医院不合理用药分析及对策探讨

药师参与临床治疗、重视合理用药、提高合理用药水平是当前临床药学工作的重要任务。根据安全、有效、经济、适当的原则,药师利用PASS系统,对全院用药医嘱进行技术干预,深入临床参与药物治疗,加强药学监护同时,结合"院领导参与、医务处、感染科、质量管理科"等行政干预,使我院合理用药水     

贵州铝厂医院不合理用药处方分析

1 对象和方法 笔者对本院2002-01～2002-12门诊、住院处方进行抽样分析,抽取15236张,发现不合格处方743张,对其按配伍不合理、选药不合理、用法不合理进行分类,分别填入专门设计的调查表中,并对有关内容进行统计和分析。     

门诊不合理用药实例分析

目的：分析门诊处方不合理用药情况,促进门诊临床合理用药。方法：采用回顾性调查方法,随机抽取河南科技大学第一附属医院2008-01/2008-12门诊处方共16 815张。结果：大多数处方合理,不合理用药处方共计1 096张（6.5%）,且与抗生素使用有关的825张,占不合理处方的75.2%。结论：注重门诊合理用药,加强药师们的用药指导、用药咨询、用药监督职能,防止耐药和不良反应的发生。     

孕妇合理用药

药源性疾病是指人们在防治疾病过程中所用药物引起的疾病或综合征,是由于用药而引起的不良反应。近年来,随着制药工业的发展,人们生活的改善,药物品种增多,应用增加。特别是化学药物和生物制品的广泛应用,药源性疾病的发病率逐渐升高。现对孕妇合理用药探讨如下。1引起胎儿药源性疾病1.1海豹畸形婴儿本世纪规模最大的带有世界性的镇静止痛药反应停虽减轻了早孕反应,     

临床合理用药探讨

临床合理用药是目前医院工作的一项重要内容。笔者结合多年工作实践,就如何促进临床合理用药,谈儿点个人建议。     

重庆某院不合理用药的防范措施

药物是指能够影响机体生理、生化以及病理过程,用以预防、诊断,继而治疗疾病以及计划生育的化学物质。药物是把双刃剑,具有治愈疾病和危害健康的两面性,规范合理的使用药物不仅可以缓解症状、治愈疾病,而且有利于良好的医疗环境、规范化医疗体系的形成。不合理用药不但不能起到药物本身的治愈作用,反而可能引发一系列不必要的后果。随着社会的发展,如何安全、有效的合理用药已成为社会关注的热点。药物的不合理使用,不仅增加了药物不良反应的可能性,还有可能引起药源性疾病,严重威胁患者的生命健康,而且不利于促进医疗环境及医疗体系的健康发展［1］。本文通过分析本院临床用药的现状,结合已有文献报道,讨论不合理用药现状及主要诱发因素,希望通过整治抗菌药物、控制药占比、处方点评、开展药学服务等措施,切实推进璧山县人民医院合理用药。     

老年人合理用药体会

老年人由于各脏器功能及身体机制衰退,对药物的耐受性及安全幅度均明显下降。因此,老年人用药应掌握一定的用药原则。     

妊娠期的合理用药体会

孕妇在妊娠期可并发各种疾病而需应用药物,近年来,关于药物对胎儿、新生儿的影响,特别是在致畸方面,进行了大量的研究。新药上市之前,药物是不能直接在孕妇身上进行试验的,故药物对胎、婴儿的药理作用主要是依据动物实验和观察研究的资料。每年有成千上万的孕妇在知道自己怀孕之前,已使胎儿暴露在药物之中,这些孕妇往往不知道孕期应用这些药物是不安全的,致使有些孕妇因害怕药物致畸而要求终止妊娠。现对妊娠期的合理用药体会探讨如下。     

老年乙型肝炎的合理用药

我国是肝病大国,其中仅乙肝病毒携带者占总人口的10％,老年乙肝患者占有一定的比例[1].乙型肝炎的治疗虽然已有一些特效药物,但效果均不太满意,目前所用药物只能抑制乙肝病毒的复制,还达不到根除的效果.老年人肝肾功能随年龄增大而衰退,因用药不当引起的肝损害、肾损害屡见不鲜.因此,老年乙型肝炎的合理用药安全备受关注.     

药物配伍与合理用药分析

目的 监测我院住院患者及门诊处方用药医嘱,对医生给药方案进行分析,为临床合理用药提供参考.方法 对我院2009-06-2010-06在院病历及门诊处方用药医嘱进行审核,并对其中不合理用药现象进行总结与分析.结果 我院用药存在的不合理现象,主要表现在溶媒配伍不当、药物相互作用、配伍禁忌等方面.结论 定期进行合理用药分析,加强药物配伍的监控,以提高医生用药水平,保障用药安全.     

