ABSTRACT
OBJECTIVE:To provide reference for clinical desicion,drug use and ADR avoidance. METHODS:Clinical pharmacists participated in the consultations and therapy plan about a patient with hiatal hernia complicating with venous catheter- related infections. Clinical pharmacists suggested pulling out peripherally inserted central catheter(PICC)and placing a catheter again. Anti-infective therapy plan had been adjusted:vancomycin 0.5 g/time,ivgtt,q12 h;fluconazole 0.2 g,ivgtt,qd(0.4 g,ivgtt,qd on the first day),cefoperazone/sulbactam 2 g,ivgtt,q8h. Vancomycin and fluconazole were additionally used for anti- infective therapy. RESULTS:Doctors adopted the suggestions of clinical pharmacist,and pulled out PICC;and then the infection of the patient was controlled effectively. Finally,the infection had been cured. CONCLUSIONS:The participation of clinical pharmacists in the consultation contributes to rational drug use,and assists doctors to make the right clinical decisions and avoid adverse drug events.
ABSTRACT
OBJECTIVE:To provide reference for reducing and avoiding medication errors of high-alert drugs in outpatient de-partment. METHODS:The medication errors of high-alert drugs in outpatient prescriptions were collected from our hospital during 2013-2014,and then analyzed retrospectively in terms of the type and degree of medication error,caused factors of medication er-rors,etc. RESULTS:670 997 prescriptions were checked in two years,and 501 medication errors were found,including 26 medi-cation errors of high-alert medication. There were 7 incorrect route of administration of insulin,1 repeated medication and 1 incor-rect dose of oral hypoglycemic agents,6 repeated administration of opioid drugs and non steroidal anti-inflammatory drugs,2 indi-cation error of paracetamol and codeine phosphate,1 specification and 1 indication error of glucose injection,2 route of administra-tion error of lidocaine,2 administration frequency errors of methotrexate,2 dose error of digoxin and 1 dose error of warfarin;18 doctors'prescribing errors were found by pharmacists'prescription audit,accounting for 69.2%;8 doctors'prescribing errors were not found by pharmacists'prescription audit,accounting for 30.8%. CONCLUSIONS:Medication errors of high-alert drugs occur mainly in the prescription segment,and the main reason is that the electronic prescription system lack of compulsory strategy and policy constraints. Improvement of safety administration of high-alert drugs need to find the error link and adopt targeted medi-cation safety practices.
ABSTRACT
OBJECTIVE:To systematically evaluate the efficacy and safety of prostaglandin E1 combined with hydration for the prevention of contrast-induced nephropathy(CIN)and provide evidence-based reference for the clinical treatment. METHODS:The PubMed,Medline (Ovid),EMbase (Ovid),Cochrane Library,VIP,CJFD and WanFang database were retrieved to collect the randomized controlled trails(RCT)of prostaglandin E1 combined with hydration for the prevention of CIN. After information collec-tion and methodology quality evaluation,the Meta-analysis was performed using Rev Man 5.3 software. RESULTS:12 RCTs involv-ing 1 732 patients were included. The results of Meta-analysis showed that the incidence of CIN in test group was significantly low-er than control group[RR=0.40,95%CI(0.30,0.53),P<0.001],the incidence of phlebitis was higher than control group [RR=10.18,95%CI(1.37,75.67),P=0.02] and there was no significant difference in the need rate of renal replacement between test group and control group[RR=0.44,95%CI(0.12,1.61),P=0.21]. CONCLUSIONS:Intravenous prostaglandin E1 combined with hydration can effectively reduce the incidence of CIN. Occurance of phlebitis should be paid attention to. Due to the limited quality and sample of included studies,it remains to be further verified by high-quality and large-sample RCT.