ABSTRACT
OBJECTIVE To develop an individualized medication list for elderly patients by evidence-based pharmacy method， and to support clinical decisions on rational use of METHODS Firstly， drugs with risk genetic information were screened out by systematically reviewing evidence-based pharmacy information. Secondly， researchers investigated the included drugs in lists from different data E- sources. Drugs included in three or more data sources and drugs proposed by the expert committee were then included in the medication list. Thirdly， for the drugs included in two data sources， researchers designed questionnaires to investigate the necessity of drug-related gene testing. According to the scoring results of the expert questionnaire， drugs with higher scores were included in the list. Data sources included real-world data （list of high frequency medication in hospitals， high frequency medication for elderly outpatients and inpatients in National Health Care Claims Data， drugs related to frequent medication errors and so on） and evidence-based pharmacy evidence （the websites of Clinical Pharmacogenomics Implementation Consortium， Dutch Pharmacogenetics Working Group， Food and Drug Administration and so on）. RESULTS The study obtain 68 drugs with risk genetic information which were included in three data sources. Combined with 23 drugs proposed by the expert committee， a list containing 74 drugs was preliminarily formed after de-duplication. A total of 37 drugs included in two databases with risk genetic information were scored through the questionnaire survey to form a supplementary list of 26 drugs. This is the final composition of the list of 100 drugs developed in this study. Among them， there are 43 drugs for the central nervous system， 15 drugs for the cardiovascular system， 12 anti-tumor drugs and so on. Twelve drugs were included in six or more data sources， which mainly consisted of drugs for digestive system， all proton pump inhibitors. CONCLUSION In this study， a list of 100 commonly used drugs which require individualized medication for the elderly was developed by evidence-based pharmacy method. The drug list will be updated in time as available evidence changes， and can provide guidance for rational use of medicines for elderly patients.
ABSTRACT
Objective To conduct in vitro transdermal test on triamcinolone acetonide spray solution, and investigate the effects of ethanol and propylene glycol alone or in combination on the in vitro transdermal function of triamcinolone acetonide spray solution. Methods Rabbit abdominal skin was selected, and the in vitro penetration test of triamcinolone acetonide spray solution was carried out by Franz diffusion cell method, and the content of triamcinolone acetonide was determined by HPLC. The rate of transdermal absorption was compared. Results The transdermal absorption rate of the combined use of ethanol and propylene glycol was significantly higher than that of the single use (P<0.05), and the order of promoting the penetration of triamcinolone acetonide spray solution when ethanol and propylene glycol were combined by 10% ethanol + 25% propylene glycol >10% ethanol + 20% propylene glycol >15% ethanol + 25% propylene glycol >15% ethanol + 20% propylene glycol. Conclusion The combination of 10% ethanol and 25% propylene glycol could optimize the transdermal function of triamcinolone acetonide spray solution.
ABSTRACT
DPP-4 inhibitors are a new type of oral glucose lowering drugs based on pancreatic glucagon. There are 5 kinds of DPP-4 inhibitors that are approved in our country. Currently, DPP-4 inhibitors have been widely recommended by domestic and international diabetes treatment guidelines. The safety of DPP-4 inhibitors is particularly important in elderly patients because this is the main population in type 2 diabetes. Here, we reviewed the literatures, explore the effectiveness and safety of DPP-4 inhibitors in elderly population, and provide evidence for clinical practice.
ABSTRACT
OBJECTIVE:To provide reference for better improving the risk perception of Omeprazole sodium for injection in nurses in a third-grade class-A hospital,strengthening risk management of ward drugs and ensuring safety of patients. METHODS:Nurses in the clinical departments in a third-grade class-A hospital where usage frequency of Omeprazole sodium for injection was relatively more were adopted as study subjects and a self-designed questionnaire was used to investigate on related knowledge on medication risk in nurses in emergency department,gastroenterology department,ICU and CCU in 2012 and 2014. RESULTS:51 and 81 questionnaires were distributed in 2012 and 2014,and 51 and 81 were effectively received with effective recovery of 100%and 100%,respectively. In both surveys,100% surveyed nurses could correctly choose one solvent at least,1.96% and 3.70%nurses could correctly choose 2 solvents;correct answering rates of intravenous administration time were 94.12% and 96.30%,re-spectively;correct answering rates of stable duration after preparation were both lower than 9%;correct answering rates of adverse reaction of this drug were 3.92% and 1.23%,respectively;correct answering rates of interaction of this drug were 1.96% and 6.17%,respectively;correct answering rates of stable formulation of this drug were 17.65%and 22.22%,respectively;the propor-tion of nurses observing ADRs were 25.49% and 13.58%,respectively;the proportion of nurses finding inappropriate compatibility were 15.69% and 22.22%,respectively,Ornidazole and sodium chloride injection was the most used incompatible drug;45% or more nurses hoping to strengthen the continuing education of nursing personnel. CONCLUSIONS:Nurses in this third-grade class-A hospital lack certain knowledge on the medication risk of Omeprazole sodium for injection,the drug risk management is not sufficient,and awareness prevention of drug risk is relative weak. It is suggested that the hospital should strengthen drug risk management system,nurses should strengthen the learning about drug risk and play the role of clinical pharmacists in the drug risk management to reduce the related drug risk and incidence of adverse reactions.
