ABSTRACT
Drug-related acute kidney injury(AKI)is a common problem in clinical medicine.It is more prone to occur in children,especially in children with severe infection,low circulating blood volume,congestive heart failure,diabetes and chronic kidney disease clinically.Mechanisms include altered intra-glomerular haemodynamics, oxidative damage,hypersensitivity reactions,renal obstruction,tubular inflammatory changes,interstitial nephritis,rhab-domyolysis,thrombotic microvascular disease and metabolic disorders. Therefore,the early detection of adverse drug reactions to prevent its progression to end-stage renal disease is important.Despite many efforts to improve the early assessment of AKI in patients,effective markers are still lacking.Preventive measures requires knowledge of mecha-nisms of drug-induced AKI,improve the prognosis by correcting risk factors,assessing baseline renal function before initiation of therapy,adjusting the drug dosage and avoiding use of nephrotoxic drug combinations.
ABSTRACT
OBJECTIVE:To provide reference for the standardization of package insert of common drugs for elderly patients. METHODS:Outpatient prescriptions in our hospital from 2013 to 2014 were collected,and common drugs of elderly patients(≥60 years old)were ordered by consumption sum,and package inserts of top 100 drugs were statistically analyzed for absent items. RESULTS:The 100 common drugs for elderly patients included 28 Chinese traditional drugs and 72 chemical drugs. The Chinese traditional drug had more absent items,mostly were pharmacokinetics and drug overdose(92.9%),medication of elderly patients (85.7%),drug interactions(78.6%)and pharmacological actions(50.0%);the proportion of contraindications(16/28),adverse re-actions(15/28) and precaution(9/28) with uncertainty was relatively high. Items of chemicals package insert were better than Chi-nese traditional drug,absent items were pharmacokinetics and drug overdose(5.6%),medication of elderly patients and pharmaco-logical actions (2.8%) and drug interactions (1.4%);the proportion of medication of elderly patients (16/72),drug interaction and drug overdose(12/72)with uncertainty was relatively high. CONCLUSIONS:The common problem existing in the drug manu-al is characterized by absence of usage for elderly,drug descriptions is not clear,etc. Package inserts should be further improved to strengthen its standardization.
ABSTRACT
OBJECTIVE: To provide references for optimizing the selection of medical insurance drugs and drug review in China.METHODS: The Canadian common drug reviewers' basic duties and the Canadian common drug review process were introduced,and the existing problems in drug review and the countermeasures were analyzed.RESULTS & CONCLUSIONS: In view of the problems occurred in Canadian drug review such as redundant delay and tedious,lack of transparence and job responsibility system and so on,the corresponding measures had been taken such as defining drug review time,helding long range e-meeting,and establishing public committee etc.Chinese common drug review should draw experiences from the Canadian drug review to explore a more economical,timely and transparent practice in Chinese medical insurance drug selection and drug review.
ABSTRACT
OBJECTIVE:To provide references for drug pricing and drug administration for Chinese government.METHODS:The drug pricing and administration policies in UK were expounded and the effects of which were analyzed and evaluated,based on which some suggestions were put forward with the consideration of the specific condition of our country.RESULTS&CONCLUSIONS:The rules of market economy should be obeyed and market monitoring should be carried out in China.The non-governmental organizations should play a key role in the support and service for national drug supervision and administration.The drug prices should be controlled according to category so as to make the formula process of drug price policy scientific.The government-set price and the market price monitoring mechanism should be established and the legal system of drug price management should be established as soon as possible.