某三甲妇儿医院注射剂说明书中儿童用药信息标注情况的调查与分析

目的 调查某三甲妇儿医院里注射剂药品说明书中关于儿童用药信息的标注情况,分析该院儿童患者临床使用注射剂的用药风险.方法 通过医院信息系统统计注射剂品种285种,收集对应说明书,采用文本分析法分析儿童用药信息标注情况.结果 对说明书进行统计分析,其中国产药品246种(86.32％),进口药品39种(13.68％).有儿童...     

我院214例中药注射剂不良反应分析

目的了解掌握我院使用中药注射剂发生药品不良反应(ADR)的相关情况,为临床合理用药提供参考。方法选择2008年12月—2011年9月该院发生中药注射剂ADR患者214例,对患者的性别、年龄、药品种类、累及系统与临床表现等方面进行统计、分析。结果通过对214例中药注射剂ADR患者的资料统计分析发现,中老年人ADR发生率较高;ADR临床表现以全身性损害和皮肤及其附件损害居多。结论中药注射剂不良反应产生的原因与性别、年龄及药品种类等因素有关,中药注射剂的使用应严格遵循药物的使用原则,加强对中药注射剂不良反应监测工作,促进临床合理用药。     

试论风险管理在医院药品管理中的应用

在医院的管理中,其中对药品的管理非常重要。对药品进行风险管理可以有效的降低医院药品风险,从而有利于确保患者的安全用药和医疗安全。在药品风险管理过程中,还需要加强对药品的采购、验收和保管以及使用等每个环节需要进行细致的研究和管理,并采取有效的防范措施,有效的降低药品的用药风险。本文就医院药品风险管理的相关概念进行研究分析,并对医院药品风险管理的现状进行阐述,以便制定出相关有效的风险管理措施,降低医院药品的风险。     

某医院药品“寄售制零库存”管理的探索性分析

目的：研究某医院现行药品库存运行模式,对如何构建医院药品“寄售制零库存”模式提出相应方案,进行“药品供应链模式”再造。方法对某医院进行实地考察,分析2012—2014年药品相关数据,发现其现行药品库存运行模式中存在的问题。结果现行的药品库存运行模式已经不能适应该医院发展需求,医院可引入“寄售制零库存”模式。结论“寄售制零库存”模式可以有效解决医院药品库存积压问题,转移相关成本,能够促进医院和谐、健康、可持续发展,相应方案的提出可供类似医院参考。     

医院药品管理

医院药品管理上海市奉贤县药品检验所２０１４００唐玲琳药品管理是药剂科在医院工作中的首要任务，随着现代医药发展的日新月异，系统论、信息论、控制论等相继问世，药品管理也成了科学管理的一个分支。尤其是当前药品种类的不断增多，给医院药品管理提出了新的问题，过...     

帐外暗中收回扣明示入帐收折扣谁对?谁错?

A案例 2005年,某三级甲等医疗机构,在全市药品集中招标采购后中标的某药品批发企业处,购入了大批葡萄糖注射液,双方在<中标药品购销合同>中约定,药品送至医院库房3个月后医院付款给药品批发企业.由于医院经营状况较好,于是医院对该药品批发企业提出如果提前结算货款,是否可以给予折扣?     

有效期管理在医院临床科室备用药品应用的效果分析

目的分析我院临床科室备用药品管理资料,研究有效期管理对医院临床科室备用药品管理的应用效果。方法选取我院2014年1月—2015年12月的备用药品管理资料,并在2015年1月开始备用药品的有效期管理,将管理实施前的管理资料作为对照组,管理实施后的管理资料作为实验组,对比管理前后的备用药品管理效果差异。结果实施后,临床备用药品管理检查失误、药品过期失效、药品报损率较实施前下降(P0.05)。结论对备用药品进行系统的有效期管理,可以改善备用药品的应用效果,提高医院管理水平,减少医院经济损失。     

账外暗中收回扣明示入账收折扣谁对？谁错

A案例 2005年，某三级甲等医疗机构，在全市药品集中招标采购后中标的某药品批发企业处，购入了大批葡萄糖注射液，双方在《中标药品购销合同》中约定，药品送至医院库房3个月后医院付款给药品批发企业。由于医院经营状况较好，于是医院对该药品批发企业提出如果提前结算货款，是否可以给予折扣？     

信息系统环境下医院药品库存内控审计

运用信息技术对医院药品进行管理已经成为大中型医院的普遍做法,它改变了药品管理的流程与理念,也为传统内部控制审计理念带来了挑战。本文以某医院药品内控审计项目为例,分析了在信息系统环境下实施审计过程中的主要关键点和难点,并提出了药品内控审计的一般流程。     

