崩漏从瘀论治

崩漏属中医妇科疑、难、重、急之证,综合分析历代医家对血瘀型崩漏的认识及运用现代医学理论知识的研究成果,提出“瘀血内阻,血不循经”是崩漏的病机关键;活血化瘀、止血调经是血瘀型崩漏的治疗大法;宫腔靶向用药是活血化瘀法治疗崩漏的有效途径。     

重庆地区市民用药习惯调查分析

  目的  了解河南省居民安全用药情况,为维护居民健康提供基础研究,提升居民用药安全水平。  方法  2016年7 — 9月,采用简单随机抽样法抽取河南省郑州、新乡、焦作等15个市的2 146名居民为研究对象,使用自行设计的调查问卷进行调查,利用SPSS 22.0软件对数据进行统计分析。  结果  居民安全用药意识不高,仅有748人（34.86 %）经常关注药物说明书,关注度大致随着文化程度的增加逐渐增高,差异有统计学意义（χ² = 71.065 1,P < 0.05）。当服用药物后出现不良反应时,有85.00 %的人表示会选择立即停药咨询医生。自行购药比例较高,有88.77 %的人有过自行购药的经历,其中 ≥ 60岁居民经常自行购药的比例最高（35.42 %）,差异有统计学意义（χ² = 62.693 3 ,P < 0.05）。不良用药习惯最常见的是不按时服药,其次为稍有好转就停药、自行增减药量、自行调快输液速度等。  结论  居民安全用药意识有待提高,正确了解用药知识,合理安全使用药品,对市民促进身体健康水平、事业发展和生活质量都有着十分重要的意义。     

一则利用药师服务患者流程进行门诊用药咨询实例

目的： 利用药师服务患者流程（pharmacists'patient care process,PPCP）完成1例哺乳期患者使用封闭疗法治疗腱鞘炎的用药咨询解答,验证其可实施性。方法： 采用PPCP项目的五步分析法即收集、评估、计划、执行、跟进：监测和评价解答患者咨询。包括收集患者用药及临床相关信息;评估所咨询问题的重点部分;制定方案解决患者关注的药物治疗问题;通过患者教育提出药学监护建议;电话随访评估其用药安全性、依从性和有效性。结果： 解答患者提问：腱鞘炎患者使用2%利多卡因2 mL加曲安奈德混悬液1 mL进行痛点封闭治疗不影响哺乳,但需要注意药学监护,防止可能发生的母乳减少等不良事件。结论： 对比国内和美国部分关于用药咨询的文件,PPCP项目步骤更为精炼,能够明确用药咨询流程,保证患者更好更快地得到解答。     

Opportunities for Improving Post-Hospital Home Medication Management Among Older Adults

SUMMARY

Effective post-hospital home medication management among older adults is a convoluted, error-prone process. Older adults, whose complex medication regimens are often changed at hospital discharge, are susceptible to medication-related problems (e.g., Adverse Drug Events or ADEs) as they resume responsibility for managing their medications at home. Human error theory frames the discussion of multi-faceted, interacting factors including care system functions, like discharge medication teaching that contribute to post-hospital ADEs. The taxonomy and causes of post-hospital ADEs and related risk factors are reviewed, as we describe in high-risk older adults a population that may benefit from targeted interventions. Potential solutions and future research possibilities highlight the importance of interdisciplinary teams, involvement of clinical pharmacists, use of transitional care models, and improved use of informational technologies.     

Mental Health Issues and Psychotropic Medication: Current Applications for Children and Adolescents in Residential Treatment

ABSTRACT

Severe mental and emotional conditions are much more prominent in juvenile resident treatment facilities than they are within the general adolescent population. These conditions are often painful to the juveniles and create management difficulties for the facility. Several mental illnesses are particularly severe and troublesome when not properly treated. Many of these require medication in order to be treated properly. This article identifies and describes those conditions, identifies many of the medications commonly used to treat them, and discusses both the effects and common side-effects of the medications. The paper does not offer medical advice and cannot be used as a guide to effective treatment. Rather, it is intended to improve the understanding of non-medical practitioners in the mental health field.     

某院47名护士长高危药物外渗相关态度技能认知调查分析

目的了解护士长对高危药物外渗态度技能知识掌握情况,为加强高危药物的风险管理提供依据,促进护理持续质量改进.方法采用自制高危药物外渗相关态度技能知识调查问卷对暨南大学附属第一医院47名护士长进行调查评定,调查内容包括高危药物外渗相关态度、技能和知识3个维度,采用SPSS 16.0统计软件进行系统描述分析.结果关于高危药物外渗态度、技能、知识的平均正确率分别为99%、75%、23%;加权后总体平均正确率为70%.不同年龄、学历、职称、工作年限的护士长问卷总体平均正确率差异均无统计学意义(P>0.05).结论护士长在高危药物外渗态度方面掌握较好,在技能和知识方面存在欠缺.作为风险管理者和质量控制者,护士长应同时重视处理高危药物外渗技能和知识方面的提高.     

东莞市某镇居民家庭安全用药现状及影响因素分析

目的了解东莞市城镇居民家庭安全用药现状,探讨其影响因素,以更好地为社区居民家庭安全用药干预提供依据。方法选取东莞市某镇29个社区卫生服务中心(站)就诊的1 450名社区居民作为调查对象,采用自制的调查问卷进行调查,内容包括一般资料、安全用药认知情况、药物服用依从情况、药物储存与管理情况。结果该镇居民的家庭安全用药总得分(33.72±6.12)分,经回归分析,学历、婚姻、家中是否有6岁以下儿童、家中是否有慢性病患者是家庭安全用药总得分的影响因素(P<0.05或P<0.01)。结论社区居民对家庭用药安全知识整体偏低,受学历、婚姻、家庭中是否有儿童及慢性病患者的影响。管理者应根据影响因素采取有针对性的干预措施,提高安全用药的认知,规范药物服用的依从性,加强家庭药箱的储存与管理,以促进居民合理用药,保障用药安全。     

Demystifying Analytical Approaches for Urine Drug Testing to Evaluate Medication Adherence in Chronic Pain Management

ABSTRACT

This comprehensive review of analytical methods used for urine drug testing for the support of pain management describes the methods, their strengths and limitations, and types of analyses used in clinical laboratories today. Specific applications to analysis of opioid levels are addressed. Qualitative versus quantitative testing, immunoassays, chromatographic methods, and spectrometry are discussed. The importance of proper urine sample collection and processing is addressed. Analytical explanations for unexpected results are described. This article describes the scientific basis for urine drug testing providing information which will allow clinicians to differentiate between valid and questionable claims for urine drug testing to monitor medication adherence among chronic pain patients.