Establishment and application of DUE criteria of Dolasetron / 药学实践杂志

Objective To establish the drug use evaluation ( DUE) of Dolasetron, evaluate the rationality of the clinical use of Dolasetron and provide a reference for the rationally clinical use of Dolasetron．Methods On the basis of Dolasetron DUE criteria, a retrospective analysis was made in 794 hospitalized patients from January 2021 to June 2021. Results The drug use evaluation criterion on Dolasetron consisted of drug indications, drug use process, the result of drug use and indication management. Conclusion There are some inappropriate medication problems in Dolasetron utilization in the hospital. The DUE criterion is very practical which could be used to standardize the clinical utilization of Dolasetron.

Construction and application of rational drug use database for children in our hospital / 中国药房

OBJECTIVE To establish a database of rational drug use for children in our hospital， and to provide reference for ensuring the safety of drug use in children. METHODS The construction and filling of the knowledge base of rational drug use for children were performed by establishing the basic structure of the knowledge base， formulating reference standards for the quality level of pediatric medication evidence， and refining evidence-based evidence of pediatric medication. The rule base of rational drug use for children was designed and built from four aspects： preliminary determination rules for patient information， basic drug information rules， prescription suitability review rules， result labeling and post-processing rules. The database was embedded into prescription review system of our hospital and was applied online to test its effectiveness. RESULTS A set of database containing 672 commonly used pediatric medicines and more than 15 000 rules for rational drug use for children was initially constructed. The average interception rate of unreasonable medical orders for hospitalized children after database application（from December 2021 to May 2022）was 2.03%， and was higher than 0.80% before database application（from June 2021 to November 2021）（χ 2＝5 784.389， P＜0.001）； after post-sampling and prescription review， the average qualified rate of medication orders in discharged medical records for children after the application of the database was 99.10%， and was higher than 94.58% before the application of the database （χ 2＝301.237， P＜0.001）. CONCLUSIONS Self-constructed evidence-based rational drug use database for children is close to the actual clinical needs of pediatrics in medical institutions， which can effectively reduce clinical irrational drug use behaviors in pediatrics， improve the pass rate of prescriptions， and ensure the safety of children’s drug use.

Framework design of WHO and typical national essential medicine lists and its implications for China / 中国药房

OBJECTIVE To sort out the common presentation forms and components of the framework of domestic and foreign essential medicine lists （EMLs）， in order to provide reference for optimizing the framework of the Chinese EML. METHODS The latest edition of the EMLs of WHO， China， South Africa， India， Malaysia and other typical countries were compared， and the similarities and differences of the presentation form and constituent elements of the list framework were analyzed. RESULTS & CONCLUSIONS The common presentation forms of WHO and typical countries’ EMLs included version， classifications and symbols， of which management ideas， functions， and implementation difficulties varied； common framework elements included target population， hospital levels， drug use conditions， core and supplementary lists and procurement priority. Through comparison， it was found that the information covered by the Chinese EML was relatively thin， and the framework design had not yet fully played the ideal role in guiding clinical rational drug use and optimizing the allocation of health resources， and there was still some room for improvement. It is recommended that China clarify the characteristics and roles of different presentation forms of the EML， and reasonably set the EML framework based on national conditions and development needs； the multi-dimensional drug information should be supplemented， such as clinical use， economy， and policy attributes of drugs in the EML， to ensure the rational use of essential drugs； it is also necessary to add “the level of hospitals” in the framework of the EML， refine the management requirements for the allocation and use of essential medicine， and optimize the resource allocation of hospitals.

