2013～2015年镇痛药物应用分析

目的评价我院镇痛药物的临床应用情况,为镇痛药物的管理和临床合理用药提供参考。方法采用回顾性分析方法,对我院2013~2015年镇痛药物的销售金额、用药频度和科室分布进行统计分析。结果我院3年间镇痛药物地佐辛注射液销售金额最高,奥沙普秦片、右旋酮洛芬片和布洛芬缓释胶囊的用药频度最高,麻醉性镇痛药物的使用主要集中在肿瘤科、骨科、产科和普外科。结论我院镇痛药物的使用情况基本合理,个体化给药仍需加强,门诊口服镇痛药物使用应加强监督。     

2001～2003年上海地区镇痛及解热镇痛抗炎药用药分析

目的:探讨上海地区镇痛及解热镇痛抗炎药用药趋势。方法:按购药金额,对上海地区48家医院2001-2003年镇痛药及解热镇痛抗炎药的用药数据作统计,并进行分析。结果:(1)上海地区整个镇痛药用药呈上升趋势,每年增长率在23%以上。用药金额最高的是曲马朵、吗啡;增长率最高的是芬太尼,特别是其贴剂。(2)解热镇痛抗炎药用药水平总体较平稳。较新的品种特别是环氧化酶-2(COX-2)选择性抑制剂和特异性抑制剂有较大增长。传统的非甾体类抗炎药(NSAIDs)用量呈现下降趋势,但仍排名前列。结论:整个镇痛及解热镇痛抗炎药用药构成将会在现有的基础上有较小的改变,镇痛药用量还将继续上升,在NSAIDs类药物中COX-2选择性抑制剂会有进一步增长,而特异性抑制剂用量将减少。     

Determinants of medicine use in a Swedish primary health care practice population

BACKGROUND: Pharmaceuticals represent an increasing share of private and public health care expenditures. The aim of this study was to characterise users and to determine the pattern of uses of prescribed medicines and to identify determinants of medicine use in a multi-ethnic Swedish general practice population. METHODS: The study was performed in 1055 of 1442 consecutive adult patients visiting the Jordbro Health Centre (JHC) in Stockholm, Sweden. RESULTS: In a regression analysis adjusted for the influence of confounders, subjects reporting 10-30 complaint symptoms, subjects with chronic disease and subjects that had a cost limitation card all reported a higher number of used medicines than subjects with a few (0-10) symptoms and those without chronic disease and a cost limitation card. In a Poisson's regression analysis, high age, female gender, not working, more than 10 symptoms, chronic disease and having a cost limitation card were related to use of prescribed medicines. All included variables predicted 19% of the explanation. Marital status, multi-symptomatology, chronic disease and having a cost limitation card were related to polypharmacy in a logistic regression analysis. CONCLUSION: A high number of complaint symptoms, chronic disease and having a cost limitation card were all significantly and independently related to use of medicines and polypharmacy.     

Characteristics of methadone maintenance treatment patients prescribed opioid analgesics

ABSTRACT

Background: Opioid analgesic use and disorders have dramatically increased among the general American population and those receiving methadone maintenance treatment (MMT). Most research among MMT patients focuses on opioid analgesics misuse or disorders; few studies focus on MMT patients prescribed opioid analgesics. We describe demographic, clinical, and substance use characteristics of MMT patients prescribed opioid analgesics and compare them with MMT patients not prescribed opioid analgesics. Methods: We conducted a cross-sectional secondary data analysis using screening interviews from a parent study. From 2012 to 2015, we recruited adults from 3 MMT Bronx clinics. Questionnaire data included patterns of opioid analgesic use, substance use, comorbid illnesses, and demographic characteristics. Our main dependent variable was patients' report of currently taking prescribed opioid analgesics. To compare characteristics between MMT patients prescribed and not prescribed opioid analgesics, we conducted chi-square tests, t tests, and Mann-Whitney U tests. Results: Of 611 MMT patients, most reported chronic pain (62.0%), hepatitis C virus (HCV) infection (52.1%), and current use of illicit substances (64.2%). Of the 29.8% who reported currently taking prescribed opioid analgesics, most misused their opioid analgesics (57.5%). Patients prescribed (versus not prescribed) opioid analgesics were more likely to report human immunodeficiency virus (HIV) infection (adjusted odds ratio [aOR] = 1.6, 95% confidence interval [CI]: 1.1–2.3) and chronic pain (aOR = 7.6, 95% CI: 4.6–12.6). Conclusion: Among MMT patients primarily in 3 Bronx clinics, nearly one third reported taking prescribed opioid analgesics. Compared with patients not prescribed opioid analgesics, those prescribed opioid analgesics were more likely to report chronic pain and HIV infection. However, between these patients, there was no difference in illicit substance use. These findings highlight the complexity of addressing chronic pain in MMT patients.     

