中药临床药师在神经内科开展中药临床药学服务的探索与实践

中药临床药师是合理用药的倡导者、实践者和监督者,承担着临床中药合理用药的具体任务。为促进临床合理用药,提高中药临床药师服务质量,为医护人员和患者提供优质的中药临床药学服务,文章介绍了某院中药临床药师在面临挑战和机遇时,正在开展的中药临床药师药学服务现状,从药学查房、中药处方点评、中药不良反应上报、中药用药教育、中药用药咨询和药物治疗监护等内容出发,阐述了该院神经内科中药临床药师在开展有关中药合理用药药学服务的主要内容,探讨当前工作模式下中药临床药师深入临床、服务临床的切入点,在实践中探索科学、合理的中药临床药师药学服务模式。     

基层医院开展临床药学服务的实践与体会

目的探讨基层医院开展临床药学服务的方法和体会。方法通过用药咨询、处方点评、临床合理用药指导和药物不良反应监测等模式有力推进该院临床药学工作的深入开展。结果通过近年来的实践与摸索,该院的临床药学服务模式已具雏形。结论临床药学服务的开展切实提高了医院的合理用药水平。     

我院门诊药学服务切入点及实例分析

目的:探讨临床药师开展门诊药学服务的切入点,为提高门诊合理用药及丰富药学服务形式提供参考。方法:结合部分典型药学服务实例的分析,从药品的选择、重复给药、药物相互作用(配伍禁忌)、超说明书用药、溶剂的选择、重点关注抗菌药物的合理应用、参与用药过程中的咨询等方面,探讨药学服务的模式。结果与结论:临床药师在处方审核、患者用药教育等方面大有可为。我院门诊提供的多种形式的药学服务,对合理用药起到了积极的作用,但仍需完善对慢性病患者持续性的药学治疗管理。     

临床药师对血液肿瘤科药物治疗的药学监护

目的探讨临床药师在血液肿瘤科开展药学服务的工作模式和切入点。方法结合血液肿瘤科临床药师在药物治疗、给药环节及患者用药教育等方面的工作体会,总结工作内容和模式。结果我院临床药师在药物治疗方案、药物相互作用、药品不良反应监测、对护士的指导、用药咨询和药患沟通等方面发挥了重要作用,取得了明显效果。结论临床药师只有深入临床,按照适宜的工作流程,才能切实做好临床药学服务。     

我院实施专业化药学服务工作的实践及体会

目的:推动医院药学服务工作开展,促进临床合理用药。方法:结合实例介绍我院在门诊设立药物咨询窗口以及监测不合理用药与药品不良反应的情况。结果:通过明确药物咨询基本条件和方法,设立药物咨询窗口开展药学服务,以及通过监测不合理处方与药品不良反应,规范临床用药,提高患者用药依从性和满意度,减少药品不良反应的发生。结论:实施专业化药学服务可保障医疗安全,药学人员应改进药物咨询工作的方法和技巧,培养独立解决临床用药问题的能力和提高自身学习主动性。     

我院门诊药房药学服务实践与体会

目的 探讨新医改后门诊药房药学服务模式及转型方向。方法 介绍北京清华长庚医院自开院以来门诊药房开展的多项药学服务,并分析其对药物服务品质提升带来的意义与影响。结果 门诊药房通过开展处方预调剂、前置处方审核、拆零给药以及多模式患者用药教育等药学服务在保障安全合理用药、提升患者用药满意度等方面起了重要作用。结论 门诊药房药师应该积极探索药学服务转型方向,体现药师工作价值。     

开展药学服务，促进合理用药

目的：促进合理用药。方法：我科从加强处方审核,开展处方点评、药品咨询服务,监测收集药品不良反应,参与会诊,学习药学监护、书写药历等药学服务。结果：不合理用药处方数从2年前的9％下降到2％。结论：通过开展药学服务共同促进合理用药,保障用药安全、有效。     

我院开展临床药学工作的体会

目的介绍我院临床药学工作的开展情况。方法从临床药师参与临床查房,开展处方点评,ADR监测和报告,用药咨询,学术活动,专业培训等方面阐述我院临床药学工作的内容。结果与结论我院临床药学工作目标明确,对临床合理用药起到了一定的促进作用。     

