我院精神科门诊患者苯二氮(艹卓)类药物的应用分析

目的 分析我院精神科门诊患者使用苯二氮(艹卓)类(BDZ)药物的情况.方法 随机选取2011、2012年我院精神科门诊使用BDZ的患者243例,统计两年BDZ处方诊断及使用药物情况.结果 2011年和2012年BDZ处方诊断情况比较,差异无统计学意义(P＞0.05);两年均以抑郁、失眠诊断为主.2011年和2012年BDZ处方用药情况比较,差异无统计学意义(P＞0.05);两年均以氯硝西泮、阿普唑仑及艾司唑仑为主.结论 本院处方中BDZ治疗的临床症状主要为失眠和抑郁,主要以中、长效BDZ药物为主.     

女性精神分裂症患者应用苯二氮类药物分析

目的分析苯二氮类(BDZ)药物在女性精神分裂症患者中的应用情况。方法采用自制量表对住院的119例女性精神分裂症患者使用BDZ情况进行调查。结果抗精神病药物合用BDZ者56例(4706%)，以应用硝西泮、氯硝西泮为多。结论苯二氮类辅助抗精神病药治疗精神分裂症使用率很高，疗效好，使用安全，但临床上应注意合理用药，避免医源性药物依赖。     

女性精神分裂症患者应用苯二氮Zhuo革类药物分析

目的分析苯二氮Zhuo类(BDZ)药物在女性精神分裂症患者中的应用情况。方法采用自制量表对住院的119例女性精神分裂症患者使用BDZ情况进行调查。结果抗精神病药物合用BDZ者56例(47．06％)，以应用硝西泮、氯硝西泮为多。结论苯二氮Zhuo类辅助抗精神病药治疗精神分裂症使用率很高，疗效好，使用安全，但临床上应注意合理用药，避免医源性药物依赖。     

女性精神分裂症患者应用苯二氮(艹卓)类药物分析

目的分析苯二氮NFDA8类(BDZ)药物在女性精神分裂症患者中的应用情况.方法采用自制量表对住院的119例女性精神分裂症患者使用BDZ情况进行调查.结果抗精神病药物合用BDZ者56例(47.06%),以应用硝西泮、氯硝西泮为多.结论苯二氮(艹卓)类辅助抗精神病药治疗精神分裂症使用率很高,疗效好,使用安全,但临床上应注意合理用药,避免医源性药物依赖.     

140例住院精神病患者苯二氮(艹卓)类药物使用情况分析

目的:了解我院住院精神病患者苯二氮(艹卓)类药物(BDZ)使用情况.方法:填写BDZ使用监测表,对586例住院精神病患者BDZ使用情况进行回顾性分析.结果:住院精神病患者合并使用BDZ占23.9%,其中发生依赖为32.1%.BDZ用于镇静催眠占82.9%;使用种类以氯硝安定为多,占74.3%;BDZ合并抗精神病药物(APD)以利培酮为多,占25.7%.结论:住院精神病患者BDZ的用药剂量及用药原因是合理的,但不宜长期使用.     

曲唑酮治疗苯二氮(艹卓)类依赖患者疗效观察

目的观察对抗焦虑药苯二氮类(BDZ)依赖的患者使用曲唑酮替代的疗效。方法符合DSM-Ⅲ-R诊断标准的15例BDZ依赖患者住院治疗2周,给予曲唑酮(50~150mg,1次/d),并快速减少其BDZ类药物的每日用量。之后每周进行一次门诊检查,随访3个月,剂量根据个人情况增减。结果在BDZ药物逐渐减量阶段很少出现戒断现象,在随访的3个月中,所有患者保持停用BDZ类药物且没有滥用曲唑酮现象,同时焦虑、抑郁症状明显改善。汉密尔顿焦虑量表(HAMA)评分从12.5降为5.3(P<0.05),汉密尔顿抑郁量表(HAMD)评分从11.8降为4.9(P<0.05)。结论曲唑酮对BDZ类药物有滥用危险的焦虑患者可作为长期治疗的重要替代药,且曲唑酮没有潜在的滥用可能性。     

老年精神科安全用药护理管理及成效

目的:分析老年精神科护理用药安全管理的现状,探讨用药安全管理的相关措施,完善护理用药安全管理水平。方法:成立老年精神科护理用药安全管理小组,分析用药流程的安全隐患,制定有效的用药安全流程,进行临床护理用药安全的培训,加强质量控制与管理。结果:在老年精神科实施有效的安全用药流程管理后,护理用药差错发生率显著低于实施前,且药物过期发生率显著低于实施前,差异均具有统计学意义(P0.05;同时患者投诉率也有了显著下降(P0.05)。结论:在老年精神科实施临床护理用药安全管理,完善了安全用药流程,规范了护理行为,减少了用药差错,保障了患者用药安全,提高了临床护理质量。     