Correlates to over-the-counter drug use among college students

Abstract

Background: Over-the-counter (OTC) drug use is an increasing problem among college students. Purpose: The present study examined correlates to OTC drug use among this population. Methods: After a comprehensive review of the literature, a three-page survey was developed to examine the research questions. Students were surveyed in health, fitness and leisure classes. Results: Results indicated that approximately 16% of students used OTC drugs in their lifetime. No significant differences were found based on sex and grade whereas significant differences were found based on perceived harm and friends’ use of drugs. OTC drug use was also associated with recent use of other substances. Discussion: The present study indicates substantial rates of OTC use among college students. Findings may aid prevention specialists and college health professionals in developing effective prevention and intervention programs.     

大学生午睡情况调查

目的:了解大学生午睡情况及相关的影响因素。方法:于2005-06-11采用整群抽样的方法对新乡医学院二年级住校大学生602名用自行设计的午睡情况调查问卷进行调查,内容包括午睡习惯(经常、有时、很少)、午睡对下午及晚上学习的影响(有明显帮助、有帮助、无帮助)、午睡的原因(晚上睡眠不足、担心下午及晚上学习效率不高、中午有午睡时间)、对取消午睡的态度(不同意、同意、无所谓)、午睡习惯形成的时间(小学、中学、大学)、季节对午睡的影响(夏季、冬季、春秋季节)、午睡对夜间睡眠的影响(有影响、无影响、无所谓)等。该学校学生早上出操,作息制度为:夏季午休3h,其他季节均为2.5h。结果:发放问卷602份,删除填写不规范者,获回答合格问卷596份,有效率为99.0%。①经常午睡者占调查总人数的88.6%(528/596),有时午睡者占8.2%(49/596),很少午睡者占3.2%(19/596)。②午睡对提高下午及晚上学习效率有明显帮助者占调查总人数的53.5%(319/596),有帮助者占38.8%(231/596),无帮助者占7.7%(46/596)。③午睡的原因主要是晚上睡眠不足,占48.5%(289/596)、其次是不午睡则下午和晚上学习效率不高,占46.1(275/596)。④76.8%的同学不同意取消午睡,同意者仅占3.7%(22/596)。⑤午睡习惯的形成主要始于中学,占66.6%(397/596),小学和大学形成午睡习惯者分别占20.3%(121/596)和13.1%(78/596)。⑥夏季午睡的同学占96.1%,冬季午睡的人数相对少一些,占81.4%(485/596),春秋季节午睡的人数居两者之间,占89.3%(532/596)。⑦认为午睡对夜间睡眠无影响的同学占80.7%(481/596),认为午睡对夜间睡眠有影响的同学占12.8%(76/596),对午睡影响夜间睡眠表示无所谓的同学占6.5%(39/596)。结论:午睡现象在大学生中极为普遍,午睡有助于提高下午及晚上的学习效率,午睡也许是一种生理需要,但更是一种生活习惯。     

大学生午睡情况调查

目的：了解大学生午睡情况及相关的影响因素.方法：于2005-06-11采用整群抽样的方法对新乡医学院二年级住技大学生602名用自行设计的午睡情况调查问卷进行调查,内容包括午睡习惯（经常、有时、很少）、午睡对下午及晚上学习的影响（有明显帮助、有帮助、无帮助）、午睡的原因（晚上睡眠不足、担心下午及晚上学习效率不高、中午有午睡时间）、对取消午睡的态度（不同意、同意、无所谓）、午睡习惯形成的时间（小学、中学、大学）、季节对午睡的影响（夏季、冬季、春秋季节）、午睡对夜间睡眠的影响（有影响、无影响、无所谓）等.该学校学生早上出操,作息制度为：夏季午休3 h,其他季节均为2.5 h.结果：发放问卷602份,删除填写不规范者,获回答合格问卷596份,有效率为99.0%.①经常午睡者占调查总人数的88.6%（528/596）,有时午睡者占8.2%（49/596）,很少午睡者占3.2%（19/596）.②午睡对提高下午及晚上学习效率有明显帮助者占调查总人数的53.5%（319/596）,有帮助者占38.8%（231/596）,无帮助者占7.7%（46/596）.③午睡的原因主要是晚上睡眠不足,占48.5%（289/596）、其次是不午睡则下午和晚上学习效率不高,占46.1（275/596）.④76.8%的同学不同意取消午睡,同意者仅占3.7%（22/596）.⑤午睡习惯的形成主要始于中学,占66.6%（397/596）,小学和大学形成午睡习惯者分别占20.3%（121/596）和13.1%（78/596）.⑥夏季午睡的同学占96.1%,冬季午睡的人数相对少一些,占81.4%（485/596）,春秋季节午睡的人数居两者之间,占89.3%（532/596）.⑦认为午睡对夜间睡眠无影响的同学占80.7%（481/596）,认为午睡对夜间睡眠有影响的同学占12.8%（76/596）,对午睡影响夜间睡眠表示无所谓的同学占6.5%（39/596）.结论：午睡现象在大学生中极为普遍,午睡有助于提高下午及晚上的学习效率,午睡也许是一种生理需要,但更是一种生活习惯.     

