Establishment of standardized treatment demonstration ward for cancer pain and its influence on the management of narcotic drugs / 中国生化药物杂志

Objective To explore the effect of setting up standardized treatment demonstration ward for cancer pain on the management of narcotic drugs. Methods The study group (from 2015 to 2016 to create the standardized treatment of cancer pain ward) and control group (from 2013 to 2014 to create a standardized pain treatment demonstration unit ) all kinds of narcotic drugs dosage and medication frequency (DDDs), a monthly 30 prescriptions from tumor anesthesia, analysis of prescription writing quality qualified the rate and the rate of unreasonable use. Results The study group of patients with cancer pain drug usage and DDDs, oxycodone dosage rises fast, DDDs way ahead, dosage of morphine increased gradually, morphine dosage gradually decreased, transdermal fentanyl DDDs decreased, pethidine dosage remains low. The research group for the passing rate of prescription writing quality 99.3％, the control group of prescription writing quality qualified rate is 81.1％, the research group of narcotic drug use rate was only 4％, reasonable utilization rate is as high as 96％ is not reasonable, unreasonable use of narcotic drugs control group was as high as 18.5％, reasonable utilization rate is only 81.5％ (P<0.05). Conclusion The creation of standardized pain treatment demonstration unit narcotic drugs more reasonable structure, can improve the quality of narcotic drugs prescription writing qualified rate, reduce the rate of unreasonable use, reasonable use of pain medicine has positive significance to ensure patient safety and efficacy of.

Estimation of self – medication practices among rural Kanchipuram, India

Background: Interest in self-care, poor economic conditions,health-seekingbehavior, socio-cultural factors, ignorance, excessive advertisement on drugs and availability of drugs in other than medical shops are responsible for the practice of Self-Medication. Aim and objectives: To find out prevalence of Self-Medication practice among rural people in Kanchipuram and to find out possible reasons for Self-Medication and factors influencing selfmedication practice. Materials and methods: A cross-sectional study was done in five randomly selected villages in the field practice area of MMCH&RI. After getting informed consent, the questionnaire was administered to 250 households randomly. Results: Among 250 households surveyed, 47.6% (119) respondents were in the age group of 20-40 years, 56.8% (142) were females and 51.2% (128) households belong to the poor socio-economic class. The prevalence of self-medication in the sample was 58.4% (146). Younger age, higher educational status, and higher socioeconomic status were associated with higher prevalence. In this study, the main reason given for self-medication practice was the poor quality of care in Government hospitals (32.9%) followed by 26% of subjects said they treat themselves for similar illness from previous experience etc. The common symptoms for taking self-medication were fever (39.8%) and headache (23.45%). Majority of them (74%) kept the medicines in closet and few (15.2%) kept in bags. Commonly taken medicines are fever relieving drugs (39.04%) and cough syrups (28.08%). Adverse drug effects which were commonly encountered due to self-medication are gastritis (39.04%), rash and swelling (29.45%), sedation (15.06%) and increase in symptom (16.43%). Among the people who took painkillers, 59% of them experienced gastritis. Gayathri S, Kokila Selvaraj, Satyajith P, Mithunkumar G.H. Estimation of self - medication practices among rural Kanchipuram, India. IAIM, 2017; 4(10): 87-92. Page 88 Conclusion: Increased prevalence of self-medication even among rural people may lead to consequences such as drug interactions, drug dependence and drug resistance due to irrational use of drugs and causes increased morbidity.

Current Application Status and Countermeasures of Antibiotics Irrational Use in China / 中国药师

In recent years,antibiotics have been playing more and more important roles in maintaining human health with the increasing variety and quantity.However,under the influence of different reasons caused by subjective or objective factors,antibiotics irrational use has induced bacterial resistance and adverse reactions,which are becoming more and more serious.The paper put forward the countermeasures of antibiotics irrational use and provided reference for rational use of antibiotics based on the present situation analysis in China and foreign experience in order to control the irrational use.

