临床药师主动参与药品不良反应报告的体会

通过介绍临床药师加强药品不良反应知识宣传及主动参与报告后,药品不良反应报告数量和质量改善的体会,提出由临床药师主动承担不良反应报告,充分发挥临床药师的专业优势,建立由临床药师主导的医院药物警戒体系。     

临床药师在药品不良反应监测中的优化实践

目的探讨在医院药品不良反应监测工作中,临床药师的优化实践对于不良反应监测工作的意义。方法通过临床药师在医院药品不良反应监测工作的全程参与来完成优化实践。结果临床药师对医院不良反应监测的体系,监测的重点数据、重点药物、重点人群及整个监测过程进行了全面的优化。结论通过临床药师在医院药品不良反应监测中的优化实践,显著提高了该项工作开展的质量。     

从临床实践探讨临床药师处置药品不良反应的切入点

摘 要 目的：探讨临床药师参与药品不良反应工作的切入点。方法：对临床药师在实践工作中遇到的典型病例进行叙述及分析。结果：临床药师对若干例药品不良反应的处置提出了见解和建议,并获得了较好效果。结论：临床药师参与药品不良反应的处置,充分发挥临床药师的专业优势,降低药源性疾病和药品不良反应的危害,提高了药物治疗的安全性。     

临床药师参与消化科药品不良反应处置的实践体会

目的介绍临床药师参与消化科药品不良反应处置的体会。方法对临床药师参与的典型病例处置过程进行叙述及分析。结果临床药师对药品不良反应处置的若干病例提出了见解和建议,并获得较好的效果。结论临床药师参与临床药品不良反应的处置,不仅保证了药品不良反应处置的即时性,降低药品不良反应的危害,同时促进了临床药师更深入的结合临床为临床提供更完善的药学服务。     

1例依达拉奉联合卡马西平致重症多形红斑型药疹的治疗分析及药学监护

摘要：临床药师参与1例依达拉奉联合卡马西平致重症多形红斑药疹病例治疗过程,协助临床医生制订个体化治疗方案,发现并解决药品不良反应与药物相互作用方面的问题,并对患者进行全程药学监护。提高药物治疗的有效性和安全性。临床药师作为临床治疗团队成员,应充分发挥善于发现和解决药物相互作用和药品不良反应问题的优势,提高临床药物治疗与合理用药水平。     

药师在预防和减少药品不良反应发生中的作用

药品不良反应是危害人们生命安全的重要因素之一,本文旨在探讨药师在预防和减少药品不良反应发生中的作用。通过了解药品不良反应及药物警戒相关知识,加强对药品不良反应的认识、预防、监测和报告。发挥药师专业优势,开展药物监测、促进安全、合理用药,提高生命质量,药师在预防和减少药品不良反应发生中将发挥更大的作用。     

药师下临床的体会

药师参与临床用药是势之所趋，向临床医生、护士提供临床药物使用咨询，收集药物的不良反应，开展临床药动学的研究、进行个体化给药，可明显提高临床药品应用的水平和降低药品不良反应。     

1例脑梗死患者的药学监护

目的探索临床药师对脑梗死患者的药学监护方案。方法以脑梗死防治指南为依据,根据掌握的药学知识,临床药师对患者在住院期间的用药情况进行全程监护,重点针对药物选择的合理性和药品的不良反应及药物的相互作用,对患者进行具体化药学服务并制定个体化监护计划。结果I临床药师积极参与临床的治疗过程,指导临床用药,可减少药品不良反应及药物配伍禁忌的发生,规范临床合理用药,提高治疗水平。结论临床药师应针对具体患者,开展个体化的药学监护。     

临床药师参与1例宫颈恶性黑色素瘤治疗的药学实践

目的：探讨临床药师参与药物治疗方案的制定以及提供药学服务的方法。方法：临床药师参与1例宫颈恶性黑色素瘤的治疗过程,从抗肿瘤个体化方案制订、给药剂量的计算、药物不良反应监测等环节,为患者提供全面的药学服务。结果：临床药师提出的治疗方案被采纳,提高了临床治疗效果,减少了药品不良反应。结论：临床药师参与临床药物治疗实践,有利于提高药物治疗水平。     

