我院住院药房口服拆零药品外观特征分析

目的为临床安全使用口服拆零药品提供参考。方法将某院住院药房的口服拆零药品按胶囊剂与片剂分类,分别按外观特征(颜色、形状、表面标识)进行统计,并计算外观特征识别率。同时,比较进口、合资及国产药品外观特征识别率差异。结果该院住院药房口服拆零药品共219种,其中胶囊剂44种,能通过外观特征识别的40种(占90.91%);片剂175种,能通过外观特征识别的71种(40.57%);进口及合资药品的外观特征识别率分别为77.27%及88.14%,均高于国产药品的30.43%。结论该院口服拆零药品中片剂及国产药品外观特征识别率均较低,药品生产企业应尽量丰富药品的外观特征,提高其识别度。     

精神科门诊精神药品应用分析

目的：了解某院门诊精神药品使用的特点及规律。方法：对该院2012年门诊精神药品处方,分别按疾病种类、药品名称、用药剂量、合并用药情况进行统计和分析。结果：用药以治疗抑郁症、精神分裂症、失眠症为主。9354张精神药品处方涉及13个品种,二类精神药品12种,涉及处方9221张,占处方总数的98．58％;一类精神药品只有一种（哌甲酯）,涉及处方133张,占处方总数的1．42％。以氯硝西泮、劳拉西泮、艾司唑仑、阿普唑仑、奥沙西泮排名前5个品种使用频率最高（共占92．05％）。12种药品的药物利用指数（DUI）〈1．00,1种药品〉1．00。合并用药404例（占4．32％）,抑郁症合并用药占合并用药总数的43．07％。结论：苯二氮革类以卓越的抗焦虑、镇静、催眠效果,以及较好的安全性和便宜的价格而应用最广。临床需进一步加强对精神药品处方的点评工作。     

住院药房全自动口服摆药机应用分析

目的分析全自动口服摆药机应用情况,为医院病房口服药品的分包使用及管理提供参考。方法统计口服摆药药房的药品种类、剂型、分劈药片及临床口服摆药医嘱情况,对常见问题进行分析,并提出解决办法。结果我院目前常摆药品289种,占口服药品的77.69%,其中分劈药品156种,占口服摆药品种的53.98%,分劈药品摆药品种仍以普通片剂和胶囊为主,缓控释制剂品种相对少。结论我院住院药房全自动口服摆药机应用普及较广,品种配置合理,分劈药品的共性问题仍存在。     

我院2007年婴幼儿湿疹用药情况分析

目的：调查分析我院门诊皮肤科婴幼儿湿疹2007年用药情况。方法：统计我院2007年1月至12月份0～3岁婴幼儿湿疹处方．针对药品用法、药品品种、用药金额、用药数量、用药人数及人均用药数量、人均费用进行分析。结果：共收集到处方569例。按给药途径分类主要以皮肤粘膜给药和口服给药为主。联合用药为临床主要用药方法．占90.68％。用药人数最多的依次为6101霜（乳膏基质一号）228例、复松霜（复方醋酸曲安奈德乳膏）188例、苯海拉明维B口服溶液169例．人均费用最少的依次为复松霜（复方醋酸曲安奈德乳膏）3.39元／人、振荡洗剂（氧化锌滑石粉洗剂）3.58元／人、苯海拉明维B口服溶液3.85元／人。结论：我院皮肤科门诊0～3岁婴幼儿湿疹患者给药途径以口服和外用为主．用药方法以联合用药为主．以医院自制制剂用药为主．处方金额较小．总体用药情况安全、经济、有效。     

口服固体制剂精准分剂量在精准用药中的探索与实践

目的:为医院口服固体制剂的使用提供一种精准分剂量方法,为临床合理用药提供参考。方法:利用药片切割器、药片磨粉器等对口服固体制剂进行分劈、磨粉或胶囊内容物直接分装,并称重进行调整,以保证分剂量准确度控制在均分量的85%~115%以内。结果:提供药品精准分剂量服务,能够保证分剂量准确度,提高用药安全性、有效性和方便性,减少药品浪费,降低用药成本。结论:医院药学部门开展药品精准分剂量是精准用药的现实基础,使医院药学服务更加精细,提高患者用药依从性,医护患满意,值得推广。     