Investigation of Xingnaojing Injection Applied in the Patients of Neurosurgery Department in a Certain Hospital / 中国药师

Objective:To investigate the application of Xingnaojing injection ( XNJI) in the patients of neurosurgery department to provide reference for the rational drug use. Methods:The retrospective investigation was applied to survey 200 hospitalization records with XNJI from a certain hospital between January 2014 and June 2015. The usage, dosage, medication purpose, course of treatment, compatibility and adverse effects of XNJI were analyzed. Results:The unlabeled use of XNJI was found in neurosurgery department, and 34. 50% of the surveyed patients were found that their diagnoses didn’t conform to the indications in the medicine specification of XNJI. Moreover, 92. 50% of the inpatients were treated with overdose and almost 90. 00% were treated with single drug dose of 40 ml. It was also found that XNJI was often combined with potassium chloride or with potassium chloride plus insulin in clinical use. Conclu-sion:There is some irrational use of XNJI in clinics, thus the use and management of traditional Chinese medicine injections should be strengthened and regulated.

Prescription Auditing of Patients Admitted at Psychiatry ward of a Tertiary Care Hospital of Western UP

Introduction: The World Health Organization (WHO) proposed core-prescribing indicators for prescription audit and drug utilization studies. The focus of Indian studies has mainly been on the WHO core-prescribing indicators such as the range and number of drugs per prescription. Critical evaluation of prescriptions including rational auditing of prescriptions of patients admitted at Psychiatry Ward of Jawaharlal Nehru Medical College Hospital, A.M.U., Aligarh, from the period of 31/05/2013 to 30/05/2015. Materials and Methods: Permission for retrospective study to access medical records of the past 2 years of all patients admitted in the Psychiatry ward from 31/05/2013 to 30/05/2015 was obtained from the competent authority. Prescriptions of 44 patients (26 female, 18 male) were available in the Central Record Section during this period. The following parameters were taken to analyse and audit prescriptions as per WHO prescribing indicators: 1) Patient details, 2) Mention of diagnosis, legibility & spelling mistakes, 3) Details of the consultant, 4) Use of antibiotics/antipsychotics by various routes, 5) Provision of proper instructions to patients and 6) Additional parameters - Percentage of prescriptions with nutritional supplements and antacids. Results: Only 36% of prescriptions contained the full names of patients, while age, sex and address were present in 84.09% of the prescriptions. 100% prescriptions were found written with complete diagnosis and contained the signature of the concerned doctor. None of the prescription had the doctor’s contact number. A mean number of 3.18 drugs were written per prescription. All prescriptions were legible and 2.27% contained spelling mistakes. Insufficient instructions for both oral and injectable drugs were mentioned on all prescriptions. Conclusion: As per WHO laid guidelines, study related to drug use indicators are simple as a supervisory tool to assess prescribing patterns by individual doctors. These prescription studies provide scope to improvement in prescribing patterns and promotion of rational use of drug among practitioners.

The Knowledge and Attitude of Practicing Dentists towards the Antibiotic Prescription: A Regional Study.

Aims: To assess dentist’s knowledge and practice in relation antibiotic prescription and to investigate if they follow the current international guidelines. Methodology: In this cross sectional study a structured and pretested questionnaire was sent to 202 licensed dental practitioners in UAE, Iran and Jordan took place in period between December 2011 and January 2012 by e-mail and physical delivery. Results: Of 160 responding dentists 93.1% would prescribe antibiotics for dentofacial infections with systemic signs but many prescribe antibiotics for conditions where antibiotic therapy is not required according to good practice. Amoxicillin was the most frequently prescribed antibiotics. The non-clinical factor that may affect decision of the majority of dentists to prescribe antibiotics was perception of the effectiveness of those antibiotics in previous cases they treated with same agent (61.25%). Most of the respondents (84%) prescribe prophylactic antibiotics for patients at risk of infective endocarditis. Conclusion: This study reveals that antibiotics were still being prescribed by dental practitioners where recent guidelines suggest there is no indication.

Study of prescribing practices of injections in outpatients of a rural tertiary care teaching hospital.

