开展临床药学的有效方法探讨

临床药学是指药学与临床相结合,直接面向患者,以病人为中心,研究与实践临床药物治疗,提高药物治疗水平的综合性应用学科。以提高药物治疗的安全性、有效性与经济性为目标。但是临床药学服务工作在我国各级医院的发展不但缓慢,而且不平衡。在经济比较发达地区、大专院校、科研院所的附属医院,临床药学开展的比较好。而在经济欠发达地区和基层医院,临床药学发展非常缓慢,部分医院几乎还是空白。那么该如何有效开展临床药学工作,根据实际工作经验,结合相关报道和法律法规的要求,对切实有效的开展临床药学工作方法作一探讨。     

适应现代医院模式 重视发展临床药学

随着医院药学从传统药学经临床药学逐步向全面药学治疗服务发展,传统临床药学以“药”为重点的工作模式已不能满足临床医学发展的需要,临床药学的工作范畴逐渐由传统的工作服务型转变为学术服务型,要求药师直接介入病人用药全过程,以保证药物治疗过程中的安全、有效、经济、合理。我院于二十世纪九十年代初即开始着手这一转变工作,经过多年摸索总结,在药物经济学分析、血药浓度监测、药物不良反应监察、用药咨询、临床药师培训和药品供应管理方面取得了明显成效。近年来,我院的     

应对突发地震灾害事件医院药品应急保障和药学服务

目的通过对汶川地震救灾中药品应急保障和药学服务的总结,探讨医院药剂科在应对重大灾害事件中做好药品保障和药学服务经验。方法对保障过程的药品品种及药学人员的服务特点进行研究。结果在地震灾害救援中,药品保障品种以止血药、升压抗休克药、手术麻醉用药、抗破伤风药物、注射剂及抗微生物类药物等为主;药物剂型宜选择便于携行,不易破碎的品种,如袋装注射剂;大量伤员救治过后,药品保障以预防治疗常见病为主。结论医院药剂科在各种突发灾害事件的救援中是药品保障和药学服务的主要力量,研究如何应对药品应急保障和药学服务,具有重大意义。     

药师发展方向——药学服务

20世纪 70年代就已经提出了“药学服务 (Pharmaceuticalcare ,PC)”这一概念 ,1990年 ,Hepler和Strand明确了药学服务的含义 :药学服务 (PC)是提供直接的、负责的药物治疗 ,其目的是让患者达到一个明确的治疗目标 ,进而改善患者的生活质量。药学服务是以患者为中心的服务 ,改变了以往药学工作者以药品和供应为中心的传统观念。药学服务的工作内容应在各个医疗机构之间保持连续性即全程化药学服务。1　药学服务的必要性当今疾病治疗最主要的手段就是使用药物。药物在发挥防病治病作用的同时 ,也给患者带来了负面作用 ,造成患者乃至社会的…     

中国军事药学的历史与发展

军事药学的定义:为军事服务,保障军队作战行动与保证军人健康的药学即为军事药学。它几乎包括药学科学的各个领域,如中草药学、药剂学、药理毒理学、药物化学、药物分析、药事管理、药物情报、药学教育、军需药物供应(包括平时的预防与治疗药物和战役战斗的药材保障等)以及药物科研、生产和药学史等。     

临床药学较难实施的原因及对策

根据2005年全国卫生工作会议精神,今年在全国各级各类医院开展“以病人为中心,以提高医疗服务质量为主题”的医院管理年活动,与此同时开展“以病人为中心,以合理用药为核心”的临床药学工作也成为了医院管理年活动中药剂科工作的重要内容。但在我国医院药师参与临床药物治疗活动、提供药学信息咨询、促进合理用药等方面的基本临床药学工作还比较滞后,与先进发达国家相比尚有一定差距,主要表现在药师的知识结构、思想观念、心理素质等方面。下面笔者结合本院临床药学工作存在的问题及对策谈点初浅的看法: 1 知识结构先天不足我国药学教育背景中知识结构以化学为主,强调学生实验技能培养,一些与临床相关的病理、诊断     

临床药学现状和发展研究

随着人类社会的发展,医疗改革不断向前推进,医学已进入了全新的发展阶段,医院药学也步入了转型与发展的轨道。新的医改方案中提出了基本药物制度的两个目标［1,2］：一是提高贫困人群对基本药物的可及性：二是促进合理用药。2002年1月21日由卫生部、国家中医药管理局颁布实行的《医疗机构药事管理暂行规定》第十条明确指出药学部门要建立以病人为中心的药学管理工作模式,开展以合理用药为核心的临床药学工作,参与临床疾病诊断,治疗,提供药学技术服务,提高医疗质量。临床药学系指医院药学面向临床,以患者为中心,研究与实践临床药物治疗,保障药物合理应用,提高药物治疗质量的应用型技术学科［3］。医院药学面临由“传统保障供应型”向“临床药学服务型”转变与发展,将从以下几方面对临床药学现状及发展进行分析与探讨。     

2007年度中国药学发展奖天士力创新药物奖推荐工作在全国全面展开

经国家科技部奖励工作办公室同意，天津天士力制药股份有限公司提供500万元在中国科学技术发展基金会药学发展基金委员会设立中国药学发展奖天士力创新药物奖。该奖的设立旨在奖励在研制创新药物领域做出突出贡献或取得重大科技成果的科技工作者，促进创新药物的研究和发展，赶超世界先进水平，振兴我国的药学事业。     

