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OBJECTIVE:To shorten the turnover days of hospital drug inventory,reduce the cost of drug inventory and improve the level of hospital drug inventory management.METHODS:The data of 65 kinds of antitumor drugs and its adjuvant drugs during Jan.1st,2016-Dec.31st,2016 were collected from hospital information system (HIS) of our hospital,such as price,inventory to classify by using ABC classification method.According to demanded quantity of class A drugs in the secondary drug storage,the amount purchased of upper and lower limitation of class A drugs could be calculated.The data of class C drugs were analyzed one by one to determine the "temporary use" drug directory.The turnover days of class A drugs and the inventory cost of class C drugs were counted before and after classification management.RESULTS:There were 10 class A drugs,accounting for 15.38％ of total types and 78.27％ of total consumption sum;the turnover days of pharmacy inventory decreased from (43.96 ± 19.04) d to (13.64 ± 8.02) d by adopting the principle of purchasing in small quantity by several times.There were 10 "temporary use" drugs of class C drugs,accounting for 26.32％ of total types,270 thousand yuan inventory cost saved each year.CONCLUSIONS:Hierarchical management of hospital drug inventory by ABC classification can effectively optimize the inventory types and amount,and provide definite evidence for "temporary use" drugs so as to shorten turnover days of pharmacy inventory and recue the cost of pharmacy inventory.
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Objective:To analyze the utilization of adjuvant drugs in a three-A hospital to provide reference for rational drug use in clinic. Methods:The utilization of top 10 adjuvant drugs in the list of consumption sum in the hospital was analyzed statistically in re-spects of total consumption and constituent ratio,the consumption sum of single type, DDDs and DDC, etc. Results: The total con-sumption increased year by year from 2014 to 2016, and the constituent ratio was over 30%. The top 3 adjuvant drugs in the list of consumption sum were traditional Chinese medicine injection, neurotrophic drugs and enteral nutrition(EN)and parenteral nutrition (PN)preparations. Monosialotetrahexosylganglioside sodium injection, alprostadil injection and coenzyme complex for injection were with the highest DDDs.Conclusion:The adjuvant drugs used in the hospital are with too many variety,too high consumption sum and too frequent administration. The hospital authority should take comprehensive measures to promote the rational use of adjuvant drugs.
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Objective: To investigate the utilization of adjuvant drugs in the secondary hospitals from Xi'an, and to provide reference for rational use of adjuvant drugs.Methods: The utilization of adjuvant drugs of the top 20-ranked drugs in 32 secondary hospitals from Xi'an during 2013 and 2015 was analyzed statistically in respects of total consumption sum of adjuvant drugs, the proportion of adjuvant drugs sum, the consumption sum, DDDs and DDC of each adjuvant drug, and adverse drug reaction.Results: The total consumption sum and the proportion of adjuvant drugs sum increased year by year from 2013 to 2015.13 kinds of adjuvant drugs were included in top 20 in the list of total consumption sum from more than 3 hospitals in three years.Danhong injection, shuxuening injection, xueshuantong injection, xueshuantong injection, xuesaitong injection, deproteinized calf blood serum injection took up the front in the list of consumption sum and DDDs in 3 years.The cases of adjuvant drugs-induced ADR increased year by year.Conclusion: At present, adjuvant drugs become the important part of clinical drug use in this area.The consumption sum and amount is increasing rapidly.Great importance should be attached to the rational administration and safety use of the adjuvant drugs to control the unreasonable increase of drug expenses.
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OBJECTIVE:To provide reference for rational use of adjuvant drugs in the clinic.METHODS:By retrospective method,the utilization of top 10 adjuvant in the list of consumption sum and DDDs in our hospital during 2013-2015 were analyzed statistically in respects of consumption sum,DDDs,DDC,B/A,etc.RESULTS:During 2013-2015,the consumption sum of adjuvant drugs in our hospital increased from 32 959 000 yuan to 42 436 500 yuan,and its proportion in total consumption sum increased from 31.28％ to 35.22％.The top 10 adjuvant dosage forms in the list of consumption sum were injection,and varieties included activating blood circulation to dissipate blood stasis,nerve nutrition,immunoregulation drugs.The consumption sum fluctuated but was on the increase in general.Top 10 adjuvant drug types in the list of DDDs were mainly drugs for enhancing tissue metabolism,vitamins,nerve nutrition,activating blood circulation to dissipate blood stasis.In terms of DDC,main dosage form was injection;B/A of these drugs was poor and drug price was in high level.CONCLUSIONS:It is suggested to standardize the utilization of adjuvant drugs,so as to promote the effective,economical and rational use of drugs.