ABSTRACT
Objective To investigate the rationality and safety of dengzhanxixin injection used in elderly inpatients. Methods The clinical data of 986 inpatients including 620 males and 366 females were collected, and questionnaires containing age, sex, discharge diagnosis, symptoms, drug dosage, course of treatment, laboratory examination, adverse drug reaction and drug effect were analyzed. Results For the 986 cases, the average age was(74.3±7.5)years. The average dose of dengzhanxixin injection was (38.2±4.4) ml, once daily by intravenous drip, and the average period of treatment was (10.8±5.2) days. The adverse reaction rate was 0.81%. The levels of blood glucose and hemoglobin were decreased after treatment(t orμ=1226.5,2620.0, both P<0.05), but there were no statistical differences in the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine (CREA), blood urea nitrogen (BUN) and white blood cell count (WBC) before and after treatment (t or μ=122.5, 405.0, 513.5, 996.5, 956.5, all P>0.05). Conclusions It is safe to use dengzhanxixin injection according to the medication description for elderly inpatients.
ABSTRACT
Objective To investigate the values of tCho concentration in early assessment therapeutic response of tumor to neoadjuvant chemotherapy with 1HMR spectroscopy. Methods Twenty patients with breast cancer were recruited. All patients underwent biopsy before neoadjuvant chemotherapy and surgery after chemotherapy. The pathologic results before and after neoadjuvant chemotherapy were compared. The patients were divided into effective response group (R) and ineffective response group (IR). MRS acquisitions were performed within 1 week before chemotherapy and within 3 week after the first cycle of chemotherapy, respectively. The tCho concentration was calculated quantitatively using external standard method. The tCho concentrations before and after chemotherapy and the tumor sizes between R group and IR group were compared using t test and nonparametrie test. The values of tCho concentration in early assessment of the effectiveness of chemotherapy were analyzed by ROC. Results Of 20 cases, 16 were included in R group and 4 in IR group. In R group, significant differences of tCho concentration (t=5. 040, P < 0. 01 ) existed between before and after chemotherapy [ (4. 24 ± 3.09 ), ( 1.13 ± 1.14 ) mmol/L ], while not in I R group [ ( 3.72 ± 2. 69), ( 3.06 ± 2. 21 ) mmol/L, t = 1. 785, P > 0. 05 ]. The median sizes of tumor between R and IR group had no significant differences (0. 00,0. 00 cm, U = 23.00, W = 33.00, P = 0. 437). The area under ROC curve of tCho concentration was 0. 984. Conclusion With in vivo 1HMRS, the tChn concentration in breast cancer can serve as an indicator for predicting response to neoadjuvant chemotherapy with relatively high sensitivity and specificity.
ABSTRACT
OBJECTIVE: To discuss the characteristics and regular pattern of the adverse drug reactions(ADR) in our hospital.METHODS: A total of 314 ADR case reports collected by ADR monitoring center in our hospital during 2007 were analyzed statistically.RESULTS: 13 categories(178 kinds) of drugs and 338 cases were involved in the total 314 ADR case reports,mainly anti-infective agents(128 cases,38 kinds) and Chinese drugs preparation(51 cases,20 kinds).The ADR were manifested chiefly as lesions of skin and its appendants(134 cases) followed by gastro-intestinal lesion(56 cases).The patients showed a favorable turn and the death occurred in only 1 case.CONCLUSION: More attention should be paid to the monitoring of rational drug use to avoid or reduce the incidence of ADR.