儿科用药特点与合理用药

药物在治疗疾病的过程中起着重要的作用。小儿处于生长发育的重要阶段,在生理上不同与成人,小儿合理用药非常重要,因此,本文就小儿的药代动力学特点及合理用药的原则阐述如下,并对不合理用药剖析,以引起重视小儿的合理用药,减少不合理用药现象。1.小儿的生理特点及对药代动力学     

消化系统疾病的不合理用药病例分析

目的为促进临床合理使用消化系统疾病用药。方法通过临床药师在药学查房,医嘱审查中收集的具有代表性的消化科不合理用药的医嘱,进行详细的用药分析。结果消化系统疾病用药医嘱存在不合理使用现象。包括无指征使用药、选药不当、用药方法不当、相互作用等。结论通过临床药师医嘱分析,参与药物治疗过程,从药物的适应证、药代动力学、药物相互作用、不良反应、配伍禁忌等方面充分发挥自身优势,能够及时发现临床消化系统疾病不合理应用现象,提高医师药物治疗水平,确保患者用药安全、有效、经济。     

儿科合理用药原则及不合理用药

儿童时期,是人生长发育的一个重要时期,儿童的各脏器功能及各大系统(如免疫系统、消化系统、呼吸系统、中枢系统等)都未发育完善,与成人有着明显的差别;另外,儿童对药物的排泄速度及代谢均异于成人,与成人相比,儿童更加容易产生药物不良反应。因此,临床用药治疗中,医师必须熟悉各种儿童药物的作用、性质、剂量、用药注意事项及相关的合理用药原则,避免发生不合理用药现象[1]。为了探讨儿科不合理用药现象及合理用药原则,本文特针对如何合理安全使用儿科药物进行分析,现综述如下。1儿科合理用药的原则[2]1.1合理药物选择在给予患儿药物治疗前,医师必须要先     

门诊西药房中儿科处方的不合理用药分析

目的 分析儿科处方在我院门诊西药房中的不合理用药情况.方法 研究中收集我院2014年1月～2016年1月门诊西药房的儿科处方,随机抽选60张,对所抽选的处方资料进行审查并加以分析,对其中用药不合理的儿科处方挑出来,对其进行归类分析.结果 在对我院随机抽取的60张儿科处方用药审核中发现,其中有22张儿科处方存在不合理用药情况.分析归类用药不合理情况包括:2例不合理的药物选用、4例不合理的给药周期、8例不合理的抗生素使用情况、5例不合理的药物配伍、3例不合理的联合用药时间.结论 儿科处方的合理安全用药在门诊西药房中是非常重要的,为减少不合理用药的频率,我院可针对门诊医生进行合理用药知识的培训,以便提高我院门诊西药房的用药安全度.     

分析我院儿科门诊用药现状促进临床合理用药

目的：分析我院儿科门诊用药现状,为促进临床合理用药提供建议。方法：从我院儿科门诊2014年1～3月开具的处方中随机抽取1250张进行研究,对儿科疾病构成比、处方用药分布及抗菌药使用情况进行归纳统计,明确儿科门诊中不合理用药情况。结果：我院儿科门诊疾病以上、下呼吸道感染为主,占61.0%（762/1250）;抗菌药物使用率为64.0%（800/1250）,其中三代头孢药物使用率占18.75%（150/800）;800张抗菌处方中,76%为口服中成药,使用率最高,12%为注射剂,均为单联用药。不合理用药以无指征滥用抗菌药物几率最高,达到31.0%,其次为选药不合理及重复用药。结论：我院儿科门诊用药做到中西药并重,抗菌药物使用率高,但给药途径相对合理,三代头孢抗菌药物选择占18.75%,用药起点偏高,易导致耐药菌,需引起注意。     

我院门诊儿科处方不合理用药分析

目的:调查门诊儿科处方中的不合理用药情况,探讨合理的给药方案。方法:在2004年6月~2005年5月本院门诊儿科处方中,每月随机抽取2天的处方共18 842张进行分析统计。结果:不合理处方762张,分别在溶媒使用、给药间隔、选择药物、合并用药以及重复用药等方面存在问题。结论:我院儿科门诊处方中抗生素的不合理使用较明显,应加强抗菌药物合理应用的再学习。     

糖皮质激素类药物的用药误区及合理用药分析

目的 分析糖皮质激素类药物的用药误区及合理用药.方法 入选2014年1月至2017年1月使用糖皮质激素类药物的患者120例,分析患者的糖皮质激素类用药情况,使用误区并提出合理用药策略.结果 120例使用糖皮质激素类药物分患者分布在各科室的使用情况为儿科、呼吸科、妇产科和骨科,其中呼吸科三种及以上糖皮质激素类药物联用的使用率为32.4%,明显高于儿科、妇产科和骨科,差异有统计学的意义(P<0.05).用药误区包括与其他药物相互作用发生不良反应,当成退热药使用,当成抗生素使用,在慢性疾病和皮肤疾病中滥用.结论 糖皮质激素类药物使用错误会增加药物治疗中的不良反应的发生,产生药源性疾病,分析使用误区有利于合理用药的提出,可避免糖皮质激素类药物的临床中滥用.     

