住院精神疾病患者诊断和药物使用情况调查

目的 调查我院住院精神疾病患者的诊断和药物使用情况,提高医院临床合理用药水平.方法 于2019年10月6日对我院住院的218例精神疾病患者的临床诊断及用药情况进行统计分析.统计入组患者疾病诊断与分类情况,抗精神病药物联合使用情况,单一抗精神病药物使用情况,药物使用频率及剂量,缓解药物副反应用药情况.结果 入组患者中,精...     

抗精神病药物在老年精神病患者中的应用研究

选取2013年我院收治的100例60岁以上的精神病患者的电子病例及其处方,统计针对这些老年精神病患者治疗中抗精神病药物的使用情况,并对应用的抗精神药物的使用情况进行客观的调查分析。结果 100例老年精神病患者中有71例患者在应用抗精神病药物进行治疗,在这些患者中,又包含着52例应用单独的一种抗精神病药物进行治疗的精神病患者以及19例联合应用两种抗精神病药物进行治疗精神病患者。经过分析,在应用抗精神病药物的用药日剂量上将情感性精神障碍、精神分裂症与慢性乙醇中毒所致精神障碍、阿尔茨海默病、躯体疾病所致精神障碍、脑血管病所致精神障碍进行比较,差异均有统计学意义(P0.05),但将情感性精神障碍与精神分裂症二者进行比较,差异无统计学意义(P0.05)。老年精神病患者的用药剂量在精神病患者性别上进行比较,女性精神病患者在应用抗精神病药物的平均日剂量为7.11±5.71mg,男性精神病患者在应用抗精神病药物的平均日剂量为6.70±7.38mg,二者相比差异无统计学意义(P0.05)。应用抗精神病药物治疗老年精神病时应格外注意,并且做到定时定期的调查研究老年精神病患者的抗精神病药物的使用情况。     

抗精神病药物临床使用情况的调查分析

目的 了解抗精神病药物临床使用情况，分析合理用药中应注意的问题。方法 采用自行设计的调查表，统计和分析3所精神病院共1000例住院精神病患者资料。结果 抗精神病药物使用前六位的依次是氯丙嗪、氯氮平、利培酮、奋乃静、氟哌啶醇、舒必利。72％的患者用药剂量为200～600mg／d，单一用药占87％。老年与有躯体合并症者中选用氯丙嗪、氯氮平或“双氯”合并较为多见。结论 多数住院患者用药规范、剂量合理，但老年与有躯体合并症患者的用药选择、剂量的控制和联合用药存在不合理现象，是安全、合理使用抗精神病药物中亟需注意的问题。     

老年住院精神病患者跌倒损伤的原因分析与护理对策

目的：了解老年住院精神病患者跌倒的原因,制定相应的护理对策。方法：对对43例老年精神病患者住院期发生跌倒损伤的相关因素进行回顾性调查分析,并提出护理对策。结果：收治的老年精神病患者1009例中发生跌倒损伤43例（4.3%）,其中以阿尔茨海默病、使用抗精神病药物及夜间跌倒发生率最高。结论：针对住院老年精神病患者跌倒原因,采取对专业护理人员进行上岗前培训,对患者及家属进行安全防范教育及改善住院环境等相关的护理对策,可减少住院期间跌倒损伤的发生率。     

三种类型医院抗精神病药物使用情况比较

目的：比较三种不同类型医院抗精神病药物使用情况，为临床用药提供参考。方法：采用全国精神科药物使用调查表同时对一所教学医院精神科门诊患者94例（13－84岁）、住院患者119例（12－76岁）一所市级精神病院门诊患者95例（17－77岁）、住院患者142例（14－77岁）；和一所区级精神病院门诊患者34例（19－72岁）、住院患者117例（20－70岁）在连续5天内抗精神病药物使用情况进行调查。结果：不同类型医院患者的人口学资料和一般情况有差异；在教学医院，患者的首次入院和诊断抑郁症的比例较高；住院时间较短；非典型抗精神病药的应用比例较其他类型的医院高，以维思通和氯氮平的应用为主；在联合用药方面，联合应用氯氮平的比例最高；在不同类型的医院，典型抗精神病药舒必利的应用比例均居首位。结论：不同类型医院使用抗精神病药物情况不同，教学医院使用非典型抗精神病药的比例较高。     

住院精神病患者临床用药状况调查

目的 了解我院住院精神病患者用药现状,为提高临床合理用药水平提供依据.方法 对561例住院精神病患者的用药现状进行统计分析.结果 54.9%的患者为单一用药;药物使用频率最高者为利培酮(49.2%).结论 我院住院精神病患者用药较为规范,新型非典型抗精神病药已成为临床用药主流.     