医院药品库房管理优化措施探讨

目的探讨医院药品库房管理优化的措施。方法选取洛阳市某医院药品库房中的100种药品作为观察对象,并对2017年1—12月药品库房管理过程中出现的问题进行整改,提出相应优化措施,然后再将2018年1—12月实行优化措施后的医院药品库房管理情况与实行前进行对比。比较实行医院药品库房管理优化措施前后药品安全问题的发生情况及药品安全管理、质量管理评分。结果医院药品库房管理优化前,药品安全问题的发生率为13.00%。而医院药品库房管理优化后,药品安全问题的发生率为2.00%,明显低于优化前,差异有统计学意义(P0.05)。医院药品库房管理优化后,药品安全管理及质量管理评分均明显高于优化前(P0.05)。结论针对主要问题对医院药品库房管理进行优化,制定可行性措施,可有效降低药品安全问题的发生率,提高药品使用安全性,提升医院管理水平。     

CO2无针喷射注射装置的设计特点与应用

介绍了以液态CO2为动力源的无针喷射注射装置的结构。原理及其设计特点，此装置适用于皮下（SC）或肌内（IM）以及大量人群免疫程序及快速多剂量疫苗的注射，也可用于其它可注射给药。     

中药注射液的不良反应及避免措施

目的对中药注射剂的不良反应（ADR）进行统计分析。方法收集我院2009年1月～2009年12月中药注射液不良反应报告60例进行总结,针对中药注射制剂不良反应的种类、成因、临床表现等进行分析,统计出ADR发生率较高的5种中药注射液。结果 ADR发生率较高的前5位药品依次为双黄连针、复方丹参注射液、疏血通注射液、清开灵注射液、血必净注射液。结论中药注射剂易发生ADR,且以过敏反应居多,临床上应慎用,医护人员用药前应认真学习药物的有关资料,掌握适应症及禁忌症,规范、合理、安全地使用中药注射液。     

2006-2009年某医院抗高血压药物应用及剂型分析

目的了解本院抗高血压药应用现状及其剂型改变趋势。方法对2006-2009年抗高血压药销售金额、剂型等进行统计分析。结果2006-2009年抗高血压药销售总金额分别为1611625．00元、2340422．92元、2783096．25元、3105116．65元，逐年上升；用量最大的药物为氨氯地平片；不同类型药物中，钙通道阻滞剂类销售金额最大；药物种类从2006年25种增至2009年32种；2006—2009年缓控释制剂销售额占总额的比例分别为14．24％、20．91％、21．45％、23．03％，也呈逐年上升。结论钙通道阻滞剂、血管紧张素Ⅱ受体阻滞剂类药物为本院抗高血压的主流药物；药物品种不断增加，缓控释制剂在临床应用中逐渐受到欢迎。     

对围手术期抗菌药物应用进展及干预管理的探讨

抗菌药物合理应用是医院感染管理的一个重要方面。为减少医院感染的发生,降低药品不合理支出费用及住院天数．减少耐药菌株的产生和不良反应,必须加强对抗菌药物合理应用的管理。从手术部位感染的病原体种类、来源、围手术期预防使用抗菌药物的适应症、给药的时机、使用的疗程、选择的种类、预防手术部位感染的预防措施及围术期抗菌药物的干预管理等几方面的进展作一概述。     

Managing drugs for rare genetic diseases: trends and insights

Managed care organizations generally pay for expensive drugs that treat rare genetic diseases because few patients have these conditions, the conditions are often life threatening, and the benefit design mandates coverage. In most cases, the cost-control measures and management restrictions applied to many other specialty pharmaceuticals do not make sense for the orphan drugs used to treat extremely rare genetic conditions because treatment alternatives usually are lacking for rare conditions (e.g., Gaucher's disease) and because the per member per month costs for truly rare conditions are low. The increasing number of biologic and injectable therapies for more common conditions, however, is prompting managed care decision makers to manage these new therapies more actively. There is a potential that treatments for rare disorders will be swept up in this broad-based response. This article provides definitions, background, and stakeholder perspectives on this topic and describes recent trends and challenges in health system management of exceedingly rare genetic diseases. The author suggests that current protocols are appropriate for managing rare and ultra-rare diseases, and that applying more active management practices to less rare diseases is neither efficient nor productive; in fact, it may be counter-productive.     

Contraceptive injections by community health workers in Uganda: a nonrandomized community trial

OBJECTIVE: To compare the safety and quality of contraceptive injections by community-based health workers with those of clinic-based nurses in a rural African setting. METHODS: A nonrandomized community trial tested provision of injectable Depo Provera (DMPA) by community reproductive health workers and compared it with routine DPMA provision at health units in Nakasongola District, Uganda. The primary outcome measures were safety, acceptability and continuation rates. FINDINGS: A total of 945 new DMPA users were recruited by community workers, clinic-based nurses and midwives. Researchers successfully followed 777 (82% follow-up): 449 community worker clients and 328 clinic-based clients. Ninety-five percent of community-worker clients were "satisfied" or "highly satisfied" with services, and 85% reported receiving information on side-effects. There were no serious injection site problems in either group. Similarly, there was no significant difference between continuation to second injection (88% among clients of community-based workers, 85% among clinic-going clients), nor were there significant differences in other measures of safety, acceptability and quality. CONCLUSION: Community-based distribution (CBD) of injectable contraceptives is now routine in some countries in Asia and Latin America, but is practically unknown in Africa, where arguably the need for this practice is greatest. This research reinforces experience from other regions suggesting that well-trained community health workers can safely provide contraceptive injections.     