门诊肿瘤科癌症患者非阿片类镇痛药处方分析

摘 要 目的： 调查我院门诊肿瘤疼痛患者使用非阿片类镇痛药的用药现状,以促进患者非阿片类镇痛药的合理使用。方法: 通过电子处方抽样,抽取2014年1月1~31日门诊肿瘤科全部处方,其中41张处方含非阿片类镇痛药,对非阿片类镇痛药处方基本指标以及非阿片类镇痛药消费金额、消耗量、非阿片类合用药品情况等指标进行处方分析。结果: 门诊非阿片类镇痛药处方合理率为65.85%,不合理处方主要集中在氨酚羟考酮的用法用量开具不清或缺项、药品剂型或给药途径不适宜或缺项、用法用量不适宜等问题。氨酚羟考酮的处方使用率最高,其次是双氯芬酸钠缓释片,单用一种非阿片类镇痛的比例为73.17%,非阿片和阿片类合用比例为21.95%。结论: 我院非阿片类镇痛药处方合格率偏低,部分处方仍需规范化,应加强对非阿片类镇痛药的使用管理和安全监测。     

湖南地区镇痛药使用频度分析

目的 :探讨镇痛药在医院的使用状况及镇痛药推广应用和发展前景。方法 :应用DDDs排序法对湖南地区 12家综合医院 1997年 - 2 0 0 0年的镇痛药购药量进行分析。结果 :芬太尼针剂、苯噻啶片剂的DDDs排列在第一、二位 ,硫酸吗啡控释片用量上升。结论 :湖南地区 12家综合医院镇痛药使用基本合理 ,但镇痛药使用量小 ,品种少 ,剂型、规格单一。     

某院2010～2012年癌症患者麻醉性镇痛药使用情况分析

目的评估某院癌症患者麻醉性镇痛药使用情况,为临床合理规范使用麻醉性镇痛药提供参考。方法对该院2010～2012年麻醉性镇痛药的用量、DDDs、用药金额及其排序等进行统计、分析。结果金额排序/DDDs比值多数接近于1。结论麻醉性镇痛药临床用药基本合理,金额排序/DDDs比值越大,药物不合理应用的因素越多。     

2016—2017年咸阳市中心医院镇痛药物的使用情况分析

目的 了解咸阳市中心医院镇痛药物的应用现状及变化趋势,为临床合理用药提供参考。方法 收集咸阳市中心医院2016-2017年镇痛药物的应用数据,对其使用金额、用药频度（DDDs）、日均药费（DDC）及药品排序比（B/A）等进行统计和分析。结果 2016-2017年使用金额前3位的分别是地佐辛注射液、右旋酮洛芬肠溶片、酮咯酸氨丁三醇注射液。DDDs前3位的均为治疗轻度疼痛的镇痛药物,分别是右旋酮洛芬肠溶片、酮咯酸氨丁三醇注射液、塞来昔布胶囊。地佐辛注射液的DDC居首位,其他DDC均较2016年有所下降。结论 咸阳市中心医院镇痛药物的应用基本合理,但仍需加强监督管理,规范使用行为。     

Training primary health care professionals to prvide Buprenorphine and LAAM treatment

This paper describes the development and implementation of training programs for primary care medical practitioners and pharmacists in the delivery of buprenorphine and LAAM treatment in the management of opiate dependence. Separate training programs were developed for each medication. Each training package included learning objectives, training materials, and assessment instruments. Findings of the evaluation of these initiatives and the subsequent Australian postregistration training program for buprenorphine are described.     

对抗感染药物不合理应用的门诊处方调查及分析

目的调查某院门诊处方用药情况,促进合理用药,保障患者用药安全有效。方法随机抽取医院2009年1至12月门诊处方共12000张,对其中不合理用药处方进行统计分析。结果不合理用药处方372张,占抽查处方3.1%。结论该院门诊处方用药合理性有所提高,但不合理用药现象仍然存在,医师在加强合理用药的同时,药房工作人员也应加大监督的力度。     

Taming effect of nonnarcotic analgesics on the septal syndrome in rats

A series of nonnarcotic analgesics (aspirin, mefenamic acid, phenylbutazone, aminopyrine and methampyrone) as well as chlordiazepoxide and trazodone were administered to septal rats to examine the effects of these drugs on the hyperreactivity and viciousness characteristic of this syndrome. All the nonnarcotic analgesics tested showed taming effects, as did chlordiazepoxide and trazodone. To examine whether this effect was due to an antiinflammatory action of the nonnarcotic analgesics, acute and chronically prepared septal rats were treated with these drugs at different time periods following lesioning. No noticeable difference of the effect of these drugs existed between acute and chronic groups. The nonnarcotic analgesic drugs have a taming action on septal rats which appears to be independent of an antiinflammatory component.