住院精神病患者噎食窒息的成因分析

目的探讨住院精神病患者噎食窒息的危险因素。方法对1998年8月至2013年2月在九龙坡区精神卫生中心发生的27例噎食窒息精神病患者的临床资料进行分析。结果 27例噎食窒息患者中,老年22例,中年5例;15例单独使用典型抗精神病药物,3例单独使用非典型抗精神病药物,8例联合使用抗精神病药物,1例未使用抗精神病药物;咬合牙对数多于10对者2例,少于10对者22例,情况不清楚3例;活动能力明显下降10例,长期卧床5例,生活完全能自理12例;11例患者站立进食发生,7例患者在行走间进食发生,5例患者在坐着进食发生,4例患者进食体位不清;食物为大块肉类11例,为馒头8例,为普通食物5例,为鸡蛋3例;抢救成功20例,死亡7例,死亡病例中6例为馒头所致。结论出现噎食窒息的住院精神病患者常为老年患者,与伴有脑器质性疾病及严重躯体疾病,抗精神病药物不良反应,咀嚼功能下降,活动能力下降,站着进食,进食大块固体食物等因素相关,其中馒头所致的噎食窒息抢救难度大,致死率高。     

精神科门诊应用抗精神病药物状况调查

目的了解我院应用抗精神病药物状况及用药趋势,为提高合理用药水平提供依据。方法采用自编抗精神病药物使用调查表对在我院门诊接受治疗的380例精神病患者的用药状况进行调查分析。结果联合应用抗精神病药物占73．7％,单一应用抗精神病药物占26．3％;单一用药疗效较好,不良反应较轻微;应用频度排前3位依次为氯氮平、奋乃静、利培酮;药物剂量〈400mg·d^-1者疗效明显优于〉400mg·d^-1者,剂量越大不良反应发生率越高,且程度越严重。结论精神科门诊患者应尽量单一应用抗精神病药物治疗,剂量〈400mg·d^-1为宜;不主张长期和预防性使用盐酸苯海索;应推广新型非典型抗精神病药物的应用。     

住院精神病患者抗精神病药物应用现状调查

目的 探讨住院精神病患者抗精神病药物应用现状。方法 对288例住院精神病患者进行了时点调查,并于1992年、1995年的时点调查结果进行了统计分析。结果3a同期抗精神病药物的排序有所不同,但氯氮平名列榜首,联合用药仍常见,抗胆碱能药物应用仍然普遍。结论新一代抗精神病药利培酮、奎的平等被广泛应用,但氯氮平仍是多年来的首选药物。     

老年精神病患者抗精神病药物应用状况调查

目的 了解老年精神病患者抗精神病药物应用状况,为临床合理用药提供依据.方法 对398例老年精神病患者抗精神病药物用药状况进行了调查,并对患者性别、年龄、应用药物种类、药物剂量等临床资料进行统计分析.结果 抗精神病药物应用频率依次为:利培酮(28.14%)、氯丙嗪(21.61%)、奋乃静(17.84%)、氯氮平(13.57%)、舒必利(10.80%)、喹硫平(8.04%);抗精神病药物平均应用剂量低于常规剂量.结论 在老年精神病的临床治疗中,非典型抗精神病药物的比例逐渐增加,药物应用剂量低于常规剂量.     

Lack of effect of vancomycin and gentamicin on auditory function in guinea pigs.

The dispositions of vancomycin (VCM) and gentamicin (GM) in plasma and perilymph after single and multiple administrations and the effects of multiple administrations of VCM or GM alone and the combination of both drugs on auditory function were studied in male guinea pigs. The pharmacokinetic parameters of VCM and GM obtained from plasma drug concentration-time data after single and multiple (22 days) intramuscular administrations of VCM (200 mg/kg of body weight) alone and GM (50 mg/kg) alone were not significantly different from those after combined administration of VCM (200 mg/kg) and GM (50 mg/kg). There was no change in the penetration ratio of VCM and GM into perilymph between administration of VCM or GM alone and the combination of both drugs. Furthermore, the hearing threshold of guinea pigs was not affected by VCM or GM alone or the combination of both drugs within the range of therapeutic VCM and GM levels in plasma in humans.     

阑尾炎手术患者围手术期预防性应用抗菌药物情况及合理性

目的 调查分析阑尾炎手术患者围手术期预防性应用抗菌药物情况,探讨其用药的合理性.方法 随机选取2018年4月至2020年1月在我院实施手术治疗的106例阑尾炎患者作为研究对象.统计患者围手术期预防性应用抗菌药物的情况,并了解其用药时间及联合用药情况,分析用药合理性.结果 106例阑尾炎手术患者中,97例为预防性用药,占...     