140例住院精神病患者苯二氮类药物使用情况分析

目的了解我院住院精神病患者苯二氮(艹卓)类药物(BDZ)使用情况.方法填写BDZ使用监测表,对586例住院精神病患者BDZ使用情况进行回顾性分析.结果住院精神病患者合并使用BDZ占23.9%,其中发生依赖为32.1%.BDZ用于镇静催眠占82.9%;使用种类以氯硝安定为多,占74.3%;BDZ合并抗精神病药物(APD)以利培酮为多,占25.7%.结论住院精神病患者BDZ的用药剂量及用药原因是合理的,但不宜长期使用.     

140例住院精神病患者苯二氮革类药物使用情况分析

目的：了解我院住院精神病患者苯二氮草类药物(BDZ)使用情况。方法：填写BDZ使用监测表，对586例住院精神病患者BDZ使用情况进行回顾性分析。结果：住院精神病患者合并使用BDZ占23．9％，其中发生依赖为32．1％。BDZ用于镇静催眠占82．9％；使用种类以氯硝安定为多，占74．3％；BDZ合并抗精神病药物（APD)以利培酮为多，占25．7％。结论：住院精神病患者BDZ的用药剂量及用药原因是合理的，但不宜长期使用。     

苯二氮(革)类药物使用情况分析

目的 探讨苯二氮(革)类(BDZ)药物的使用情况,促进临床合理用药.方法 抽取门诊西药处方12 360张,对其中816张含有BDZ药物的处方进行分析,并以限定日剂量(DDD)和药物利用指数(DUI)为指标分析研究其使用情况.结果 含有BDZ药物的处方占总处方的6.60％,出现率最高的为阿普唑仑,占46.81％；其后依次为氯硝西泮(39.21％)、艾司唑仑(10.05％),地西泮(3.92％),BDZ药物使用的DUI均小于1.处方中用药时间超过4周的处方高达60.42％,其中超过8周的处方为8.82％,最高处方时间为90d.结论 BDZ药物的使用基本合理,没有滥用倾向；但存在对BDZ药物使用日处方教较高等问题.     

Psychiatric disorders in a sample of repeat impaired-driving offenders

OBJECTIVE: This study was conducted to assess alcohol- and drug-use disorders and other psychiatric disorders in a sample of repeat driving under the influence (DUI) offenders. METHOD: We interviewed offenders to estimate lifetime and 12-month prevalence of psychiatric disorders as designated by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (alcohol and drug abuse and dependence, major depressive or dysthymic disorder, bipolar disorder, post- traumatic stress disorder [PTSD], and obsessive-compulsive disorder). The offenders interviewed (385 men, 74 women) were those who had been adjudicated in the Multnomah County, OR, Driving Under the Influence of Intoxicants Intensive Supervision Program. Psychiatric diagnoses were assessed using the Composite International Diagnostic Interview. RESULTS: The majority of respondents (53.8%) were alcohol dependent. Sixty-five percent of men and 79.7% of women had at least one lifetime disorder comorbid with alcohol abuse or dependence. The most prevalent lifetime non-substance-use disorder was major depressive or dysthymic disorder (30.9%) followed by PTSD (15.3%). Approximately 40% of subjects reported meeting criteria for lifetime nonalcohol drug abuse for at least one drug type, and 30% were drug dependent for at least one drug type; overall, 54% of all offenders had drug abuse or dependence disorders. CONCLUSIONS: Assessment and treatment services for repeat alcohol-impaired driving offenders should be sufficiently comprehensive to provide care for drug-use disorders and other psychiatric problems.     

55例患者应用氯诺昔康镇痛效果及其不良反应回顾性调查

目的 :评价55例住院患者服用氯诺昔康的效果及其不良反应情况。方法 :回顾性调查住院患者应用氯诺昔康的镇痛效果、不良反应发生率及用药合理性。结果 :55例疼痛患者应用氯诺昔康后疼痛缓解率为100 % ;发生药品不良反应3例 (5.45 % ) ;不合理用药18例 (32.73 % ) ;不良反应的发生与患者年龄及不合理合并用药有关。结论 :氯诺昔康镇痛疗效确切 ,但应避免不当的合并用药。     

Dual Diagnosis and Chronology of Illness in Treatment-Seeking Italian Patients Dependent on Heroin