浅谈儿童合理用药

儿童不合理使用药物对儿童身体危害极大,本文通过从儿童本身用药特点及合理选用药物的品种、使用剂量、用药时间以及给药途径等方面来阐述针对儿童应该如何正确合理用药,减少不良反应发生。     

某院儿科门诊处方用药分析

目的分析某院儿科门诊使用药物的情况,为合理用药提供依据和参考。方法抽取2019年1月~6月儿科门诊处方2350张,统计分析儿科的疾病分布比例,抗菌药物的使用状况和不合理处方。结果2350张儿科门诊处方中,抗菌药物的使用比例为62%,不合理处方的比例为8%。结论儿科门诊处方存在不合理用药的情况,应该从医生、药师等方面改善我院不合理用药的现象,促进儿科用药合理性。     

小儿临床合理用药分析

药物是治疗疾病的一个重要手段,而其不良反应和过敏反应常会对机体产生不良影响.尤其是儿童这个群体,由于其本身的生理特点和药物在体内代谢过程的特殊性,发生药物不良反应(adverse drug reaction,ADR)的几率更大.我国现有＜14岁的儿童约4亿,而我国每年约有3万名儿童因不合理应用药物而导致耳毒性药物致聋及其他ADR.因此,儿童合理用药,保证儿童健康成长关系到祖国的未来、生存与发展,具有现实和深远的历史意义.现结合小儿的生理特点、小儿药物治疗的特点及如何科学合理的使用儿科药物综述如下.     

Early onset of drug and polysubstance use as predictors of injection drug use among adult drug users

Early onset of alcohol, marijuana, and cigarette use is an indicator of later substance use problems in adulthood such as alcohol or other drug dependence. This paper seeks to address the association between early onset alcohol, marijuana, cigarette, and polysubstance use with injection drug use among recent illicit drug users. The current study used baseline data from the Baltimore site of the NEURO-HIV Epidemiologic Study, an investigation of neuropsychological and social-behavioral risk factors of HIV, hepatitis A, hepatitis B, and Hepatitis C among both injection and non-injection drug users in Baltimore, Maryland. The present study used a subset (N=651) of the larger parent study that identified as White or Black, and reported any drug use in the past 6 months. In the full sample slightly more than half (52.5%) of study participants were IDUs. IDUs differed from non-IDUs on age of initiation for cigarettes, marijuana, and alcohol, with IDUs initiating the use of all three substances significantly earlier than non-IDUs. IDUs also had significantly greater proportions of early onset of alcohol (χ(2)=19.71, p<.01), cigarette (χ(2)=11.05, p<.01), marijuana (χ(2)=10.83, p<.01), and polysubstance use (χ(2)=23.48, p<.01) than non-IDUs. After adjusting for age, gender, and race/ethnicity, only participants identified as early onset alcohol users (AOR=1.47, 95% CI: 1.00-2.18) and early onset polysubstance users (AOR=1.62, 95% CI: 1.10-2.38) were more likely to have IDU status than those who reported initiating substance use later. IDU status was then stratified by race/ethnicity. After controlling for age and gender, only early polysubstance use was a significant predictor of IDU status for Whites (AOR=2.06, 95% CI: 1.07-3.93). Consistent with literature on early substance initiation and later illicit substance use, early onset of alcohol and polysubstance use is an important risk factor for IDU in adulthood.     

Chronic drug use and crime

This paper used bivariate and multivariate analyses to estimate the relationships between chronic drug use and various measures of criminal activity. The data for these analyses were derived from the 1993 (1) and 1995 (2) National Household Surveys on Drug Abuse (NHSDA). Measures of criminal justice system contact and criminal activity included ever arrested, arrested during the previous year, commission of a predatory crime (e.g., assault, fighting) during the previous year, and commission of a property crime (e.g., theft, property damage, car theft, breaking and entering) during the previous year. The analysis was conducted separately for males, females, and age groups, and it distinguished between chronic drug users, nonchronic drug users, and nondrug users. The results consistently showed a significant linear relationship between criminal activity and frequency of drug use. These findings have implications regarding the potential reduction in predatory and property crime that could occur from a decrease in drug use. Significant differences in criminal behavior between chronic drug users and other cohorts may signal a critical need to develop targeted interventions for this particular type of drug user.     