儿童用药存在的问题及建议

1　儿童用药剂型少 ,规格少1.1　片剂　目前儿童用药大多仍以成人用药来代替。如常用的抗过敏药异丙嗪仅有供成人用的片剂 ,儿童用药时须将其分成几份 ;治疗心力衰竭必不可少的地高辛 ,市场上供应的口服制剂只有含量为 0 .2 5ｍｇ的片剂 ,有的患儿只能用 1 4片或更少的量 ,这样 ,要把 1片直径只有 0 .4～ 0 .5ｃｍ的药片平均分成 4,8或多份 ,不要说家长、护士 ,就是有丰富经验的药剂师也会感到困难 ,用药量过多易引起毒副作用 ,过少则病情不能控制 ,不仅影响疗效 ,还易污染药品。1.2　包衣片　某些包衣片在分割时破坏了包衣层 ,失去了其特定…     

南京地区上市西药剂型的调查研究

目的调查和分析上市西药剂型的分布情况。方法建立南京地区上市西药剂型研究数据库，运用相对分析法对数据库的计数资料作统计和分析。结果上市西药剂型61种，有效成分1296个，制剂品种1982个；1个有效成分有1种或2种剂型的品种占88，0％；注射剂占34，9％，片剂占33．5％，胶囊剂占12，5％；口服缓释和控释、透皮给药等药物传输系统占3，53％。结论注射剂、片剂、胶囊剂为上市西药的主要剂型，国内药品的剂型谱较窄，应加强对口服固体制剂及注射剂的药剂学评价工作，药物传输系统制剂的比例较低，急需开发。     

常用口服药品说明书中的用药时间分析

目的：指导患者合理用药,提高用药依从性。方法：对325种常用口服药品进行归纳、整理并分析。结果：体现服用时间的药品占47．08％,其中饭前服用的药品占28．10％,饭后服用的占22．92％,饭前饭后均可的占22．22％,睡前服用的占13．73％,饭时、晨服和必要时服用的药品所占比例分别为7．19％、5．23％和2．61％。大部分（83．66％）的服药时间列在“用法用量”项中。结论：只有正确掌握药物的服用时间和方法,才能指导患者合理用药。     

本院门急诊处方抽查点评与分析

目的：对本院2009年门急诊处方进行调查、分析及点评,规范临床处方管理,提高临床合理用药水平。方法：随机抽取本院2009年门急诊处方,对不规范和合理用药处方进行统计、分析。结果：不合格或不合理处方414张,占抽查处方总数的20．7％。超过5种药品的处方160张,占抽查处方总数的8．0％。平均每张处方的品种数为4．5个。超过处方管理办法规定的用药天数未注明原因的处方156张,占抽查处方总数的7．8％。结论：对本院不合理用药处方进行分析,提出改进建议,可促进临床合理用药。     

我院住院药房口服固体制剂标记情况浅析

目的：为我院住院药房口服固体制剂的标记提供参考。方法：对我院住院药房实行中心摆药的共348种口服固体制剂标记情况按不同形式进行分类统计,并分析各类标记形式的作用。结果：未标记的口服固体制剂为218种;而有标记的口服固体制剂为130种,占中心摆药药品总数的37.36%。药品标记形式大致可以分为6类：Ⅰ类：标记了药品商品名;Ⅱ类：标记了药品通用名;Ⅲ类：标记了药品商品名或药品通用名,并标注生产企业名;Ⅳ类：标记了药品生产企业名;Ⅴ类：标记了主药含量;Ⅵ类：标记了不明意图的记号。采用药品名或生产企业名＋主药含量进行标记易于识别和核对,一些制剂采用异形片形式或者丸剂形式等,即使没有标记也很容易识别和核对。结论：药品生产企业应在口服固体制剂上标记通用名＋主药含量,以便识别和核对,利于保证患者用药安全。     

