我院慢性阻塞性肺疾病患者用药情况分析

目的：了解我院慢性阻塞性肺疾病的药物使用规律及用药合理性。方法：采用回顾性药物利用评价的方法,以DDDs值代表用药频度,以药物利用指数（DUI）作为分析判断指标,对我院2008年入院的第一诊断为慢性阻塞性肺疾病的病历用药情况进行分析评价。结果：我院慢性阻塞性肺疾病使用的药物主要为化痰、平喘、抗感染、维生素、营养类及消化系统用物;氨溴索、甲泼尼龙、头孢吡肟等16种药物的DUI〉1;联合用药中以二羟丙茶碱＋地塞米松磷酸钠、头孢菌素类＋氟喹诺酮类多见。结论：我院慢性阻塞性肺疾病的药物使用基本合理。     

Air Pollution and Hospital Admissions for Chronic Obstructive Pulmonary Disease in a Tropical City: Kaohsiung,Taiwan

This study was undertaken to determine whether there is an association between air pollutants levels and hospital admissions for chronic obstructive pulmonary disease (COPD) in Kaohsiung, Taiwan. Hospital admissions for COPD and ambient air pollution data for Kaohsiung were obtained for the period from 1996 to 2003. The odds ratio of hospital admission was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. In the single-pollutant models, on warm days (≥25°C) statistically significant positive associations were found in all pollutants except sulphur dioxide (SO₂). On cool days (< 25°C), all pollutants were significantly associated with COPD admissions. For the two-pollutant models, CO and O₃ were significant in combination with each of the other four pollutants on warm days. On cool days, NO₂ remained statistically significant in all the two-pollutant models. This study provides evidence that higher levels of ambient pollutants increase the risk of hospital admissions for COPD.     

我院门急诊药房退药原因分析及对策

目的分析门急诊患者退药原因,探讨减少患者退药的有效措施。方法对医院门诊药房2008年1月至3月的958例退药记录,按退药原因、药品种类及退药剂型进行统计分析。结果引起患者退药的主要因素有药物不良反应、病情改变、患者依从性差和医院服务缺陷等。结论应建立严格的退药制度,规范医师用药行为,加强医患沟通,提高患者用药依从性,从而减少退药的发生。     

Drug Metabolism within the Brain Changes Drug Response: Selective Manipulation of Brain CYP2B Alters Propofol Effects

Drug-metabolizing cytochrome P450 (CYPs) enzymes are expressed in the liver, as well as in extrahepatic tissues such as the brain. Here we show for the first time that drug metabolism by a CYP within the brain, illustrated using CYP2B and the anesthetic propofol (2, 6-diisopropylphenol, Diprivan), can meaningfully alter the pharmacological response to a CNS acting drug. CYP2B is expressed in the brains of animals and humans, and this CYP isoform is able to metabolize centrally acting substrates such as propofol, ecstasy, and serotonin. Rats were given intracerebroventricularly (i.c.v.) injections of vehicle, C8-xanthate, or 8-methoxypsoralen (CYP2B mechanism-based inhibitors) and then tested for sleep time following propofol (80 mg/kg intraperitoneally). Both inhibitors significantly increased sleep-time (1.8- to 2-fold) and brain propofol levels, while having no effect on plasma propofol levels. Seven days of nicotine treatment can induce the expression of brain, but not hepatic, CYP2B, and this induction reduced propofol sleep times by 2.5-fold. This reduction was reversed in a dose-dependent manner by i.c.v. injections of inhibitor. Sleep times correlated with brain (r=0.76, P=0.0009), but not plasma (r=0.24, P=0.39) propofol concentrations. Inhibitor treatments increased brain, but not plasma, propofol levels, and had no effect on hepatic enzyme activity. These data indicate that brain CYP2B can metabolize neuroactive substrates (eg, propofol) and can alter their pharmacological response. This has wider implications for localized CYP-mediated metabolism of drugs, neurotransmitters, and neurotoxins within the brain by this highly variable enzyme family and other CYP subfamilies expressed in the brain.     

我院常见药物咨询问题及分析

目的:为开展药物咨询提供参考。方法:对我院医、护、患常见药物咨询问题进行归类、整理和分析。结果与结论:我院药物咨询常见问题包括药物的安全性、配伍、稳定性、过敏试验、针刺落屑和特殊人群用药等。通过开展药物咨询,可解决临床实际存在的用药问题,提高临床合理用药水平。     

我院门急诊麻醉性镇痛药用药分析

目的:分析我院2001年～2003年门急诊麻醉性镇痛药使用情况,为临床合理用药提供参考。方法:统计3年中门急诊麻醉性镇痛药处方,对处方的一般情况、药品用量、肿瘤患者用量、药品的使用频度进行分析。结果:硫酸吗啡控释片和哌替啶注射液在肿瘤患者中的用量远高于非肿瘤患者,2003年哌替啶注射液的使用频度出现明显下降。结论:应合理使用麻醉性镇痛药,减少肿瘤患者哌替啶的使用。     