利用药历研究用药的个体差异

目的探讨用药过程中的个体差异,指导更细化的合理用药。方法通过对药历的统计和分析,探寻产生个体差异的原因。结论由于个体的性别、年龄、体质的不同,用药史以及对药物的过敏性、高敏性、耐受性的差异,会对相同的用药方案表现出不同的效果,需要对药效的个体差异进行研究,才能达到最合理用药的目的。     

Adolescent stigma towards drug addiction: Effects of age and drug use behaviour

The objective of this study was to examine adolescent age and experience with drug use on stigmatizing attitudes toward drug addiction. Data were derived from the  2005 cycle of the Ontario Student Drug Use Survey. In total, 4078, 7- to 12-graders completed self-administered questionnaires that included a measure of drug abuse stigma. Results indicated that stigma scores were higher among younger than older adolescents, and the decline across age was robust, occurring among both males and females and those from rural and non-rural areas. The decline, however, was stronger among non-drug users and among those who had no close friends that use drugs. Despite the age-related decline, the level of stigma in general suggested that drug abuse stigma may continue into adulthood. Findings highlight that individual attitudes toward drug use and drug abusers are salient factors for personal drug use. Given that stigma is a barrier to treatment, but reduced stigma may encourage greater adolescent use, this study highlights the need for more in-depth studies of drug stigma.     

临床合理用药调查与分析

目的 了解临床用药情况,促进临床合理用药。方法 根据本院制订的《合理用药调查方案》的要求,对全院2002年下半年105份住院病历的用药进行审查与分析。结果 在105份病历中,存在不合理用药问题的有69份(65.7％),发生不合理用药的项目频次共计113次,其中67频次与抗菌药物不合理应用有关(59.3％)。在9个审查项目中,不合理用药发生频率较高的是给药方法、用药疗程、药物选用、药物相互作用。结论 (1)我院存在一定程度的不合理用药现象。其中,以抗菌药物不合理应用以及给药方法不合理为主。(2)导致临床不合理用药既有医务人员方面的原因也有药事管理方面的原因。不断强化、更新医师的药物学知识,提高医师合理用药水平;制订行之有效的合理用药管理制度与措施、定期监督检查,配合一定经济手段对全院用药进行管理是我院当前合理用药工作的重点。     

超说明书用药在英国的适用

目的:介绍超说明书用药在英国的应用。方法:研究英国超说明书用药在处方权限、用药规程、信息依据以及企业规范等领域的相关规定。结果:英国对超说明书用药有比较成熟的规范,对我国有所启示。结论:我国应制定超说明书用药的有关规范,对用药的科学依据、患者的知情同意以及信息的发布等进行规定。     

Predictors of unsafe injecting drug use

This paper reports on the incidence of unsafe injecting and the factors which influence this practice in a sample of 1245 Sydney injecting drug users (IDUs). Using a needle and syringe after someone else at some time in the last six months was reported in 41.6% of the sample. Taking into account those who claimed always to clean used needles with virucidal methods, 32.9% had placed themselves at risk of HIV infection from shared needles in the six months prior to interview.

Seven factors were predictive of unsafe behaviour. These were (a) the amount spent per week on drugs, (b) the number of times a single needle was used prior to disposal, (c) having shared with a person who is now HIV infected, (d) having a regular sexual partner, (e) the proportion of times high, stoned or drunk when injecting, (f) being part of a group that injects together and (g) having been in prison.     

医院药学中的合理用药

合理用药是永恒的话题。本文回顾合理用药的历史，介绍合理用药的调研指标(处方指标、病人关怀指标、行政管理指标、补充指标、住院用药调研附加指标)与研究进展，探讨医院药学中的合理用药(包括药物评价、药物利用研究、药物流行病学、药物经济学、药学信息咨询服务、药学服务、循证医学、药事管理中的合理用药)，展望合理用药的发展趋势。     

浅谈药师在用药咨询及合理用药指导中的体会

目的探讨用药咨询在指导合理用药方面的必要性和作用，为合理用药提供依据。方法对本市一省级医院2006年1月至2007年6月用药咨询记录做统计、分析。结果咨询人次3186人，患者要求推荐用药最多，占23．9％，咨询较多的是药品用法、用量及不良反应。用药咨询对医师的用药选择和护士配伍禁忌及注意事项有一定的指导作用。结论药师通过用药咨询，密切了医、护、药的联系，在推广合理用药，减小药物不良反应的发生起重要作用。