临床药师对肿瘤科药物治疗的药学监护

目的:探讨临床药师在肿瘤科开展药学服务的工作模式和切入点。方法:结合肿瘤科临床药师在药物治疗、给药环节及患者用药教育等方面的工作体会,总结其具体工作内容和模式。结果:我院临床药师在药物治疗方案、药物相互作用、药品不良反应监测、对护士的指导、用药咨询、营养支持和药患沟通等方面发挥了重要作用,取得了明显效果。结论:临床药师只有深入临床,按照适宜的工作流程,才能切实做好临床药学服务。     

我院开展临床药学工作的实践与体会

目的:介绍我院临床药学工作的开展情况。方法:从建立临床药师制,负责药物遴选、处方审核,参与查房、会诊,开展药品不良反应监测,协助临床做好抗感染药物监测等方面阐述我院临床药师开展临床药学工作的内容。结果与结论:我院临床药师目标明确,深入临床,对临床合理用药起到了一定的作用。临床药师应加强学习,提高自身业务素质,积极深入临床,与医师、护士密切配合,促进临床合理用药。     

Oestrogen and the cardiovascular system: the good, the bad and the puzzling

The concept that oestrogen replacement therapy is cardioprotective has been challenged recently by the negative results of randomized clinical trials in coronary heart disease. These data have come at a time of rapid advances in our understanding of the cellular mechanisms of oestrogen. In particular, the cloning of the classical oestrogen receptor (ERalpha), the identification of a novel ER isoform (ERbeta), the availability of specific ERalpha and ERbeta knockout mice models, and the elucidation of receptor functions and signalling pathways linked to non-genomic actions of oestrogen are helping to unravel this complex biology. In this article, these advances will be discussed with particular emphasis on the regulation of nitric oxide synthesis by oestrogen. Furthermore, the puzzling issues that have emerged and the potential for development of novel and specific therapeutic approaches will be highlighted.     

Ketamine and phencyclidine: the good,the bad and the unexpected

The history of ketamine and phencyclidine from their development as potential clinical anaesthetics through drugs of abuse and animal models of schizophrenia to potential rapidly acting antidepressants is reviewed. The discovery in 1983 of the NMDA receptor antagonist property of ketamine and phencyclidine was a key step to understanding their pharmacology, including their psychotomimetic effects in man. This review describes the historical context and the course of that discovery and its expansion into other hallucinatory drugs. The relevance of these findings to modern hypotheses of schizophrenia and the implications for drug discovery are reviewed. The findings of the rapidly acting antidepressant effects of ketamine in man are discussed in relation to other glutamatergic mechanisms.Tables of Links

医院以及医院药学的定位和服务方式转变

本文以新一轮医药卫生体制改革的内容为切入点,分析我国现有医院与医院药学的现状,并与国外医疗体系做对比;提出了公立医院的定位问题及如何发挥医院药学在医院中的作用,转变服务方式,加强药师队伍建设等问题。     

Hydrogen sulfide and inflammation: the good, the bad, the ugly and the promising

Hydrogen sulfide is rapidly gaining ground as a physiological mediator of inflammation, but there is no clear consensus as to its precise role in inflammatory signaling. This article discusses the disparate anti-inflammatory ('the good') and proinflammatory ('the bad') effects of endogenous and pharmacological H(2)S in disparate animal model and cell culture systems. We also discuss 'the ugly', such as problems of using wholly specific inhibitors of enzymatic H(2)S synthesis, and the use of pharmacological donor compounds, which release H(2)S too quickly to be physiologically representative of endogenous H(2)S synthesis. Furthermore, recently developed slow-release H(2)S donors, which offer a more physiological approach to understanding the complex role of H(2)S in acute and chronic inflammation ('the promising') are discussed.     

Balancing the risks and the benefits

Pharmaceutical research organizations can benefit from outsourcing discovery activities that are not core competencies of the organization. The core competencies for a discovery operation are the expertise and systems that give the organization an advantage over its competition. Successful outsourcing ventures result in cost reduction, increased operation efficiency and optimization of resource allocation. While there are pitfalls to outsourcing, including poor partner selection and inadequate implementation, outsourcing can be a powerful tool for enhancing drug discovery operations.