ABSTRACT

Although there are studies describing the prevalence of patients with drug addiction and dual diagnosis, there is a paucity of data regarding the progression from psychiatric disorders to drug addiction or vice versa. A total of 1,090 patients dependent on heroin were interviewed to examine the presence of dual diagnosis and the progression from psychiatric disorders to drug dependence or vice versa. A total of 574 patients met the criteria for a dual diagnosis. A total of 362 patients progressed from substance abuse disorders to psychiatric disorders (SUD-PR) and 144 patients progressed from psychiatric disorders to drug addiction (PSY-PR). SUD-PR patients are more frequently affected by mood disorders. PSY-PR patients were more frequently diagnosed as psychotic or affected by anxiety disorders. The authors’ findings suggest that the self-medication theory of dual diagnosis was relevant only for those with existing diagnoses of schizophrenia or anxiety disorders. When treating patients with a dual diagnosis, clinicians should ensure that the same attention is given to the treatment of drug dependence as it is to the treatment of comorbid psychiatric conditions.     

Impairment of performance associated with long-term use of benzodiazepines

The long-term effects of benzodiazepines (BDZ) on psychomotor and cognitive functions were assessed in 28 out patients, users of low therapeutic doses of diazepam (13.6 ± 4.9 mg/day, range: 5-20 mg/day) for 5-20 years (10.1 ± 5.0 years). These patients' performance was compared with two control groups: 53 BDZ-free anxious out patients and 56 healthy volunteers. The three groups were similar in sex, age and education. BDZ chronic users were tested before and after short-term (3 weeks) and long-term discontinuation (at an average of 10 months). Performance of chronic users of BDZ was consistently worse than those of the control groups, suggesting an impairment in these patients on both psychomotor and cognitive functions. These were not related to either dose or cumulative exposure to BDZ, and were also independent of diagnosis and levels of anxiety and depression. Moreover, these deficits were persistent as their performance failed to improve after drug discontinuation.     

河南郑州新乡农村家庭过期药品处置的现状调查

目的：报道农村家庭过期药品处置的抽样调查情况,以引起社会对农村家庭过期药品处置问题的广泛关注,为农村居民用药安全管理提供参考。方法以河南省郑州市、新乡市的农村地区为例,针对家庭储存药品习惯、对药品有效期了解程度、过期药品处理方式等方面,采用自制调查问卷,随机对500名当地居民进行调查,获取不同家庭、不同年龄、不同社区的数据,并用 SPSS v19.0作数据统计和相关性分析。结果该地区农村家庭安全用药意识薄弱,对过期药品的处理方式存在很多误区,存在较大的用药安全及环境危害隐患。结论应推进家庭过期药品回收工作,加强合理用药宣传,改善农村地区不恰当的过期药品处置习惯,以保障农村居民用药安全。     

Dual diagnosis and chronology of illness in treatment-seeking Italian patients dependent on heroin

Although there are studies describing the prevalence of patients with drug addiction and dual diagnosis, there is a paucity of data regarding the progression from psychiatric disorders to drug addiction or vice versa. A total of 1,090 patients dependent on heroin were interviewed to examine the presence of dual diagnosis and the progression from psychiatric disorders to drug dependence or vice versa. A total of 574 patients met the criteria for a dual diagnosis. A total of 362 patients progressed from substance abuse disorders to psychiatric disorders (SUD-PR) and 144 patients progressed from psychiatric disorders to drug addiction (PSY-PR). SUD-PR patients are more frequently affected by mood disorders. PSY-PR patients were more frequently diagnosed as psychotic or affected by anxiety disorders. The authors' findings suggest that the self-medication theory of dual diagnosis was relevant only for those with existing diagnoses of schizophrenia or anxiety disorders. When treating patients with a dual diagnosis, clinicians should ensure that the same attention is given to the treatment of drug dependence as it is to the treatment of comorbid psychiatric conditions.     

2001～2005年精神病专科医院口服降糖药利用分析

目的:分析精神病专科医院住院患者口服降糖药使用数据,为临床用药提供参考。方法:利用医院信息系统数据库,统计2001～2005年口服降糖药使用数据,分析药物利用情况。结果:根据DDDs排序以及消耗金额排序,二甲双胍为我院最常用的口服降糖药;格列喹酮金额排序稳居第一,金额与序号比值逐年上升;磺酰脲类为我院治疗糖尿病的一线药;整体上看,我院更倾向于使用低价位的磺酰脲类和双胍类药,但糖尿病患者60%血糖控制不理想。结论:我院现有口服降糖药已不能满足需求,应引进新型药物,同时结合精神病病人的特点采用综合治疗。