specific minor illnesses could be beneficial in facilitating effective community-based training to promote responsible self-medication in Indonesia. The priority for therapeutic areas chosen for the module should be based on the local needs. Further research is required to confirm the findings in broader community members.     

羟基喜树碱与5-氟脲嘧啶联合治疗晚期胃肠道肿瘤近期疗效观察

目的 观察羟基喜树碱(HCPT)和5-氟脲嘧啶(5-Fu)联合化疗治疗晚期胃肠道肿瘤的近期疗效和毒副反应。方法HCPT10mg／d,静脉点滴,连用10天;5-Fu0．75mg／d,静脉点滴年,连用5天。21天为-个周期,二至三个周期观察疗效。结果20例胃癌CR1例,PR9例,NC6例,PD4例,总有效率(CR PR)为50％;结肠癌15例中CR2例,PR6例,NC5例,PD2例,(CR PR)为53．3％。毒副反应多为胃肠道反应及骨髓毒性,多为1～2级。结论以HCPT和5-Fu联合治疗晚期胃肠道肿瘤疗效较好,且毒副反应可以耐受。     

HFJV联合药物治疗兔海水淹溺肺水肿

目的：观察高频喷射通气（HFJV）联合4种药物治疗海水淹溺肺水肿（PE-SWD）的效果并探讨其作用机制。方法：用海水灌注的方法诱导PE-SWD模型,采用HFJV联合地塞米松、东莨菪碱、尼莫地平和果糖二磷酸钠4种药物进行治疗,观察记录相关的生理、生化指标。结果：HFJV联合4种药物治疗能明显改善PE-SWD相关指标。结论：HFJV联合4种药物治疗能有效治疗PE-SWD,可作为其基础治疗。     

Developing rational protocols for paediatric psychopharmacological prescribing.

The number of child psychiatrists, paediatricians and general practitioners prescribing psychotropic medication for children in the UK is increasing. Medication is being used not just to treat children of normal intelligence with hyperkinetic disorder or depression, but also to modify behavioural problems in children with developmental disorders and severe learning difficulties. Literature reviews highlight the lack of robust randomized controlled drug trials on which to base clinical practice and the authors have found no appropriate existing protocols to help develop a systematized approach. Against such a background the authors have developed a comprehensive set of protocols covering prescribing details for individual drugs, and also addressing issues such as informed consent, long-term monitoring and school liaison. All children referred to the authors' clinics go through a standardized decision-making process. This article describes both the protocols themselves and the philosophies that guided their development. The authors describe how such a system benefits the children, their families, general practitioners and schools, whilst also facilitating audit and research.     

多巴酚丁胺与复方丹参注射液联用治疗肺心病心衰32例

目的　观察多巴酚丁胺与复方丹参注射液联合应用治疗肺心病心衰的疗效; 方法　在综合治疗的基础上,将多巴酚丁胺２０ｍｇ 加入１０％ 的葡萄糖２５０ｍｌ 中静滴, 复方丹参注射液１６ｍｌ 加入１０％ 的葡萄糖２５０ｍｌ 中静滴,每日一次,７ 日为一疗程,所获数据经卡方检验; 结果　治疗组显效２１ 例,有效８ 例,总有效率９０．６ ％（ Ｘ２ ＝９ ．３６,Ｐ＜０ ．０５）,与对照组比较,有显著性差异; 结论　改善肺微循环,提高心肌收缩力,减轻心脏负荷有助于肺心病心衰的纠正。     

Neuroleptic malignant syndrome during low dosed neuroleptic medication in first-episode psychosis: a case report

 Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal side-effect of antipsychotic drug therapy, especially of dopamine receptor antagonists. As a dose relationship has been postulated, low dose neuroleptization would be expected to help to avoid this side-effect. In contrast, we report on a 21-year-old female following low dose fluphenazine treatment with 2.5 mg/day. The patient recovered from NMS after 3 days of dantrolene administration. Eventually, remission from psychotic symptoms was achieved with clozapine. At 8-month follow-up, psychopathology remained stable and there were no more signs of NMS. Received: 8 July 1998 / Final version: 6 November 1998     

作用于消化系统药物应用分析

目的：统计分析我院消化科作用于消化系统药物用药情况，提高临床合理用药水平。方法：应用电脑统计2002年9月4日～2003年5月6日我院消化科用药有效数据，采用金额排序法和DDDs排序法，对作用于消化系统药物进行统计分析。结果：用药金额和DDDs最高的是抗酸药及治疗消化系溃疡药类，具体药物是奥美拉唑。结论：我院消化科对作用于消化系统药物的使用基本合理。     

我国现行药品价格管理模式研究

目的 :探索我国药品价格管理的合理模式。方法 :对现行药品价格管理模式的现状及弊端详加分析。结果与结论 :药品价格管理的合理模式指药品价格应主要由市场来决定。为此 ,在现阶段 ,应当进一步加大市场调节价格的力度 ,提高政府定价的科学性和透明度 ,并进行生产、流通、医疗保险等各个方面的配套改革 ,使药品价格更趋合理。     

西藏高原藏族患者用药依从性调查

目的 :了解西藏高原藏族患者用药依从性现状 ,探讨提高患者用药依从性的方法。方法 :采用问卷调查法 ,对188例藏族患者进行疾病种类、用药情况、依从性情况调查。结果 :用药依从性与疾病性质、患者文化程度、患者对疾病的认知程度有关。提高患者对疾病及其药物治疗的认知程度 ,强化医师与患者的沟通及加强用药指导不失为提高患者用药依从性的好方法。结论 :针对不同年龄患者 ,其用药咨询服务内容应有所区别     

药浴剂的研究和应用

药浴剂为综合性新剂型。药浴剂是医务工作者在患者的配合下共同配制的洗浴药水。药浴剂在给药范围上应用广泛；在用药途径上，属于外用药中的一种；在治疗方法上属于透皮疗法；在临床应用上，可以治疗或辅助治疗各学科的多种疾病。药浴剂治疗疾病的机理有二，其一是透过全身汗毛孔进入体内，其二是刺激各个穴位，通行十二经脉，透达全身，激活或调动体内各器官和组织的积极因素，以加强五脏六腑的功能，达到治疗疾病的目的。