临床路径管理与合理用药

目的本研究主要对临床路径的合理用药以及管理进行简单的分析讨论。方法将我院2011年3月——2012年3月的临床用药安全监督中的相关医嘱以及咨询记录作为研究对象,对其中存在的不规范现象的处方进行分析,并对处方中的不合理医嘱利用临床路径管理来进行监管。结果通过对我院的临床用药情况进行临床路径管理,我院的临床用药不合理情况得到了明显的改善。结论临床路径管理对于医院的合理、安全用药有着至关重要的作用,此外,临床路径管理还可以在一定程度上降低患者的治疗费用,因此,可以在临床用药过程中进行推广。     

Hepatitis C and young drug users: are they about to join the epidemic?

Abstract: This study investigated what some high-risk youth in Perth knew about, believed about and did about hepatitis C, and the extent to which they had been exposed to the virus, by surveying 234 12-to-20-year-old users of injectable drugs. About half of the respondents (108) gave a blood sample for anonymous hepatitis C virus antibody testing. All respondents had used at least one illicit drug other than marijuana in the previous 12 months and most (75 per cent) reported injecting drugs at least once in the past 12 months. The study group was obtained through drug treatment agencies and interviewer networks. Although more than 80 per cent of the study group had heard of hepatitis C, only 50 per cent considered the infection to be a serious problem. Eighty per cent of respondents were at risk of infection from unsafe injecting practices, and their relevant knowledge of hepatitis C was at best, barely adequate. Of those tested, 5.5 per cent were seropositive. A pool of infection, albeit small, already exists among this group of users of illicit drugs. Given the low average duration of illicit drug use among this group (less than 2 years) and the fact that many of the users are part of a hidden population that will probably never be in treatment, that there is any infection present is of concern. Appropriate, well-aimed education and peer outreach programs are desperately needed if the transmission of hepatitis C among young users of injectable drugs is to be kept to a minimum.     

Management of Schizophrenia

Schizophrenia is a chronic disease that typically manifests during adolescence and early adulthood. Treatment of this disease consumes a significant proportion of the healthcare budget (billions of dollars in the US). Primary management options for schizophrenia include both pharmacologic and psychosocial interventions, with antipsychotic therapy (typicals or atypicals) being the mainstay of any treatment plan. Atypical agents are recommended in current guidelines as first-line treatments for patients with newly diagnosed schizophrenia. The newer atypical antipsychotic agents have a lower propensity to cause extrapyramidal symptoms and tardive dyskinesia, and are at least as effective as typical agents.Long-acting injectable formulations of antipsychotic drugs help to ensure drug delivery and are recommended in patients who are partially or fully noncompliant, or who prefer this formulation. The goal of using these agents is to reduce noncompliance, thus reducing the likelihood of relapse and/or hospitalization, and ultimately reducing treatment costs. Benefits associated with long-acting formulations include the maintenance of stable plasma concentrations, the reduction of overdose risks, and the establishment of regular contact between the patient and their healthcare provider. Currently, risperidone is the only atypical agent available as a long-acting injectable formulation.In patients with schizophrenia, long-acting injectable risperidone (25–50mg every 2 weeks) is no less effective than once-daily oral risperidone, has superior efficacy to placebo over the short term, and significantly improves symptoms over the long term in patients who are symptomatically stable at baseline. Long-acting injectable risperidone is well tolerated and has a tolerability profile similar to that of oral risperidone, apart from injection-site reactions, which are generally mild and transient. This formulation of risperidone reduces the incidence of hospitalization and significantly improves health-related quality of life (HR-QOL; in particular mental health-related domains) in patients with symptomatically stable schizophrenia. Pharmacoeconomic models have indicated that long-acting injectable risperidone — relative to oral risperidone, oral olanzapine, or long-acting haloperidol — is associated with cost savings and is the dominant strategy in terms of cost effectiveness.The efficacy and tolerability profile of long-acting injectable risperidone, its ability to reduce hospitalization rates and improve HR-QOL, and its demonstrated cost effectiveness in pharmacoeconomic models support the use of this agent in the management of schizophrenia.     

抗菌药物分级管理制度在西药房抗菌药物管理中应用的意义分析

目的：探讨抗菌药物分级管理制度在西药病房抗菌药物管理中的意义。方法：对本院自2011-2012年西药房中抗菌药物的等级使用品种进行归纳性的统计分析,采用金额排序法以及用药频度（DDDs）对药物等级管理效果进行评估。结果：西药房中抗菌药物的用药金额逐年升高,但占总药品的销售比例逐年降低,比例分别为36.21%、29.26%。用药金额位居前列的药品主要为头孢菌素类药物、青霉素类药物、喹诺酮类药物。采用药品分级管理之后,一线（非限制使用的药物）、三线（特殊使用的药物）抗菌药物的用药频次每年下降,二线（限制使用的药物）抗菌药物使用率逐渐上升。结论：采用抗菌药物分级管理制度,可以有效地指导本院抗菌药物的使用,但也存在某些问题,需要在各个科室医师、药师以及管理部门的共同努力下解决存在的问题,提高西药房抗菌药物的合理管理。