临床药师在神经内科开展药学监护的切入点探讨

目的:探索临床药师在神经内科实施药学监护、参与制订治疗方案的切入点。方法:临床药师通过在神经内科实施药学监护,重点监护反复发热及长期应用广谱抗菌药物的患者、肾功能不全的老年患者、应用安全性低的药物或用药依从性差的患者及有特殊用药注意事项的药物和药品不良反应,参与临床治疗,与医护人员组成治疗团队。结果:通过药学监护,促进合理用药,减少药品不良反应发生,提高了临床治疗的有效率和成功率。结论:临床药师可为临床提供多种形式的药学服务,以使药物应用更加安全、有效。     

临床药师参加会诊的典型病例分析

目的:总结临床药师参加会诊的典型病例,以便为临床药师的工作提供参考。方法:结合以往临床药师参加的会诊工作,从个体化给药方案的制定、药品不良反应的判别、参与中毒急救、不良反应监测、围术期预防性使用抗菌药物的选择等几个方面进行总结。结果:通过参加会诊,临床药师能够为临床提供帮助,对药师的工作有一定的指导作用。结论:通过以上会诊工作的开展,临床药师的建议得到临床医生的采纳,药师自身素质明显提高。     

重症急性胰腺炎合并严重药物不良反应的药学服务

目的：通过分析1例重症急性胰腺炎合并严重药物不良反应病人的药学服务,探讨临床药师如何在临床实践中发挥作用。方法：在药学服务过程中,临床药师从药物不良反应评价、抗菌药物使用、营养支持等方面提出建议。结果：临床药师提出多项合理建议,优化了治疗方案。结论：临床药师是治疗团队的重要成员之一,为促进临床合理用药发挥了重要作用。     

Improved reporting of adverse drug reactions

A program using satellite pharmacists to improve adverse drug reaction (ADR) reporting in an 1100-bed teaching hospital is described. Because relying on physicians to report ADRs had met with little success (only six reports in seven years), the pharmacy department proposed that pharmacists in satellite pharmacies on patient-care units be called upon to identify and report ADRs. To begin this program, an ADR team composed of a physician, pharmacist, and nurse made weekly rounds of the satellite pharmacies to assist pharmacists in identifying potential ADRs. The FDA definition of an ADR was adopted. Also, inservice education programs about ADR reporting were conducted for pharmacists and nurses. Currently, suspected ADRs are reported to the satellite pharmacist, who forwards a completed drug reaction report form to the assistant director for clinical pharmacy services. Reports are discussed quarterly by the ADR subcommittee of the pharmacy and therapeutics committee; the sub-committee members determine whether any follow-up action is needed. In the first three years after implementation of this program, 306 ADRs were reported; 90% of the reports were filed by pharmacists. An ADR reporting system based on reporting by staff pharmacists has been effective in increasing the number of reported reactions and pharmacist involvement in monitoring patients for ADRs.     

临床药师对我院呼吸科药品不良反应监测和处置的影响

目的：根据我院呼吸科药品不良反应（ADR）报表,分析专职临床药师对临床药品不良反应的监测和处置的影响。方法：自我院药品不良反应监测中心调取2006年4月-2008年3月ADR报告,对呼吸科临床药师参与临床常规工作前后的ADR情况进行回顾性调查与分析。结果：临床药师参与临床常规工作前（第一阶段）ADR报表为8例,且均为一般ADR。临床药师参与临床常规工作后（第二阶段）ADR报表增至43例,其中由临床药师上报的占67.44%,一般和严重ADR分别占72.41%和27.59%。51份ADR涉及的可疑药物以抗肿瘤和抗感染居多,分别占39.22%和23.53%;静脉途径给药发生的ADR占总计的66.66%。结论：专职临床药师参与临床常规工作后,提高了ADR的监测水平,有助于及时应对ADR,促进合理用药。     

Pharmacist’s knowledge,practice and attitudes toward pharmacovigilance and adverse drug reactions reporting process

Background

Adverse drug reactions (ADRs) are a major cause of drug related morbidity and mortality. Pharmacovigilance is the science that plays an essential role in the reduction of ADRs, thus the evolution and growth of this science are critical for effective and safe clinical practice.

Objectives

This study is considered the first study in the region to evaluate pharmacist’s knowledge, practice and attitudes toward ADRs reporting after establishing the national ADRs reporting center in Jordan.

Method

A cross sectional study was used to evaluate pharmacist knowledge and attitude toward ADRs reporting. A structured validated questionnaire was developed for this purpose and a total of 208 pharmacists were recruited to participate in this study.