Admissions to methadone maintenance: Comparisons between programs and implications for treatment

Male admissions to six methadone maintenance programs in three cities were interviewed. The characteristics of these patients in the seven Addiction Severity Index (ASI) scales-medical, employment/support, alcohol, drug, lelgal, family/socila and psychiatric—were described. The characterization of drug addicts was not found to be unidimensional. Though the admissions, as a group, had some positive characteristics (e.g., over 50% reported full time employment over the past three years), they also reported severe problems. For the 30 days prior to interview, heroin was the most commonly used drug, followed by cannabis, cocaine, and alcohol. Less than 10% had never been arrested and subjects reported engaging in crime on 6.4 of the past 30 days. The majority of these subjects had never married, but very few lived alone. The most common psychiatric symptoms reported were depression and anxiety. Characteristics were compared between programs and differences were found in race and age as well as two of the seven ASI areas. Thus, despite differences in demographics there was a great commonality in terms of the characteristics of adminissions to these programs. The implications of this for the behavioral problems related to drug abuse and for the development of treatments aimed at specific areas (such as measured by the ASI) were discussed.     

2011年1～6月份我院门急诊处方点评与用药分析

目的:了解门急诊开具处方的合理性,为规范和改进医院处方点评工作,提高处方质量,规范医疗行为,促进合理用药.方法:处方点评工作小组随机抽取我院201 1年1～6月份每月门急诊处方100张,总计600张,进行审核点评及统计分析.结果:在抽查点评的600张处方中,不合格处方268张(44.67％)其中书写不规范处方占234张...     

老年慢病患者用药相关性问题的识别与分析

探索临床药师对老年慢病患者用药相关性问题的识别与干预。选取我院2017年2~7月老年慢病门诊132例病人,对其用药相关性问题进行回顾性分析。发现132例患者中有药物相关性问题191项,主要集中在“药物疗效不佳（37.2%）”和“无适应证用药（24.1%）”等方面。临床药师分析了191项药物相关性问题的形成原因,并讨论了识别的效果与不足。患者是药物相关性问题的承受者,医药患三方面共同努力可减少多重用药的负面问题,保证用药安全合理。     

某院药品采购过程存在的问题及其对策

目的为药品采购管理提供依据。方法本文对我院长期以来药品采购管理过程中存在的问题进行分析及总结。结果可通过加强药品采购平台硬件建设及维护、加强沟通及协调、加强人血白蛋白的临床应用管理、建立有效的临时用药采购管理体系等措施来规范和完善药品采购工作。结论药剂科应制定药品采购管理制度,有计划的制定采购计划,保障药品质量,汇总药品采购过程中遇到的各种问题,总结经验,全方位为临床和患者提供安全、质优、价格合理的药品。     

对我院麻醉性镇痛药使用中存在问题的分析

对我院2004年1月至2007年10月间麻醉性镇痛药的用药频度、日均费用等进行统计分析。结果发现,吗啡制剂已成为目前我院用于癌症止痛的主要药物,这符合世界卫生组织所提倡的用药原则,但在品种和制剂的选择使用上尚存在某些问题。因此认为,有关人员需要进一步了解和掌握癌症患者三阶梯止痛原则,更合理有效地使用麻醉性镇痛药。     

某儿童专科医院急诊药房存在的问题与对策

目的：探讨如何加强儿童专科医院急诊药房管理,为患儿提供更加安全、高效的药学服务。方法：针对儿童专科医院急诊药房的问题现状,分析原因,提出对策和改进措施。结果：通过优化急诊药房的管理,急诊药房药学服务能力增强,医师处方更合理,患儿家属满意度提高。结论：在儿童专科医院急诊药房的工作中,要注意硬件设施、人力资源配备、医师、药师、药品、收费、家属等多方面的问题,主动参与到治疗过程中,更好的为患者服务。     

Drug Treatment Effectiveness: An Examination of Conceptual and Policy Issues

This paper discusses different concepts or views of what constitutes effective treatment for drug dependence and how these views are involved in policy decisions regarding treatment. The paper reviews the rise of evidence-based medicine, discusses the emergence of efficacy research, effectiveness research, and other types of outcome-based evaluations of drug user treatment, but notes that despite a growing consensus among researchers on the effectiveness of drug user treatment, substantial public skepticism about the value of treatment still exists in the United States. The paper argues that one of the primary reasons for the lack of public consensus in the United States is that there is wide disagreement over which type of problem drug dependence is and for whom it may be a problem. The paper reviews some of the most common models and their implications for evaluating effectiveness, and argues that it is the differences in perspective among these models that are at the heart of policy debate over drug treatment policy in the United States. The paper concludes that because evaluation research as currently practiced does not address these issues, its utility for policy purposes is limited in the American context.     