少年儿童精神障碍患者精神药物应用状况调查

目的探讨住院少年儿童精神障碍患者精神药物应用状况。方法采用分层整群抽样的方法,抽取121例在我院住院的少年儿童精神病患者的临床资料进行回顾性分析。结果男童59例（48．76％）,女童62例（51．24％）;年龄集中于13a～14a（69例,57．02％）;诊断：精神分裂症37例（30．58％）,心境障碍18例（14．88％）,精神发育迟滞13例（10．74％）,癫痫12例（9．92％）。应用药物频度依次为利培酮（38．84％）、地西泮（24．79％）、氯氮平（21．48％）、丙戊酸钠（17．36%）;单一用药21例（17．35％）,2种联用53例（43．81％）,≥3种46例（38．02％）;31．40％联用苯海索,药物剂量均在正常范围。精神药物副反应发生频度依次为体重增加21．67％、口干15．00％、嗜睡14．17％。结论少年儿童精神障碍临床治疗中注重用药安全,联合用药较多,非典型抗精神药物及新型抗抑郁药物应用增多。     

硝苯地平片在妇产科急诊的超说明书用药情况分析

目的 调查分析我院妇产科急诊用药中硝苯地平片的超说明书用药合理性,并比较硝苯地平片用于晚期先兆流产和先兆早产中的临床效果,为保障妇产科临床上安全合理的用药提供依据.方法 分层随机抽取2020年1月至12月西北妇女儿童医院妇产科急诊的用药医嘱,以药品说明书为依据,对硝苯地平片的超说明书用药情况进行统计.比较硝苯地平片用于...     

我院住院患者抗菌药物使用情况调查分析

目的了解住院患者抗菌药物临床使用情况及存在的问题。方法对我院2010年随机抽取的住院手术病例400例及非手术病例400例抗菌药物的用药频度（DDDs）和费用情况进行调查分析。结果我院2010年DDDs排序前三位的抗菌药物为左氧氟沙星、哌拉西林钠-舒巴坦钠和奥硝唑注射液;预防用药〉72h的病例占84．00％。非手术的400例中使用抗菌药物者128例（32．00％）：治疗性用药92例（71．88％）,预防性用药36例（28．12％）;单用一种抗菌药物94例（73．44％）,二联用药34例（26．56％）,无三联及以上用药。手术的400例中324例（81．00％）为预防性用药;术前使用抗菌药物12例（3．00％）、术后24h内停用6例（1．50％）,术后〉24—48h用药13例（3．25％）,〉48—72h用药45例（11．25％）,〉72h用药336例（84．00％）。400例手术患者中I类切口无联合用药情况,Ⅱ类切口联合用药113例（42．64％）。结论住院患者抗菌药物使用情况存在细菌培养送检率较低、手术患者预防用药时间长、抗菌药物选择不当等问题,应加强与规范临床合理用药。     

Frequency and determinants of drug administration errors in the intensive care unit

OBJECTIVE: The study aimed to identify both the frequency and the determinants of drug administration errors in the intensive care unit. DESIGN: Administration errors were detected by using the disguised-observation technique (observation of medication administrations by nurses, without revealing the aim of this observation to the nurses). SETTING: Two Dutch hospitals. PATIENTS: The drug administrations to patients in the intensive care units of two Dutch hospitals were observed during five consecutive days. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 233 medications for 24 patients were observed to be administered (whether ordered or not) or were observed to be omitted. When wrong time errors were included, 104 administrations with at least one error were observed (frequency, 44.6%), and when they were excluded, 77 administrations with at least one error were observed (frequency, 33.0%). When we included wrong time errors, day of the week (Monday, odds ratio [OR] 2.69, confidence interval [CI] 1.42-5.10), time of day (6-10 pm, OR 0.28, CI 0.10-0.78), and drug class (gastrointestinal, OR 2.94, CI 1.48-5.85; blood, OR 0.12, CI 0.03-0.54; and cardiovascular, OR 0.38, CI,0.16-0.90) were associated with the occurrence of errors. When we excluded wrong time errors, day of the week (Monday, OR 3.14, CI 1.66-5.94), drug class (gastrointestinal, OR 3.47, CI 1.76-6.82; blood, OR 0.21, CI 0.05-0.91; and respiratory, OR 0.22, CI 0.08-0.60), and route of administration (oral by gastric tube, OR 5.60, CI 1.70-18.49) were associated with the occurrence of errors. In the hospital without full-time specialized intensive care physicians (which also lacks pharmacy-provided protocols for the preparation of parenteral drugs), more administration errors occurred, both when we included (OR 5.45, CI 3.04-9.78) and excluded wrong time errors (OR 4.22, CI 2.36-7.54). CONCLUSIONS: Efforts to reduce drug administration errors in the intensive care unit should be aimed at the risk factors we identified in this study. Especially, focusing on system differences between the two intensive care units (e.g., presence or absence of full-time specialized intensive care physicians, presence or absence of protocols for the preparation of all parenteral drugs) may help reduce suboptimal drug administration.     

