2013～2015年镇痛药物应用分析

目的评价我院镇痛药物的临床应用情况,为镇痛药物的管理和临床合理用药提供参考。方法采用回顾性分析方法,对我院2013~2015年镇痛药物的销售金额、用药频度和科室分布进行统计分析。结果我院3年间镇痛药物地佐辛注射液销售金额最高,奥沙普秦片、右旋酮洛芬片和布洛芬缓释胶囊的用药频度最高,麻醉性镇痛药物的使用主要集中在肿瘤科、骨科、产科和普外科。结论我院镇痛药物的使用情况基本合理,个体化给药仍需加强,门诊口服镇痛药物使用应加强监督。     

Side effects from acute myeloid leukemia treatment: results from a national survey

Objective: Acute myeloid leukemia (AML) is experiencing a therapeutic renaissance due to the heightened biomedical understanding of AML and patient-focused drug development (PFDD). Many AML patients now live long-term with the side effects of treatment. This study documents the prevalence and severity of AML treatment-related side effects.

Methods: A national cross-sectional survey designed with the Leukemia & Lymphoma Society assessed patients’ experiences with short-term (nausea/vomiting, diarrhea, hair loss, mouth sores, infection, rash) and long-term (organ dysfunction, chemobrain, fatigue, neuropathy) treatment side effects. Patient and caregiver participants rated side effect severity (none–severe).

Results: Survey participants (n?=?1182) were mostly female (65%), AML patients (76%), and had undergone chemotherapy (94%). Eighty-seven per cent of participants reported severe short-term effects, and 33% reported severe long-term effects of treatment. Only 11% of respondents did not have any severe effects. Hair loss and fatigue were the most common severe short- and long-term side effects (78%, 33%). There was a moderate correlation between having short- and long-term adverse effects (r?=?0.41, p?<?0.001). Caregivers were more likely than patients to report severe organ dysfunction, fatigue, and neuropathy (p-values <?0.05).

Conclusions: Survivors experience a high burden of side effects from AML treatments highlighting the need for the development of less toxic therapies. Differences in patients’ and caregivers’ experiences illustrate the importance of sampling from diverse sources to understand the full burden of AML treatment, and the need for less toxic drugs. This study informs patients, patient-advocacy groups, clinicians, and regulators about AML treatment burdens and provides the community with information to inform PFDD.     

2016—2017年咸阳市中心医院镇痛药物的使用情况分析

目的 了解咸阳市中心医院镇痛药物的应用现状及变化趋势,为临床合理用药提供参考。方法 收集咸阳市中心医院2016-2017年镇痛药物的应用数据,对其使用金额、用药频度（DDDs）、日均药费（DDC）及药品排序比（B/A）等进行统计和分析。结果 2016-2017年使用金额前3位的分别是地佐辛注射液、右旋酮洛芬肠溶片、酮咯酸氨丁三醇注射液。DDDs前3位的均为治疗轻度疼痛的镇痛药物,分别是右旋酮洛芬肠溶片、酮咯酸氨丁三醇注射液、塞来昔布胶囊。地佐辛注射液的DDC居首位,其他DDC均较2016年有所下降。结论 咸阳市中心医院镇痛药物的应用基本合理,但仍需加强监督管理,规范使用行为。     

2009—2011年我院门诊麻醉性镇痛药应用分析

目的:分析我院麻醉性镇痛药使用情况,为临床合理使用麻醉性镇痛药提供参考。方法:统计我院2009—2011年门诊患者麻醉性镇痛药使用数据,并进行回顾性分析。结果:2009—2011年我院麻醉性镇痛药除盐酸吗啡片外基本呈逐年增长趋势。硫酸吗啡缓释片、盐酸羟考酮缓释片和芬太尼透皮贴剂的用药频度(DDDs)均较高。结论:我院麻醉性镇痛药使用基本合理。     

本院202例药品不良反应报告分析

目的：探讨本院药品不良反应（ADR）特点及相关因素,促进临床合理用药。方法：对从本院门诊药房退药记录中收集的202例ADR报告进行统计分析。结果：202例ADR中,静脉给药引起的ADR最多,占总例数的75.74%（153例）;与抗感染药物有关的ADR最为多见,占总例数的76.23%（154例）;中药制剂占总例数的10.89%（22例）;ADR表现以皮肤及附件损伤为主,占总例数的47.52%（96例）,其次是消化系统,较严重的ADR有7例（3.47%）。结论：应重视ADR监测工作,加强对抗感染药物的使用管理并重点监测,以避免或减少ADR发生。     

糖尿病住院患者降糖药应用分析

目的:对我院内分泌糖尿病患者降糖药应用情况进行调查分析,为临床合理用药提供参考。方法:查阅我院2011年6月至2012年6月内分泌科病历,采用回顾性分析法,设计调查表格,对降糖药使用情况进行调查,将所得数据用Excel2000软件进行统计分析。结果:382例患者应用降血糖药物,应用最多的是胰岛素,其次是双胍类药物;两药联合治疗的比例最高,其次为三药治疗;96例患者发生不良反应,其中低血糖反应27例。结论:我院内分泌病区糖尿病患者降血糖药物应用比较合理,但临床药师对患者的用药教育还比较欠缺,充分发挥临床药师作用,有利于降血糖药物的合理应用,并减少不良反应的发生。     