Results

The majority of pharmacists have insufficient awareness and lack of knowledge about pharmacovigilance and ADRs reporting. Also the rate of reporting of ADRs was extremely poor. Several factors were found to discourage pharmacists from reporting ADRs, which include inadequate information available from the patient, unavailability of pharmacist ADRs form when needed, unawareness of the existence of the national ADRs reporting system. Also pharmacists think that ADRs are unimportant or they did not know how to report them.

Conclusion

The results of this study suggest that pharmacists have insufficient knowledge about the concept of pharmacovigilance and spontaneous ADRs reporting. On the other hand, pharmacists had positive attitudes toward pharmacovigilance, despite their little experience with ADRs reporting. Educational programs are needed to increase pharmacist’s role in the reporting process, and thus to have a positive impact on the overall patient caring process.     

Multidisciplinary program for detecting and evaluating adverse drug reactions

An adverse drug reaction (ADR)-reporting program involving detection of charted ADRs by quality assurance nurses and data collection and causality assessment by staff pharmacists is described. The voluntary ADR-reporting mechanism used in a 900-bed, university-based hospital complex produced less than one ADR report per month. The newly implemented system depends on nurses to detect and report documented ADRs through concurrent chart review. Staff pharmacists are then responsible for follow-up chart review, data collection, and causality assignment based on two published algorithms. An inservice education program designed to increase the awareness and understanding of ADRs was provided to the department of pharmacy and the quality assurance nurses. The clinical staff provides quality assurance through weekly ADR committee meetings. Drug information center personnel complete the causality algorithms by using the data collected by the staff pharmacists. The ADR committee then compares the algorithm results of the two assessors. Discrepancies in scoring are evaluated to determine whether a change in the system is necessary. An FDA report is generated if the staff pharmacist assessor and the drug information center assessor obtain results of "probable" for both algorithms. An ADR-reporting program that relies on quality assurance nurses to detect charted ADRs and on staff pharmacists to evaluate reported ADRs increased the average number of ADRs reported from 0.4 to 20 per month.     

硝苯地平在临床应用中的不良反应

目的汇总硝苯地平在临床应用中发生不良反应的文献,分析不良反应类型及特点,为临床合理应用硝苯地平提供参考。方法检索维普中文科技期刊数据库（CSTJ）1989~2008年关于硝苯地平在临床应用中的不良反应文献,对文献进行总结分析。结果硝苯地平在临床应用中的不良反应类型及临床表现呈多样化。结论临床医生及药师应对硝苯地平的不良反应有足够的重视,以保证患者用药安全。     

Do pharmacists' reports of adverse drug reactions reflect patients' concerns?

Aim: The aim of the present study was to investigate whether the concerns patients express to a Drug Information Line about possible adverse drug reactions (ADRs) they have experienced, are sufficiently reflected by the ADR reports submitted by pharmacists to the Netherlands Pharmacovigilance Centre Lareb with regard to the type of ADRs and the drug groups involved. Methods: ADR-related questions patients addressed to the Dutch Drugs Information Line were compared with the ADR reports pharmacists sent in to Lareb in the same period. The similarities and differences between the characteristics of the suspected ADRs and the kinds of drugs mentioned were investigated, as well as the severity of the reported ADRs. To compare the two data sets and to establish whether significant differences were present, a logistic regression analysis was conducted on the reported drugs and ADRs. Results: Analysis of the content of the phone calls yielded 1168 (14.6%) calls concerning possible experienced ADRs. The suspected ADRs pharmacists reported to the Netherlands Pharmacovigilance Centre Lareb in the same period included 1734 reports. There were only slight differences between the queries patients put to the Drug Information Line regarding possible adverse drug reactions and the reports on suspected ADRs pharmacists submitted to the pharmacovigilance centre. With respect to possible ADRs in the psychiatric spectrum and ADRs associated with the use of antidepressants, there seems to be a deficiency in the reporting by pharmacists. Conclusion: The ADRs pharmacists report to the national pharmacovigilance centre reflect patients' concerns about ADRs they experience in relation to the medication they are taking.     

阿奇霉素在儿科临床应用中的不良反应

目的：汇总阿奇霉素在儿科临床应用中发生不良反应的文献，分析不良反应类型及特点，为临床合理应用阿奇霉素提供参考：方法：检索维普中文科技期刊数据库（CSTJ）1989～2008年关于阿奇霉素儿科临床应用中的不良反应文献，对文献进行总结分析。结果：阿奇霉素在儿科临床应用中的不良反应类型及临床表现呈多样化。结论：儿科医生及药师应该对阿奇霉素的不良反应引起足够的重视，以保证儿童用药安全