An in vitro experiment to simulate how easy tablets are to swallow

The compliance of patients to solid oral dosage forms is strongly conditioned by the perceived ease of swallowing, especially in geriatric and pediatric populations. This study proposes a method, based on an in vitro model of the human oropharyngeal cavity, to study quantitatively the oral phase of human swallowing in presence of single or multiple tablets. The dynamics of swallowing was investigated varying the size and shape of model tablets and adjusting the force applied to the mechanical setup to simulate tongue pressure variations among individuals. The evolution of the velocity of the bolus, the oral transit time, and the relative position of the solid oral dosage form within the liquid bolus were measured quantitatively from high speed camera recordings. Whenever the solid dosage forms were big enough to interact with the walls of the in vitro oral cavity, a strong effect of the volume of the medication in respect of its swallowing velocity was observed, with elongated tablets flowing faster than spherical tablets. Conversely, the geometrical properties of the solid oral dosage forms did not significantly affect the bolus dynamics when the cross section of the tablet was lower than 40% of that of the bolus. The oral phase of swallowing multiple tablets was also considered in the study by comparing different sizes while maintaining a constant total mass. The predictive power of different theories was also evaluated against the experimental results, providing a mechanistic interpretation of the dynamics of the in vitro oral phase of swallowing. These findings and this approach could pave the way for a better design of solid oral medications to address the special needs of children or patients with swallowing disorders and could help designing more successful sensory evaluations and clinical studies.     

慢性肾脏病出院患者书面和口头用药指导效果比较

目的:比较书面和口头用药指导对慢性肾脏病出院患者的效果。方法:选取2010年7月-2013年9月共278例慢性肾脏病出院患者开展用药指导,其中157例进行书面用药指导,121例进行口头用药指导。采用自行设计的问卷调查,对两种用药指导的效果进行比较分析。结果:用药安全合理性方面,书面指导组情况明显好于口头指导组,两组患者在了解用药注意事项(书面指导组为65.61%、口头指导组为22.31%)以及遵从饮食指导(书面指导组为79.62%、口头指导组为23.97%)两项差别较大,两组患者对药物用法用量掌握情况较好(书面指导组为92.36%、口头指导组为83.47%);书面指导组用药依从性好于口头指导组(分别为88.89%、51.24%,P<0.05)。结论:书面用药指导能提高患者院外用药的安全性以及用药依从性。     

108例管饲用药合理性分析

调查2017年3月1日~2018年1月31日医院神经内科管饲给药患者的病例资料,统计患者基本情况、分析管饲用药合理性。本调查所涉及的108例患者均采用鼻胃管给药,管饲药物共112种,用药1326例次;药物剂型包括普通片剂、胶囊、缓控释片、肠溶片、滴丸、颗粒剂等;管饲给药常见同时服用6~10种药物,占62.04%（67/108）;甚至有患者单次管饲给药品种多达17种。61例患者管饲用药不合理,共185例次。其中药物剂型选择不合理152例次;33例次存在药物相互作用。对此,临床药师应发挥药学专业特长以促进管饲给药合理化。     

不同固体剂型盐酸伐昔洛韦制剂的溶出度考查

目的：比较4个不同厂家固体制剂盐酸伐昔洛韦片剂和胶囊的溶出度,为临床用药提供参考。方法：采用紫外分光光度法测定盐酸伐昔洛韦含量,转篮法测定溶出度,并以威布尔分布模型拟合溶出参数,再对T50,Td,m进行统计分析。结果：4个厂家不同固体剂型中盐酸伐昔洛韦片剂和胶囊剂的溶出度均符合2005年版《中国药典》规定,其T50、Td、m值两两间均存在显著性差（P（0.05）。结论：该方法操作简便、准确,可用于该药溶出度的测定。     

中国儿童常用药品剂型使用现状分析

目的 分析目前中国儿科常用药品剂型使用现状。方法 收集中国8家不同省份三级甲等儿童医院的用药目录，筛选出儿童常见系统疾病用药品种目录，对收集到的药品剂型信息进行统计分析。结果 共收集到2 495种儿科常用药品品规，其中口服剂型1 162种（46.6%）、注射剂型1 072种（42.9%）、外用剂型225种（9.0%）及吸入剂型36种（1.4%）。口服剂型中最常用的为普通片剂和颗粒剂。注射剂型中中药注射液有9种品规，其中有5种说明书中未标明儿童用法用量。儿科专用药品剂型共有190个品规，最常见的剂型为颗粒剂、口服溶液剂和糖浆剂。结论 尽管中国儿科常用药品剂型对儿童的适宜性有一定的改善，但目前儿科专用药品较少，适宜学龄前及以下儿童的药品剂型仍然比较缺乏，还远远不能满足不同年龄儿童多样化的药品剂型需求。     