60例癌症患者麻醉药品应用及管理情况分析

目的分析60例癌症患者麻醉药品应用及管理情况。方法纳入我院癌症患者60例,收集麻醉药品处方79张。记录患者麻醉药品处方不合理率,分析患者麻醉药品用药情况,比较不同麻醉药品的用药频度(DDDs)。结果 79张麻醉药品处方中,不合理处方3张,处方不合理率为3.80%。麻醉药品中,吗啡缓释片的销售金额占比最高(44.02%),其次为羟考酮控释片(28.73%)和芬太尼透皮贴剂(9.72%)。我院麻醉药品中,吗啡缓释片DDDs最高,其次为芬太尼注射液和哌替啶注射液,吗啡注射液DDDs最低。第三阶梯药物的DDDs高于第二阶梯药物。结论我院麻醉药品应用较为合理,临床应根据患者个体情况,选择合理的麻醉药品。     

Risk Factors Associated with Emergency Room Drug Abuse Admissions in Urban Taiwan, 1998-1999

The present study examined the risk factors associated with admissions for drug abuse among patients who visited an accident and emergency (A & E) department at a large metropolitan teaching hospital in Taipei, Taiwan. Two hundred and fifty-four consecutive patients reporting problems related to suspected intentional drug poisoning or acute intoxication from drugs of misuse were matched to 254 patients with internal medicine conditions unrelated to drug abuse by age within three years. Risk factors and drug use information was obtained by questionnaire. Between December 1998 and November 1999, 272 (0.7%) patients had visited the A & E for treatment of drug-related problems. Among these patients, 254 (93%) completed questionnaires and were enrolled in this study. Major reasons for hospital visits were suicide (51%), and acute drug poisoning (49%); primary drugs used were sedatives/hypnotics (81.7%) and narcotics (4.7%); most drugs came from pharmacies and drug stores (47.2%), hospitals and clinics (25.2%), or were bought from friends (7.1%) or others (11.1%). Being single (OR = 1.7, 95% CI 1.1-2.7), female (OR = 3.4, 95% CI 1.4-10.0), having an alcohol drinking habit (OR = 3.0, 95% CI 1.3-7.2), and having higher depressive scores (OR = 1.3, 95% CI 1.2-1.4) were independently associated with drug abuse. Important preventive measures against drug abuse included improving access to psychological counseling for users and controlling dispension of drugs at pharmacies.     

Use of psychoactive substances in persons with spinal cord injury: A literature review

ObjectiveTo undertake a critical review of literature on use of legal and illegal psychoactive substances (PAS) in persons with spinal cord injury (SCI) before and after trauma.Material and methodsHundred and five articles published between 1980 and 2014 on alcohol and drug use in persons with SCI before and after trauma were retrieved from the PubMed and PsycInfo search engines.ResultsBefore injury, 25% to 96% of people with SCI reported using alcohol, while 32% to 35% had used illegal drugs. At the time of injury, 31% to 50% of individuals with SCI were intoxicated with alcohol, 16% to 33% with drugs and 26% with a combination of drugs and alcohol. Among those reporting PAS use before injury, up to 50% stated that they had reduced their use during active rehabilitation, during which time only 6% consumed psychoactive substances for the first time. A variety of risk factors are associated with consumption subsequent to spinal cord injury: personality alteration (impulsiveness, aggressiveness), posttraumatic depression, poor coping skills, lack of social support and pain. PAS use can affect the process of rehabilitation, diminish the effectiveness of medication and result in various medical complications.Discussion/conclusionsFew studies have explored the use of alcohol, drugs and psychoactive medications before SCI and during active rehabilitation. To our knowledge, no study has analyzed the evolution of PAS use after hospital discharge, even though return home is associated with new stressors that may trigger risky behaviors. It should be a priority, as early as possible during rehabilitation, to detect persons at risk of developing PAS abuse.