Necesidades de información sobre medicamentos y salud pública en médicos de un hospital mexicano / Information needs about drugs and public health among doctors from a Mexican hospital

El objetivo de esta investigación fue identificar las necesidades de información sobre medicamentos y salud pública en los médicos de un hospital mexicano. Se realizó un estudio descriptivo y transversal mediante una encuesta validada por expertos y por estudio piloto a 112 médicos en el año 2016. Los participantes fueron seleccionados por muestreo aleatorio simple de un hospital público de segundo nivel en Nayarit, México. Las variables estudiadas fueron: necesidades de información, comportamiento informativo y el nivel de satisfacción. El 66,4 por ciento de los médicos necesitaban información relacionada con el tratamiento farmacológico de sus pacientes y el 63,3 por ciento de los médicos tuvo necesidades sobre datos poblacionales. Las revistas médicas fueron la vía preferida para obtener información (70,4 por ciento) y al mismo tiempo obtuvieron la puntuación más alta de satisfacción. El 89,5 por ciento no consultaba bases de datos o repositorios, y el motivo más común para no hacerlo fue por carecer de computadora e Internet en el lugar de trabajo (62,4 por ciento). El 76,8 por ciento consideró que sus necesidades de información estaban insatisfechas con los recursos y servicios proporcionados por el hospital. El estado actual de la gestión de la información de los médicos entrevistados pone en riesgo su actualización profesional, disminuye la posibilidad de prescribir tratamientos racionales y de tomar decisiones eficientes(AU)

The purpose of the study was to identify the information needs about drugs and public health among doctors from a Mexican hospital. A descriptive cross-sectional analysis was conducted in the year 2016 which was based on an expert validated survey and a pilot study of 112 doctors. Participants were selected by simple random sampling at a secondary hospital in Nayarit, Mexico. The variables analyzed were information needs, information behavior and satisfaction level. Of the doctors surveyed, 66.4 percent needed information related to the drug treatment of their patients, whereas 63.3 percent needed population data. Medical journals were the favorite source of information (70.4 percent) and obtained the highest satisfaction score. 89.5 percent of respondents did not consult any database or repository, and the most common reason was they did not have a computer with Internet access at the workplace (62.4 percent). 76.8 percent considered that their information needs were not satisfied by the resources and services available at the hospital. The current information management status of the doctors interviewed poses a risk to their professional updating, reducing the possibility of prescribing rational treatments and taking efficient decisions(AU)

Cognition of traditional Chinese medicine properties and thinking of clinical rational use of drug / 中国中药杂志

This paper discusses the rational use of traditional Chinese medicine based on chemical composition, body state and biological effect. The essence and connotations of traditional Chinese medicine are explained by modern scientific theory and technical means, and the mechanism of traditional Chinese medicine in the treatment of diseases is defined in modern medicine language, which is conducive to promoting rational and safe clinical use of drugs. Based on the chemical composition of traditional Chinese medicine,the selected genuine medicinal materials were collected and processed in a standardized way, and then used in the combination with other traditional Chinese medicines, with the aim to improve the efficacy of traditional Chinese medicine in clinical indications, increase the advantages, eliminate the disadvantages, and adapt to flexible and safe clinical drug demands. Based on the body state elements, clinical diagnosis and treatment shall be patient-centered, and doctors shall distinguish the differences of pathogenesis, symptoms and diseases, and consider the drug contraindications of special groups. According to the " dose-effect-toxicity" relationship, doctors shall select the appropriate dosage form, control the drug dosage, balance the benefits and risks of drugs, and carry out appropriate medical treatment. Based on the biological effect elements and the regulatory mechanism of traditional Chinese medicine on the target and pathway of disease, traditional Chinese medicine shall strengthen the precise positioning, provide accurate treatment; evaluate the safety of traditional Chinese medicine combination, explore the adverse reaction mechanism, strengthen the clinical safety monitoring of traditional Chinese medicine, and guide the clinical rational use of drugs, in the expectation of ensuring the safe use of traditional Chinese medicine and maximize the clinical efficacy of traditional Chinese medicine.

Discussion on Forensic Identification of the Rationality of Medical Expense / 法医学杂志

In cases on compensation for personal injury, the issue of medical expense compensation involves the vital interests of the compensation obligor, the injured party and the medical institution. The rationality of medical expenses is likely to be controversial, however, there is no unified standard and stipulation for the medical expense rationality identification in forensic clinical identification at present, therefore, in the practice of judicial expertise, expert opinions easily become confused, and the legitimate rights of the parties could be infringed, which affects the impartiality and authority of judicial expertise. This article starts with the concept of medical expense and the rationality of medical expense and the reasons for disputes over the rationality of medical expense, to put forward the basic principles that should be followed in the identification of rationality of medical expenses, for peer reference.