Appropriateness of oral dosage form modification for aged care residents: a video-recorded observational study

Background Dosage forms of oral medications are frequently modified in aged care facilities by crushing/splitting tablets or opening capsules to facilitate medication administration for residents with swallowing difficulties. These practices pose safety concerns including the risk of adverse events resulting from loss of dose during transfer and alteration in the rate of absorption. Objective To identify the incidence, methods, and appropriateness of oral dosage form modification practices in aged care facilities. Setting A purposive sample of four urban and regional aged care facilities in Queensland, Australia. Method The processes of modification of oral dosage forms were observed and video-recorded using an action camera placed on medication trolleys. Each video was then reviewed and the details of the medication modification processes were recorded in a data collection form. The appropriateness of the practices of dosage form modification was evaluated against existing national guideline (Australian Don’t Rush to Crush Handbook). Deviations from the instructions in the guideline were considered as inappropriate practice. Main outcome measure Incidence and characteristics of inappropriate modification of oral dosage forms. Results Oral dosage forms were modified in 25.7% of 810 observed medications. The most common methods of dosage form modification included crushing tablets with a manual crushing device (71.6%), cutting/splitting tablets (20.2%), and opening capsules (4.3%). According to the national guideline, 12.5% of the modification instances were inappropriate. Inappropriate practices were commonly associated with the suboptimal methods of medication preparation where medications were unsuitably modified, mixed, spilled, or incompletely dosed. Conclusion The modification of oral dosage forms seems a common practice in aged care facilities in Queensland. However, some of these modifications do not comply with the requirements of good practice according to existing guidelines. Healthcare workers in aged care facilities need to be supported and upskilled with effective training to promote the best and safest practices of ODF modification.

     

Assessment of Diffuse Transmission Mode in Near-Infrared Quantification—Part I: The Press Effect on Low-Dose Pharmaceutical Tablets

Quantitative applications for pharmaceutical solid dosage forms using near-infrared (NIR) spectroscopy are central to process analytical technology (PAT) manufacturing designs. A series of studies were conducted to evaluate the use of NIR transmission mode under various pharmaceutical settings. The spectral variability in relation to tablet physical parameters were investigated using placebo tablets with different thickness and porosity steps and both variables showed an exponential relationship with the detected transmittance signal drop. The drug content of 2.5% m/m folic acid tablets produced under extremely different compaction conditions was predicted and found to agree with UV assay results after inclusion of extreme physical outliers to the training sets. NIR transmission was also shown to traverse a wide section of the tablet by comparing relative blocking intensities from different regions of the tablet surface and >90% of the signal was detected through a central area of 7 mm diameters of the tablet surface. NIR Quantification of both film thickness and active ingredient for film-coated tablets are examined in part II of this study. © 2009 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 98:4877–4886, 2009     

Analysis of coating structures and interfaces in solid oral dosage forms by three dimensional terahertz pulsed imaging

Three dimensional terahertz pulsed imaging (TPI) was evaluated as a novel tool for the nondestructive characterization of different solid oral dosage forms. The time-domain reflection signal of coherent pulsed light in the far infrared was used to investigate film-coated tablets, sugar-coated tablets, multilayered controlled release tablets, and soft gelatin capsules. It is possible to determine the spatial and statistical distribution of coating thickness in single and multiple coated products using 3D TPI. The measurements are nondestructive even for layers buried underneath other coating structures. The internal structure of coating materials can be analyzed. As the terahertz signal penetrates up to 3 mm into the dosage form interfaces between layers in multilayered tablets can be investigated. In soft gelatin capsules it is possible to measure the thickness of the gelatin layer and to characterize the seal between the gelatin layers for quality control. TPI is a unique approach for the nondestructive characterization and quality control of solid dosage forms. The measurements are fast and fully automated with the potential for much wider application of the technique in the process analytical technology scheme.