门诊药房超说明书处方315张用药情况分析

目的:了解我院门诊药房超说明书用药情况,促进临床合理用药。方法:2013年6月,每天随机分层抽取门诊处方100张,以药品说明书为依据,比较处方中的适应证、适应人群、给药剂量、给药频次、给药途径、禁忌证与说明书的相符性,不符者即为超说明书用药处方。结果:共抽取3 000张处方,占6月总处方数的3.35%。超说明书用药处方315张,占抽取总处方的10.5%。按类型分类居前3位分别是给药频次(57.5%)、给药途径(26.7%)及适应人群(6.7%);按科室分类居前3位分别是小儿内科(67.6%)、皮肤科(14.9%)及耳鼻咽喉科(2.9%)。超说明书用药中,医护人员不规范操作占85.7%;无大量临床研究数据支持、循证医学证据不足占15.9%;有多中心大样本的循证医学证据支持的超说明书用药占1.9%。结论:超说明书用药情况较复杂,为了保障患者及医院的合法权益,提高用药安全,医院应构建相应的管理制度,规范超说明书用药程序。     

Increased risk of ischaemic heart disease mortality in elderly men using anxiolytics-hypnotics and analgesics

Objectives: An increased risk of all-cause and cardiovascular mortality in users of anxiolytic-hypnotic drugs (AHD) has been reported, and use of analgesics may be an additional factor. Therefore, we examined the association of AHD and analgesic use, alone and in combination, with all-cause and ischaemic heart disease (IHD) mortality. Methods: Multivariate 10-year survival analysis in a population based cohort of 500 men born in 1914. Relative risks (RR) were adjusted by relevant confounders (blood pressure, serum cholesterol, diabetes mellitus, smoking habit, high alcohol consumption, history of previous IHD, cancer, and other diseases). Results: The RR of both all-cause and IHD mortality were significantly increased among those using both AHD and analgesics compared to those who took neither of these drugs: RR=1.8 for all-cause mortality, and RR=2.7 for IHD mortality. Conclusion: Although the number of cases was small, warranting interpretative caution, the current study suggests that the combined use of AHD (mainly benzodiazepines) and analgesics seems to be associated with an increase in all-cause and IHD mortality in elderly men.     

静脉配置中心的不合理用药处方调查分析

目的了解静脉药物配置中心用药医嘱的合理性。方法随机抽取瑞金医院2009年7月1日至9月30日静脉药物配置中心静脉用药处方26091份,依据药物说明书及有关资料,进行合理性的调查与分析。结果随机抽查的26091份静脉用药处方中,共有2622份不合理,占10.04%。不合理性主要包括:配伍禁忌占1.20%;不合理载体溶媒占0.62%;不合理给药剂量占6.89%;不合理给药途径占1.14%;录入失误占0.19%。结论药师应充分发挥专业技能,加强与临床紧密结合,进一步建立合理用药规范,增加用药安全性。     

Dust in the Wind: The Growing Use of Embalming Fluid Among Youth in Hartford,CT

This study suggests that use of embalming fluid as a mind-altering drug has been underreported. Based on a social network recruitment strategy, findings from a study in 2000 of 401 outreach worker-recruited polydrug-involved youth (ages 16–24 years) from the inner city of Hartford, CT indicate widespread (over 80% of study participants had used the drug at least once) and regular use of embalming fluid mixed with either marijuana or mint. This paper reports findings on frequency and distribution of use, experience, and consequences of use, access to the drug, and characteristics of embalming fluid users. Given the toxic substances that comprise embalming fluid, and the tendency, affirmed in the present study, of the drug to be associated with violent behavior, there is a need to recognize embalming fluid as a drug of concern among youth.     

做好调剂工作促进合理用药

本文论述了做好调剂工作能够促进药物的合理使用，是医院药学工作的重要组成部分，同时也阐述了在新时期，医院调剂工作的新内容，新任务。     

不同规格静脉输液药品合理使用分析

目的促进静脉输液药物的合理使用。方法抽取某三甲医院2017年7月至2018年6月单月住院患者用药医嘱,统计并分析同一生产厂家同一通用名不同规格药品的名称、规格、数量、金额、配置时间、涉及科室等。结果使用小规格药品(临床单次用量大于或等于大规格药品,下同)的医嘱共377 529条,以肝胆外科居多(59 983条,15. 89%),使用大规格药品(临床单次用量小于或等于小规格药品,下同)的医嘱共398条,以儿科居多(322条,80. 90%);使用大规格药品可节省费用0. 30万元至208. 91万元,使用小规格药品可节省费用77. 65元至4 674. 00元,临床使用大规格药品,可节省药师调配药品的时间(0. 07~199. 60)×10~4 s。结论静脉输液中,不同规格的相同药品对药师工作量、用药安全性和患者住院费用的影响均不同,建议药师做好合理干预和宣传工作,督促临床医师在不影响患者疗效及用药安全情况下,选择适宜的药品规格。     

解放军第180医院2009-2012年麻醉性镇痛药的应用分析

目的：分析解放军第180医院2009-2012年麻醉性镇痛药的应用情况和发展趋势,为临床合理用药提供参考.方法：收集该院的医院信息系统中2009-2012年所有麻醉性镇痛药的用量、用药金额和限定日剂量,计算并分析用药频度（DDDs）、用药金额与DDDs排序比,以及日均费用.结果：麻醉性镇痛药的用药金额逐年增加.常用品种有7种,常用剂型为片剂、注射剂和贴剂.哌替啶注射液的用量最大,吗啡类的用量排序逐年降低.羟考酮控释片日均费用最大,用量排序逐年上升.结论：该院的麻醉性镇痛药临床应用较为合理,但在品种的选择上应加强监管.