Background: Injections are probably the most common of all medical procedures. The combination of injection overuse and unsafe practices creates a major route of transmission of blood borne pathogenic infections. Unnecessary use of injections can also lead to unnecessary burden on the institution in terms of efficiency, infrastructure, staff requirement and poor utilization of resources. Monitoring and analysis of prescribing practices can help to achieve rational use of injections. The present study was carried out to study the injection prescription patterns in outpatients of a rural tertiary care teaching hospital, Ambajogai, Maharashtra, India. Methods: A cross sectional descriptive study was conducted for duration of two months and 744 prescriptions were randomly collected and analyzed. Results: The total number of injections prescribed in 744 prescriptions was 205. Most (71.70%) of the patients receiving them were above 35 years of age. The most common complaint for which the injections were prescribed was musculoskeletal pain (45.36%) followed by fever. About 155 (75.60%) prescriptions contained injection diclofenac which was the most commonly used drug followed by injection paracetamol (11.21%). There was a high tendency of using brand names in prescriptions (89.30%). Conclusion: The study revealed high proportion of use of injectable drugs. There was overuse of analgesic injections like diclofenac, most of which were unnecessary and irrational. This leads to unnecessary burden on the institution in terms of efficiency, infrastructure, staff requirement and poor utilization of resources. There is a need to develop local guidelines for injection usage along with educational sessions for prescribing doctors.

Nuevas tendencias de la medicalización / New tendencies in medicalization

Comenzando con un análisis crítico del rol de los medicamentos en la práctica de profesionales de salud y consumidores, el texto intenta recalcar la influencia ejercida por las estrategias promocionales, tanto las mas antiguas como las mas recientes, por iniciativa de los productores, con el fin de reforzar valores y creencias que sobrepasan lo que se puede obtener con la utilización de un fármaco. Son seleccionados algunos ejemplos para ilustrar el problema de la intensificación del proceso de medicalización, particularmente a partir de los equívocos advenidos del uso irracional de anfetaminas volcadas hacia el control del apetito, o hacia los niños clasificados como hiper-activos y con deficit de atención, además de los fármacos para andropausia o depresión.

Beginning with a critical analysis of the role drugs play in the behavior of consumers and health professionals, this text aims at evaluating the influence of both traditional and new promotional strategies of the pharmaceutical industry designed to create values and believes that exceed what in fact can be expected from drug consumption. Some examples were chosen to illustrate the intensification of the medicalization process. Special emphasis was given to the irrational use of amphetamines to diminish the appetite and to control weight or to treat children supposedly suffering from Attention-Deficit Hyperactivity Disorder (ADHD) as well as to drugs used in cases of depression and supposed andropause.

Application of Antibiotics in 843 Inpatients and Analysis of Irrational Drug Use / 中国药房

OBJECTIVE:To investigate the use of antibiotics in the inpatients of our hospital.METHODS:The medical records of inpatients from Jan.2004 to Dec.2006 randomly selected in our hospital were analyzed statistically in respect to the irrational use of antibiotics.RESULTS:Of the total 1,120 inpatient medical records examined,843(75.3%) used antibiotics,56 involved irrational use of antibiotics,which manifested as improper in dosage,dosage regimen,drug combination or solvents selection etc.CONCLUSION:The irrational use of antibiotics is quite common,thus the role of clinical pharmacists should be strengthened to promote rational use of antibiotics in clinical practice.

Current Situation of Use of Antimicrobials and Feasibility and Difficulty in Intervention for Rational Use of Antimicrobials in China / 中国药房

OBJECTIVE:To discuss the feasibility and difficulty in carrying out intervention for rational use of antimicro?bials.METHODS:Based on the actual situation of use of antimicrobials in China,the presence and absence of irrational use and the necessity of carrying out intervention for clinical rational use of antimicrobials were analysed.RESULTS:In China,the use of antimicrobials was excessively frequent,and peroperative use had the irrationality of undue indication,course too long and high-grade drug at the start.Furthemore,there was irrationality in choice of antimicrobials and neglect in special population,which resulted in increase of drug-resistant strain and ADRs.CONCLUSION:There are necessity and feasibility to carry out“Guide to clinical use of antimicrobials”and to implement the intervention for rational use of antimicrobials,however,difficulty exists as well.

Problems in the use of antibiotics in our hospital and countermeasures / 中华医院管理杂志

In order to identify problems in the use of antibiotics and propose corresponding countermeasures, a statistical analysis was made into 6 000 prescriptions and medical records detailing the use of antibiotics by outpatients and inpatients randomly selected from the years 2002～2003. It was found that the irrational use of antibiotics was prevalent. It is pointed out that high attention ought to be paid to the issue and countermeasures be adopted, including strengthening physician training in the "three basics", implementing various rules and regulations, adhering to the standards and guides for the use of antibiotics, dynamically tracing the use of antibiotics by means of the computer, and providing timely analysis and feedback of information on the use of antibiotics.