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OBJECTIVE:To explore the effect of comprehensive intervention mode on the rational use of Ribonucleic acid Ⅱ for injection,and to provide reference for the management of adjuvant drugs for cancer therapy.METHODS:The rational use of ribonucleic acid Ⅱ was interfered by establishing evaluation criteria,reviewing medical record,establishing tumor therapy adjuvant management work group,classifying drug prescription right,examining and approving off-label drug use,strengthening the assessment and training,clinical pharmacists intervention.The utilization of ribonucleic acid Ⅱ was analyzed statistically in our hospital during Apr.-Jun.2015 (before intervention),Jul.-Sept.2015 (after the first intervention),Oct.-Dec.2015 (after the second intervention) and Jan.-Mar.2016 (after the third intervention).RESULTS:The reasonable rate of Ribonucleic acid Ⅱ for injection was 77.34％ before intervention,and 83.25％,83.64％,95.12％ after the first,second and third intervention respectively;the difference was statistically significant compared to before intervention (P＜0.05).The irrational types included inappropriate indications,unsuitable treatment course,inappropriate usage and dosage,and unsuitable drug combination,etc.The percentage of these irrational types decreased from 2.96％,4.93％,13.79％ and 0.99％ before intervention to 1.63％,0,3.25％ and 0 after the third intervention,respectively.The utilization rate of Ribonucleic acid Ⅱ for injection was reduced from 8.81％ before intervention to 3.93％ after the third intervention,the differences were statically significant (P＜0.05).CONCLUSIONS:The comprehensive intervention model combined with multiple intervention methods can promote the rational use of Ribonucleic acid Ⅱ for injection.It is suggested to further study and evaluate the intervention effect of this model on other adjuvant drugs for cancer therapy.
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Objective:To define the range and classification of adjuvant drugs. Methods:In order to explore the definition meth-od for the range and classification of adjuvant drugs, the information of definition and classification of adjuvant drugs was obtained by searching PubMed, CNKI, Wanfang database and medicine monographs such as Clinical Medication Notice, New Pharmacology and Martindale:The Complete Drug Reference. Results:The preliminary conclusion on definition, range and classification method for ad-juvant drugs was achieved. Adjuvant drugs were classified into ten categories, so that the adjuvant drugs in our hospital were super-vised. Conclusion:In order to promote the standardized management of clinical application of adjuvant drugs, the range and classifica-tion of adjuvant drugs still need further discussion and standardization.
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OBJECTIVE:To provide a reference for clinical use of anti-tumor adjuvant drugs as is reasonable,effective and economical. METHODS:By retrospective investigation and analysis,the utilization of anti-tumor adjuvant drugs in the oncology department of our hospital during 2010 and 2013 was analyzed statistically in respect of the type,dosage form,consumption amount,DDDs,DDC,DUI etc. RESULTS:The anti-tumor adjuvant drugs in our hospital were dominated by injections,especial-ly domestic drugs,the consumption amount of which accounted for 80% of the total consumption amount of anti-tumor adjuvant drugs each year. The anti-tumor adjuvant drugs were mainly used for symptomatic treatment of various adverse reactions. Drug syn-chronization was relatively good each year,however,excessive use of individual drugs existed. CONCLUSIONS:Anti-tumor adju-vant drugs have relatively better synchronism in the drugs quantities and medication number. However,individual drugs have exces-sive use and other irrational use.