The research progress of microRNA on regulation of drug disposition in vivo / 中国药理学通报

The disposition of drug in vivo is subjected to a series of biotransformation and transport, depending on the involvement of drug-metabolizing enzymes and transporters.However, the individual capacity varies when metabolizing and transporting the same drug, and pharmacogenomics has trouble in completely explaining the differences.microRNA, a key aspect of epigenetic modifications, is a powerful complement to traditional genetics.Emerging evidences have confirmed that drug-metabolizing enzymes and transporters be controlled by different microRNAs, and the same microRNA also regulates several drug-metabolizing enzymes or/and transporters simultaneously.All of these researches infer that microRNAs are likely to realize the comprehensive macro-regulation of gene expression.The further study of microRNAs maybe a suitable point to research the interindividual variability in disposition of drugs, and it provides a theoretical basis for rational use of drug and individualized medicine.

Clinical Study on Shenfukang Capsules for Renal Insufficiency / 中国药房

OBJECTIVE:To investigate the effects of Shenfukang capsules on clinical efficacy and renal function indexes of patients with renal insufficiency. METHODS:Totally 100 inpatients with renal insufficiency treated by Shenfukang cap-sules in the First Affiliated Hospital of Guangxi Medical University during Feb. to Mar. 2015 were analyzed retrospectively in respects of general information of patients,therapy plan,renal function indexs before and after treatment and clinical effica-cy. The relationship of clinical efficacy with age and duration was also analyzed. RESULTS:There were 33 cases of acute re-nal insufficiency and 67 cases of chronic renal insufficiency. The route of administration of Shenfukang capsules was oral ad-ministration(97 cases,97.00%),the main dosage was 6 capsule/d(36 cases,36.00%),and treatment duration were 0-0.05);among patients with chronic renal insufficiency,the total response rate of patients elder than 60 years old was significantly better than that of patients with ≤60 years old,with statistical significance (P<0.05). With the extension of treatment duration,the total response rate of patients with acute renal insufficiency was on the rise,and that of patients with chron-ic renal insufficiency increased first and then decreased. No obvious ADR was found during treatment. CONCLUSIONS:Shenfu-kang capsules can improve renal function in patients with renal insufficiency,and has definite curative effect on acute and chronic renal insufficiency with good security. The clinical efficacy may be related to age and treatment course.

Establishment and Application of DUE Criteria for Tigecycline in a Hospital / 中国药房

OBJECTIVE:To establish drug use evaluation(DUE)criteria for tigecycline,and to provide reference for rational use of tigecycline. METHODS:Based on tigecycline instructions,referring to related specifications and literatures,DUE criteria for tigecycline was established. And on a basis of it,referring to DUE criteria,in retrospective study,the utilization of tigecycline in 179 inpatients of some one hospital during Nov. 2012-Oct. 2016 was evaluated and analyzed in respects of management indexes, medication indication,medication duration,medication results,etc. RESULTS:The results for DUE of tigecycline in this hospital was that the proportion of patients with consultation records was 83.2%(aiming at 100%);microbial inspection rate was 90.5%(aiming at 80%);the coincidence rate of medication indication was 98.9%(aiming at 90%);the rates of solvent selection,ad-ministration route,drug interaction,incompatibility,drug use in special populations meeting the criteria were all 100%(aiming at 100%);the rate of prescribing authority was 20.1%(aiming at 100%);the rate of drug dosage and medication interval meeting the criteria were 7.3%(aiming at 100%);response rate was 54.7%(aiming at 80%). CONCLUSIONS:Established DUE criteria of tigecycline can standardize the clinical utilization of tigecycline.