An examination of alcohol and drug use among urban college students

This study examines factors associated with alcohol and recreational drug use among urban college students. Undergraduate students at an urban college (n = 372) in New York City completed questionnaires assessing alcohol and drug use, depression and anxiety symptoms, and delinquent behaviors. Forty-two per cent of the respondents were Hispanic, 25.3% were African-American and 18.8% were Caucasian. Alcohol and drug users were found to have higher levels of delinquency than non-users. There was no relationship between ethnicity, the number of substances used and depression, anxiety, or delinquency. These findings are discussed as they pertain to prevention and intervention programs tailored to address the unique needs of this growing population.     

护理专业学生实习压力来源调查分析

目的:了解护理专业毕业生实习压力来源,探讨减小压力的措施。方法:对全日制护理本科、护理专科200余名学生进行调查。结果:实习护生压力主要来源于精神紧张、沟通不良,对护理工作认识不足,环境与工作强度大,学习时间减少。为此我们开展了一系列教育与管理工作,加快了护生的角色转变。结论:加强教育与管理对实习护生减小压力具有重要作用。     

涉外护理大专生在校期间压力源的调查

目的调查分析涉外护理大专生在校期间的压力源和压力水平,为制定针对性的对策提供依据,以保持其身心健康。方法采用大学生压力量表对714名涉外护生和724名普通护生的压力源和压力水平进行调查。结果涉外护生学习效率低、考试压力和同学问的竞争达到高压力水平;与普通护生相比,涉外护生学习烦扰、个人烦扰和总压力均较高（P〈0．05）,而消极生活事件压力则较低（P〈0．01）;一年级涉外护生个人烦扰、学习烦扰、消极生活事件和总压力均高于二年级涉外护生（P〈0．01）。结论涉外护生的压力源主要来自学习烦扰,建议在学习上给予心理支持,指导制订切实可行的学习目标,进行心理健康教育,帮助新生尽快进入角色等方法缓解其压力。     

A cognitive-behavioral investigation of anger among college students

The purpose of the present study was to conduct a multicomponent examination of anger among college students based on Novaco's (1978) model of anger. A total of 204 subjects participated in a study specifically examining whether high-angry students differed from low-angry students in the intensity and frequency with which they experienced aversive college events, in their endorsement of irrational beliefs through which these events might be perceived, and in their manner of expressing anger. It was found that, as hypothesized, high-angry as compared to low-angry students (1) rated typical aversive college events as significantly more frequent and intense elicitors of anger, (2) endorsed irrational beliefs to a significantly greater degree, and (3) were significantly more likely to express and suppress anger. Implications for future research and clinical practice are discussed.The research was supported by North Texas State University Faculty Research Grant No. 35394.     

A retrospective drug utilization evaluation of vancomycin usage in paediatric patients

Objective: To evaluate the appropriateness of use of vancomycin in paediatric patients at KK Women's and Children's Hospital, the major paediatric hospital in Singapore to identify potential problems in prescribing practices that may necessitate intervention to optimize vancomycin usage. Methods: A retrospective drug utilization evaluation was performed for paediatric patients who received intravenous vancomycin from 1 June 1998 to 31 June 1999. The outcome measures were consistency of vancomycin indication with recommended guidelines, dosing regimens, microbiological data, monitoring of serum drug levels, renal function, clinical outcomes and adverse drug reactions (ADRs). Results: A total of 96 cases was available for evaluation. Sixty‐two (64·6%) courses of vancomycin were consistent with guidelines for indication of therapy. Eighty‐six (89·6%) of the dosing regimen were consistent. All infusion times that were recorded (56·3%) were consistent with criteria. Of the patients treated with vancomycin for more than 1 day, peak and/or trough serum vancomycin levels were ordered for 70 cases. Of the 56 cases with paired levels ordered, 46 cases had at least one level that fell outside the therapeutic range. Nineteen (19·8%) cases of ADRs were documented. Fifty‐eight (60·4%) cases received concurrent nephrotoxic drugs. However, a substantial portion of vancomycin courses were apparently not prescribed for appropriate indications, and there was poor recording of vancomycin administration information and sampling time. Conclusion: The majority of dosing regimens of vancomycin was consistent with guideline criteria. The most evident problem was the sub‐optimal use of the monitoring of vancomycin serum levels. The information derived from this study may be used as a for further study and for the development of strategies for optimize vancomycin usage.