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Objective To investigate the value of drug intervention for difficult weaning from mechanical ventilation. Methods A prospective single-blind randomized controlled trial was conducted. 120 patients with difficult weaning from mechanical ventilation encountered in Department of Critical Care Medicine of Peking University Third Hospital from January 2008 to December 2013 were included,and the patients were divided into treatment group and control group according to random number table,with 60 cases in each group. Patients received furosemide therapy in the treatment group 3 days before weaning up to 48 hours after weaning in order to control negative liquid balance. Enema was given the day before weaning to reduce abdominal pressure. On the weaning day,all of the patients received nitroglycerin and beta blocker or cedilanid to prevent or control elevation of blood pressure and heart rate in the process of weaning. All patients in treatment group received anisodamine in small dosage 2 hours before extubation.The patients in control group received conventional treatment without drug intervention. Baseline indexes of two groups were compared,including the heart rate,respiration rate(RR),mean arterial pressure(MAP),pulse blood oxygen saturation(SpO2),blood gas,hemoglobin(HG),albumin(ALB)and creatinine(Cr). The main reasons of difficulty in weaning,sedative and analgesic drug selection,presence of abdominal discomfort before weaning,interval between sputum suction before extubation,liquid balance at the beginning of the investigation and at time of weaning,24 hours and 48 hours after weaning,failures of spontaneous breathing test(SBT),length of mechanical ventilation,length of ICU stay,and total length of mechanical ventilation and total length of ICU stay during hospitalization. Results There was no statistically significant difference in the heart rate,RR,MAP,SpO2,blood gas,HG,ALB,Cr at the beginning of the investigation between the two groups. The main reasons for difficult weaning in both groups of patients were respiratory dysfunction,cardiac insufficiency,and central nervous system dysfunction. The use of propofol combined dexmedetomidine in the treatment group was more frequent than the control group〔16.7%(10/60)vs. 1.7%(1/60),χ2=8.107,P=0.004〕,and there was no statistically significant difference in the use of other combinations of sedative drugs between the two groups. Abdominal discomfort before weaning was milder in treatment group as compared with control group〔10.0%(6/60)vs. 25.0%(15/60),χ2=4.675,P=0.031〕. The interval between sputum suction before extubation in the treatment group was significantly longer than that of the control group〔hours:1(1,2)vs. 1(1,1),Z=-2.209,P= 0.027〕. SBT failure was less frequent in treatment group compared with control group〔times:0(0,1)vs. 1(1,2),Z=-6.561,P=0.000〕. Liquid balance was better in the treatment group than the control group at time of weaning,24 hours and 48 hours after weaning〔at time of weaning:-567.71 (-755.95,-226.41)vs. 1 256.76(472.48,1 796.63),Z=-9.038,P=0.000;24 hours after weaning:-5.03 (-530.28,245.09)vs. 342.28(125.36,613.25),Z=-4.711,P=0.000;48 hours after weaning:115.50(-450.26, 485.00)vs. 330.00(16.25,575.25),Z=-1.932,P=0.053〕. Compared with control group,length of mechanical ventilation〔days:1.0(1.0,2.0)vs. 2.0(2.0,3.0),Z=-6.545,P=0.000〕,ICU stay time〔days:3.0(3.0,4.0) vs. 4.0(4.0,5.0),Z=-6.545,P=0.000〕,and total length of mechanical ventilation〔days:8.0(6.0,12.0)vs. 11.0(8.0,15.0),Z=-4.091,P=0.000〕and total length of ICU stay during hospitalization〔days:12.5(9.2,19.0) vs. 17.0(12.0,29.5),Z=-2.722,P=0.000〕were all significantly shorter in the treatment group. Conclusions Adjuvant drugs therapy is helpful in patients weaning from the mechanical ventilation,and can shorten length of mechanical ventilation and ICU stay time. Propofol,combined dexmedetomidine,is helpful for weaning.
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OBJECTIVE:To investigate the utilization of antineoplastic drugs and adjuvant drugs in our hospital. METHODS: By a retrospective review, the consumption quantity, consumption sum, and constituent ratio of antineoplastic drugs and adjuvant drugs used in our hospital from 2005 to 2008 were analyzed statistically. RESULTS: The consumption of antineoplastic drugs and assistant drugs had dominated the front places from 2005 to 2008, representing 25.91%, 28.16%, 31.16% and 33.00%, respectively of the total western drugs in terms of consumption sum, assuming a year-on-year increase tendency over the 4 years. Injections took a higher proportion, making up for 75.40%, 79.80%, 80.50% and 78.12%, respectively over the 4 years. The application of antineoplastic drugs and assistant drugs from domestic manufacturers assumed a predominant place. CONCLUSION: It is still necessary to standardize the use of antineoplastic drugs and assistant drugs in our hospital so as to ensure their safety, effectiveness and economy in clinical medication.