Early Detection of Alcohol and Drug Problems — Why?

Abstract: The early detection of alcohol and drug problems has emerged as a major emphasis in the 1980s in many countries throughout the world. The World Health Organization collaborative project involving some 11 nations is a concrete illustration of this new perspective. This paper addresses three basic questions regarding early intervention. First, why should we do it? The following reasons are considered: most “excessive” drinkers do not seek treatment for their alcohol problems, socially stable individuals at early stages of drinking problems have better prognosis, health professionals in primary care settings are in an excellent position to identify problem drinkers, and brief interventions by health professionals can be effective in reducing alcohol abuse. Second, why are we not doing it? A primary reason is widespread pessimism among health professionals about being able to intervene effectively. In addition, there is confusion regarding appropriate roles about who is responsible for confronting alcohol/ drug problems, uncertainty about the proper target population (problem drinkers versus alcoholics), and lack of appropriate treatment programs, philosophies and practical training. Third, how can it be done effectively? A basic strategy on early intervention must be adopted by health professionals. Also, practical techniques and training for early intervention need to be made widely available. Finally, one must convince key people to implement such programs. Despite the growing enthusiasm and expectations regarding early intervention, certain caveats are raised regarding the uncritical adoption of such programs.     

2005～2007年我院急诊药品利用分析

目的：评价我院急诊的用药情况和趋势。方法：对我院2005-2007年急诊药品的种类、用量、销售金额等进行统计、分析。结果：2006年药品销售金额比2005年下降3.51%,而2007年药品销售金额比2006年上升27.34%,3年中各类药品金额排序基本同步。结论：我院急诊药品应用基本合理、规范,增长基本平稳。     

2种联合用药方案治疗慢性阻塞性肺疾病急性发作的成本-效果分析

目的观察普米克令舒联合万托林、爱全乐雾化吸入治疗慢性阻塞性肺疾病急性发作的疗效并评价其成本-效果比。方法将70例慢性阻塞性肺疾病患者随机分为治疗组(给予普米克令舒联合万托林、爱全乐雾化吸入)与对照组(给予万托林、爱全乐联合雾化吸入),运用药物经济学方法进行成本-效果分析。结果治疗组与对照组的成本分别为(596·80±322·27)元、(901·77±360·70)元,总有效率分别为86·67%、75·00%(P>0·05),成本-效果比分别为689、1202。结论治疗组方案较优。     

我国目前突发灾害药品应急体系存在的问题和建议

目的:为建立有效、合理和及时的药品应急体系提供参考。方法:通过文献检索、实地调研和专家咨询,分析我国医药储备存在的问题,提出建设突发灾害药品应急体系的建议。结果与结论:我国医药储备存在的问题主要是缺乏统一的指挥协调机制、缺乏法律保障机制、缺乏系统的应急保障体系和缺乏信息平台;建设突发灾害药品应急体系应建立应急药品指挥平台、保障平台、法律法规体系和数据信息平台。     

2000年～2002年我院门急诊麻醉药品用药分析

目的 :分析我院 2 0 0 0年～ 2 0 0 2年门急诊麻醉药品的使用情况。方法 :统计 3年中门急诊麻醉药品处方 ,对处方的一般情况 ,药品用量 ,肿瘤患者用量 ,药品的使用频度进行分析。结果 :复方桔梗片的使用频度在 3年中都排第 1位 ,硫酸吗啡控释片和哌替啶注射液的肿瘤患者用量远高于非肿瘤患者 ,2 0 0 2年哌替啶注射液的使用频度出现明显下降。结论 :应合理使用麻醉药品 ,减少肿瘤患者哌替啶的使用     

1例慢性阻塞性肺疾病急性加重期老年患者的用药分析与药学监护

目的:了解慢性阻塞性肺疾病急性加重期(COPD-AE)患者治疗用药的有效性、安全性和药学监护情况,探讨临床药师如何在临床实践中发挥作用。方法:药师参与吴忠市人民医院1例COPD-AE患者临床诊疗过程,特别是治疗中各种药物的实施和调整,与医生共同观察治疗效果,并对患者进行用药指导,提高患者对药物治疗的依从性。结果:该例COPD-AE患者临床症状均明显改善,治疗药物安全、有效。结论:临床药师对临床治疗进行用药分析与药学监护,在临床合理用药方面起着重要作用。     

Repression,Reform and Drug Abuse: An Analysis of the Response to the Rockefeller Drug Law Proposals of 1973

Abstract

The recent in crease in drug abusers in the criminal justice system has led to the expansion of corrections-based drug treatment facilities. Although three key evaluations have provided consistent support for the effectiveness of drug treatment within the criminal justice system, direct comparisons of outcomes across these evaluations are limited by variations in their measurement systems and the structure of official records on which they are based. This article addresses some of the issues relating to the assessment of treatment outcomes for the drug-abusing offender and provides several recommendations for future research.