Rationality Analysis of the Utilization of Anticoagulant Drugs in the Inpatients of Our Hospital during 2013-2015 / 中国药房

OBJECTIVE:To provide reference for rational use of anticoagulant drugs in the clinic. METHODS:Medical or-ders of anticoagulant drugs were collected from hospital information system of our hospital during 2013-2015. Those medical orders were analyzed in respects of consumption sum,DDDs,DDC and drug utilization. RESULTS:During 2013-2015,the sum tatio of Low-molecular-weight heparins calcium injection(6000 AXaIU),Enoxaparin sodium injection(6000 AXaIU),Dalteparin sodium injection(5000 IU) and Rivaroxaban tablets(10 mg)were on the rise,while those of Nadroparin calcium infection(6150,4100 AXaIU)and Fondaparinux sodium injection(2.5 mg)were in the decline. DDDs of Nadroparin calcium injection(4100 AXaIU), Dalteparin sodium injection(5000 IU)and Enoxaparin sodium injection(6000 AXaIU)took up the first 3 places. DDC of Rivar-oxaban tablets was the highest,being 167.60-180.25 yuan. The utilization of Nadroparin calcium injection(6150,4100 AXaIU), Low-molecular-weight heparins calcium injection (6000 AXaIU),Fondaparinux sodium injection(2.5 mg) and Warfarin sodium tablets(3 mg)showed good synchronization within 3 years,and the values of B/A ranged 0.50-1.50. Both consumption sum and utili-zation rate of rivaroxaban took up the first place in vascular surgery department. CONCLUSIONS:Based on the spectrum of diseases, the features of drugs and ADR,the utilization of anticoagulant drugs in our hospital is rational during recent 3 years. However,the uti-lization of anticoagulant drugs should be still used as routine pharmaceutical monitoring content.

Analysis of Clinical Features of Alprostadil Lipid-micro Injection from 159 Hospitals of China / 中国药房

OBJECTIVE:To provide evidence for rational use and clinical monitoring of Alprostadil lipid-micro injection (Li-po-PGE1). METHODS:Adult inpatients receiving Lipo-PGE1 from hospital information system(HIS)of 159 hospitals were select-ed as research subject. Based on frequency statistics,population,clinical diagnosis,and average daily dose of Lipo-PGE1 were all studied. RESULTS:A total of 71687 adult inpatients were included,and the male was more than female,mostly aged 61-75. The hospitalization duration was 8-14 d(45.01%),most of patients were recovered(68.20%). Lipo-PGE1 was wildly used in the clin-ic,and was used for 871 kinds of clinical diseases in total;top 3 diseases were cerebral infarction(9.06%),non-insulin dependent diabetes mellitus (8.65%) and chronic ischemic heart disease (8.08%). The average daily dose of different diseases and different hospitals were significantly different,mostly≤12.5μg. CONCLUSIONS:As adjuvant drug,medical institutions and related super-vision departments should formulate reasonable monitoring index and strengthen medication guidance and evaluation of Lipo-PGE1.

Research advance on pharmacokinetics of oleanolic acid / 药物评价研究

Oleanolic acid has a widespread pharmacologic effect,including anti-inflammation,antitumor,anfidiabetes,anti-atherosclerosis,hepatoprotection,anti-osteoporosis,etc.Bioavailability of oleanolic acid by oral administration is low,and is absorbed by intestine through passive transport.Oleanolic acid dispersion preparation can increase its solubility and bioavailability,and concentrate on liver to help treat for hepatic disease.The pharmacokinetic parameters,process in body of oleanolic acid,and the pharmacokinetic feature of oleanolic acid dispersion and its prodrug are reviewed,and its research advance on pharmacokinetics is summarized,which provides a reference for rational utilization of oleanolic acid.

Analysis of rational use of Fat Emulsion Injection in 1500 tumor patients / 药物评价研究

Objective To evaluate the clinical application of Fat Emulsion Injection in tumor patients and provide references for rational drug use.Methods A total of 1500 cases administered with Fat Emulsion Injection during January and December 2016 in Affiliated Cancer Hospital of Zhengzhou University were collected randomly and evaluated with the relevant standards.Results From the investigation of a total of 1 500 patients with cancer,fat Emulsion Injection was mainly used in the surgery department (68.2％).Of 1500 cases,unreasonable medical records accounted for 35.2 ％;inappropriate indication accounted for 16.1％,inappropriate selection of drugs accounted for 44.5％,incorrect dosage accounted for 50.6％,and incompatibility accounted for 18.3％.Conclusion Unreasonable use of Fat Emulsion Injection in the hospital is prevalent,therefore,measures should be taken to strengthen the standard use of this kind of drugs.