门诊药师如何开展药学服务

药学服务是药师应用药学专业知识向公众(含医务人员、病人及其家族)提供直接的负责任的与药物使用有关的服务(包括药物选择、药物使用知识和信息),以期提高药物治疗的安全性、有效性与经济性,实现改善与提高人类生活质量的理想目标。药学服务是高于临床药学之上的一个重要概念,强调以病人为中心的主动服务,注重关心和关怀病人。作为一个门诊药师,除了做好基本的调剂工作、被动的药物咨询外,还应将药学服务的观念渗透于日常工作中,增强服务的主动性,促进合理使用药品,提高药物疗效,减少不良反应的发生。1药物选择1.1由于新药层出不穷、一药多…     

药学信息技术在新的药学服务模式中的拓展应用

20世纪90年代由Hepler等提出的药学服务（Pharmaceutical care）已成为医院药学的又一崭新工作模式，目前在我国正处于初步建设和普及推广阶段。该模式中强调的“向包括医生、护士、患者以及普通民众的广大人群提供及时、准确、全面的药物相关信息，即实行药学信息服务（Pharmceutical information service）”是该药学服务模式所有工作的中心和基础，这一切又都离不开以计算机网络为标志的现代药学信息技术的拓展和完善。本文拟对药学信息技术在新的药学服务模式中的拓展应用作些初步探讨。     

Romanian medicine,European medicine

The aim of the present paper is to present the message transmitted by the Presidential Lecture given during the first congress of arthroscopy organised in Romania, in March 2016, by the Romanian Society of Arthroscopy and Sports Trauma (SRATS). The goal was to present the evolution of medical care in Romania over the years, with the remarkable progress made in the first half of the twentieth century and the current status of arthroscopic surgery as seen from the point of view of medical professionals, as well as from a governmental point of view.     

再生医学与中医

目的：探讨徐荣祥再生医学中的中医原理。方法：依据中医学理论，分析徐荣祥再生医学理论的形成过程，比较徐荣祥再生医学的理论和实践，阐述其中医学原理。结果：徐荣祥再生医学有意识或无意识的获取了中医学的许多精髓，而其研究方法又借助了现代医学的诸多先进方法。结论：再生医学是中西医相互借鉴，创立新的医学体系的样板。     

Military medicine and medicine of accidents

The article presents an observe of such parts of military medicine as intensive aid and operative treatment on the place of case, contestation against infectious diseases, preservation of psychic health, medical and social rehabilitation. Were lighted successful activity of military physicians during liquidation of Chernobyl accident (1986), earthquakes in Armenia (1988), railway accident in Bashkiria (1989) and other accidents. Experience of military medicine (particularly using medical units of special purposes) was used in proving of conception of medicine of accidents, and in organization of medical supply of troops in armed conflicts of restricted scale--in effectuating of antiterrorist operations in Northern Caucasus (1994-1996, 1999-2002), in effectuating of peacemaking operation in Kosovo (1999-2003), natural disasters.     

Complementary alternative medicine and nuclear medicine

Complementary alternative medicines (CAMs), including food supplements, are taken widely by patients, especially those with cancer. Others take CAMs hoping to improve fitness or prevent disease. Physicians (and patients) may not be aware of the potential side-effects and interactions of CAMs with conventional treatment. Likewise, their known physiological effects could interfere with radiopharmaceutical kinetics, producing abnormal treatment responses and diagnostic results. Nuclear medicine physicians are encouraged to question patients on their intake of CAMs when taking their history prior to radionuclide therapy or diagnosis. The potential effect of CAMs should be considered when unexpected therapeutic or diagnostic results are found.     

Eminence-based medicine versus evidence-based medicine: level v evidence in sports medicine

Through extensive survey analysis, we investigated expert opinion in sports medicine. The study had 3 purposes: to provide clinical guidance for cases in which the correct action is not necessarily apparent, to examine expert opinion itself, and to delineate areas of future study. A total of 500 members of the American Medical Society for Sports Medicine and the American Orthopaedic Society for Sports Medicine evaluated a set of 25 statements on unresolved issues in sports medicine. The following 10 statements were deemed false: "It's okay for 12-year-old pitchers to throw curve balls; it's the pitch count that matters"; "Resistance training ('weight lifting') should be avoided until physeal closure"; "Jogging during pregnancy is to be avoided"; "At an athletic event, if sideline coverage is offered by an emergency medical technician and athletic trainer, there is little additional benefit from having a physician present"; "Contact sport athletes who sustain a second concussion should be excluded from contact sports permanently"; "The utility of pre-season medical screening is derived from the history; as such, student-athletes should complete a questionnaire, with physical examination reserved for only those with a positive relevant history"; "Femoroacetabular impingement is a myth-the designation of anatomic variation as disease"; "An AC (acromioclavicular) separation in a contact athlete should not be treated surgically if the athlete won't give up the sport; it will fail"; "Ankle taping induces weakness and atrophy of the dynamic stabilizers of the ankle"; "Only autografts should be used in ACL (anterior cruciate ligament) surgery, as allografts have an unnecessary high failure rate in clinical practice." One statement was accepted as true: "Surgery to treat anterior (patello-femoral) knee pain in a patient with normal patellar mechanics and stability is contraindicated." In short, expert opinion may be a helpful adjunct to clinical practice. Expert opinion cannot replace individual judgment and certainly does not trump the primary medical literature. Yet when better evidence is lacking, expert opinion is valuable for even the staunchest practitioner of evidence-based medicine.