Analysis of the Utilization of Narcotic Drugs in Our Hospital during 2013-2015 / 中国药房

OBJECTIVE:To evaluate the current situation and trend of narcotic drugs used in our hospital,and to provide refer-ence for scientific management and rational use of narcotic drugs. METHODS:The utilization of narcotic drugs in our hospital dur-ing 2013-2015 was analyzed statistically in terms of consumption sum,DDDs,DDC and B/A,etc. RESULTS:The consumption sum of narcotic drugs in our hospital increased year by year,mainly injection. Both consumption sum and DDDs of Sufentanil ci-trate injection took up the first place during 2013-2015,Morphine hydrochloride sustained-release tablets and Fentanyl citrate injec-tion took up 2nd and 3rd place in the list of DDDs. Top 3 drugs in the list of DDC were Oxycodone hydrochloride prolonged-re-lease tablets(40 mg),Remifentanil hydrochloride for infection(2 mg)and Sufentanil citrate injection. B/A of Sufentanil citrate in-jection,Morphine hydrochloride tablets and Oxycodone hydrochloride prolonged-release tablets(10 mg)were all close to 1.0, showing good synchronization of economic and social benefits. CONCLUSIONS:The consumption sum of narcotic drugs in our hospital has increased year by year. The utilization and management of narcotic drugs is basically in line with related standard and treatment criteria,but the management of narcotic drugs still need to be strengthened in the future.

Analysis of the Utilization of Narcotic Drugs in Our Hospital during 2013-2015 / 中国药房

OBJECTIVE:To evaluate the current situation and trend of narcotic drugs used in our hospital,and to provide refer-ence for scientific management and rational use of narcotic drugs. METHODS:The utilization of narcotic drugs in our hospital dur-ing 2013-2015 was analyzed statistically in terms of consumption sum,DDDs,DDC and B/A,etc. RESULTS:The consumption sum of narcotic drugs in our hospital increased year by year,mainly injection. Both consumption sum and DDDs of Sufentanil ci-trate injection took up the first place during 2013-2015,Morphine hydrochloride sustained-release tablets and Fentanyl citrate injec-tion took up 2nd and 3rd place in the list of DDDs. Top 3 drugs in the list of DDC were Oxycodone hydrochloride prolonged-re-lease tablets(40 mg),Remifentanil hydrochloride for infection(2 mg)and Sufentanil citrate injection. B/A of Sufentanil citrate in-jection,Morphine hydrochloride tablets and Oxycodone hydrochloride prolonged-release tablets(10 mg)were all close to 1.0, showing good synchronization of economic and social benefits. CONCLUSIONS:The consumption sum of narcotic drugs in our hospital has increased year by year. The utilization and management of narcotic drugs is basically in line with related standard and treatment criteria,but the management of narcotic drugs still need to be strengthened in the future.

Analysis of the rational use of Shenmai injection of 400 cases / 中国生化药物杂志

Objective To analyse the clinical usage of Shenmai injection, promote the rational use of Shenmai injection. Methods 400 hospital medical records that used Shenmai injection in 2015 were collected and reviewed from hospital information system (HIS) by retrospective analysis method, aggregated and evaluated data by EXCEL. Results In 400 cases, 11 clinical departments used the Shenmai injection, mainly in cardiology of 347 cases(86.75%).The percentage of the non-standard clinical application of Shenmai injection was 84 cases (21.00%). The non-standardized rates of solvent dispensing was 287 cases (71.75%), and the specification incompatibility accounted for 105 cases (26.25%). There was no adverse drug reaction of Shenmai injection. Conclusion The clinical use of Shenmai injection is not yet standardized, which suggests that drugs should be strictly used in accordance with the instruction, in order to avoid risks of off-label use.

Analysis of 528 Cases of ADR Reports and Disposal Measures / 中国药房

OBJECTIVE:To provide reference for reducing the occurrence of ADR and disposing ADR correctly. METHODS:Using the Excel statistics and manual screening,528 ADR reports were collected from a third grade class A hospital in Chongqing during Oct. 2005 to Dec. 2015. Those ADR cases were analyzed statistically in respects of general information of ADR patients, routes of administration and occurence time,types of ADR-inducing drugs,organs/systems involved in ADR and clinical manifesta-tions,disposal and outcomes,etc. RESULTS:A total of 285 cases(53.98%)of ADR occurred in elderly patients aged more than 65. Most of original diseases were respiratory system disease(144 cases,27.27%). 124 ADR cases occurred in people who had al-lergic history(23.48%). Most of ADR cases were induced by intravenous administration(428 cases,81.06%). ADR frequently oc-curred within 1 h after medication(385 cases,72.92%). Anti-infective agents(211 cases,39.96%)and TCM preparations(67 cas-es,12.69%) were the top 2 involved drug types. The most common ADR occurred in skin and its appendants (175 cases, 33.14%),followed by general reaction(148 cases,28.03%)and administration sites(63 cases,11.93%). The treatment of ADR mainly involved drug withdrawal and symptomatic treatment (285 cases,53.98%). ADR mainly were cured and recovered (509 cases,96.40%). CONCLUSIONS:The characteristics and regularity of ADR disposal should be analyzed to formulate clinical path-way for ADR diagnosis,suspected cases observation,examination,disposal and rescue. When the patient has general reaction or re-spiratory system and circulatory system problems,treatments should be more actively processed.

Drug utilization analysis of hospitalized children in psychiatric hospital / 中国基层医药

Objective To investigate the drug utilization of hospitalized children in psychiatric hospital and analyze its the rationality.Methods A retrospective study was conducted to survey the utilization of psychotropic drugs in hospitalized children between January 2016 and June 2016,and according to drug instruction,its the rational-ity was analyzed.Results The top three used psychotropic drugs were aripiprazole,sertraline and sodium valproic sustained -release tablets.The types of drugs without safety data were at most and most frequently used.Diagnosis was not consistent with indications for totally 12 kinds of drugs,aripiprazole involved the most cases.A total of 5 drugs existed usage not matching drug instruction,and sodium valproic sustained -release tablets accounted for the most. Conclusion Irrational use of drugs in psychiatric hospital is still common at present.Clinical pharmacists can improve rationality of drug utilization of hospitalized children in psychiatric hospital by creating a drug database and carrying out pharmaceutical care.

PROBLEMS AND COUNTERMEASURES EXISTINGIN HOSPITAL RATIONAL MEDICATIO-NEVALUATION / 现代医院

The rational prescription evaluation is important for improving the medical quality and ensuring prescription safety.For the last few years, the health authorities have issued a series of files in order to regulate clini-cal medical conducts, and reduce the irrational prescription.Hospitals are also paying more attention to the rational medicine evaluation.The evaluation is likely to be doubted and resisted for the difference of evaluation personnel, e-valuation personnel quality and evaluation criterion.Therefore, the smooth development of hospital rational prescrip-tion evaluation need to adopt effective management measures, which is connected with responsibilities, guaranteed by rewards and punishments and based on actualities, and establish various evaluation management mechanism to ensure continuous correction and updating at work.

Change trend and antimicrobial resistance of pathogens causing infection in extensive burn patients / 中国感染控制杂志

Objective To explore the change trend and antimicrobial resistance of pathogens causing infection in extensive burn patients,and provide reference for clinical prevention and treatment.Methods Specimens from 9 extensive burn patients who were admitted to a hospital at the same time were performed pathogenic culture and an-timicrobial susceptibility testing, change trend and antimicrobial susceptibility of pathogens were observed. Results The main specimen was wound secretion,accounting for 93.81 %.The major pathogens causing infection were Acinetobacter baumannii (44.85%),Staphylococcus aureus (32.47%),Pseudomonas aeruginosa (12.37%), and Klebsiella pneumoniae (5.15%).With the prolongation of hospital stay,pathogens changed from one kind to multiple strains, and from susceptibility to resistance,multidrug resistance,and extensive drug resistance. Conclusion Itis difficult to avoid infection in burn patients,timely realizing the changes of pathogens causing infec-tion and antimicrobial resistance play an important role in the control of infection.