Retrospective study on the use of epinephrine in patients with drug-induced anaphylactic shock in Chongqing from 2015 to 2022 / 中国药房

OBJECTIVE To evaluate the rationality of epinephrine in the treatment of drug-induced anaphylactic shock， and to provide a reference for further standardizing the treatment measures of anaphylactic shock. METHODS According to the relevant data of the reports of severe adverse drug reaction （ADR） of drug-induced anaphylactic shock provided by Chongqing ADR Monitoring Center from 2015 to 2022， the selection of treatment drugs， and the application of epinephrine in anaphylactic shock were analyzed retrospectively； the clinical outcomes of anaphylactic shock with different epinephrine administration methods were investigated. RESULTS A total of 1 415 cases of severe ADR related to drug-induced anaphylactic shock were reported， with a male-to-female ratio of 1.04∶1； the drugs that caused allergic shock mainly included anti-infective drugs （47.92%）， TCM injections （9.12%）； the patients who suffered from drug-induced anaphylactic shock within 10 min after medication accounted for 43.96%； 97.24% of patients were cured or improved， and 2.76% of patients died or did not been improved. Among 1 415 patients， 63.39% of patients were treated with epinephrine， and the patients who preferred epinephrine treatment accounted for 53.14%； the intramuscular injection， subcutaneous injection， intravenous injection and intravenous drip accounted for 33.78%， 30.32%， 25.75% and 1.23%， respectively. The initial dose range of epinephrine was 0.01-10 mg， and the most frequent single dose was 1 mg （44.70%）. Excessive single doses of intramuscular injection， subcutaneous injection and intravenous injection accounted for 51.03% （148 cases）， 53.13% （136 cases） and 91.47% （193 cases） respectively， and the risk of overdose in intravenous injection was higher （P＜0.05）. The patients receiving initial treatment with epinephrine had a higher improvement rate/cure rate than those who did not use epinephrine （98.14% vs. 96.23%， P＝0.029）； the patients who preferred epinephrine had a higher improvement rate/cure rate than those who did not preferred epinephrine （98.14% vs. 95.17%， P＝0.031）； the improvement rate/cure rate of patients receiving intramuscular injection of epinephrine was higher than those without intramuscular injection （99.01% vs. 96.69%， P＝0.038）. CONCLUSIONS There are some unreasonable phenomena in the treatment of drug-induced anaphylactic shock， such as inappropriate selection of drugs， insufficient use of epinephrine， delay of administration， inappropriate route of administration and excessive single dose.

Analysis of chronic disease types and drug use of multiple chronic diseases based on regional pretrial center / 中国药房

OBJECTIVE To provide reference for chronic disease management in grass-root institution . METHODS System structure design and audit class setting of the regional pretrial center in Changning district of Shanghai were introduced. The number of prescriptions/medical orders from the start of application to February 28，2022 were counted. The prescriptions/medical orders intercepted by the system ，prescriptions/medical orders intervened by physicians ，chronic disease types and drug use of regional multiple chronic diseases were counted and analyzed. RESULTS Compared with the data when the center was on line in September 2021，total qualified rate of prescriptions/medical orders （97.67％ vs. 86.42％）significantly increased ，the number of prescriptions/ medical orders intercepted by the system and intervened by physicians decreased by 55.39％ and 72.67％ in February 2022， respectively. The top five diseases were hypertension （26.52％），coronary heart disease （20.53％），sleep disorders （16.71％），diabetes（15.24％）and bone diseases （14.09％）. Among them ， there were many problematic prescriptions involving coronary heart disease ，sleep disorder and bone disease. CONCLUSIONS The incidence of chronic diseases among community residents remains high. In addition to common chronic diseases such as coronary heart disease ，hypertension and diabetes ，the incidence of sleep disorders and bone diseases is also increasing. With the help of the regional pretrial center ，the focus of chronic disease management can be adjusted timely ，drug supervision can be carried out in real time so as to improve the level of rational drug use in grass-root institution.

Analysis of Drug Use of Anti-infective Treatment for a 400 g Super-premature Infant by Clinical Pharmacists / 中国药房

OBJECTIVE：To optimize the ant i-infective treatment plan for the super-premature infants and provide reference for the clinical treatment of the super-premature infants and the whole pharmaceutical care. METHODS ：A super-premature infant with gestational age of 25+5 weeks and weight of 400 g was delivered in the second department of neonatology in Hunan Maternal and Child Health Hospital. This child suffered from complex complications. Clinical pharmacists ，relevant medical staff and hospital infection department personnel formed a multidisciplinary treatment team. According to Neonatal Sepsis Treatment Scheme ， Antimicrobial Treatment Guide ，Premature Medicine ，combining with the analysis of infection indicators ，biochemical indicators ， vital signs and other indicators ，a individualized anti-infective diagnosis and treatment plan was developed for the child. After entering the NICU ，this child was given Piperacillin sodium and sulbactam sodium for injection （100 mg/kg，ivgtt，q12 h）for anti-infective treatment ；considering the possibility of sepsis ，clinical pharmacists suggested that Piperacillin sodium and sulbactam sodium for injection should be stopped and Meropenem for injection （40 mg/kg，ivgtt，q12 h）should be used instead. After 7 day of meropenem treatment ，clinical pharmacists suggested adding antifungal Fluconazole injection （5.0 mg/kg，ivgtt，qod）. After 11 days of meropenem treatment ，in order to avoid the aggravation of infection ，according to the drug sensitivity results （sensitive to Ticarcillin sodium and clavulanate potassium for injection ），clinical pharmacists suggested adding Ticarcillin sodium and clavulanate potassium for injection （75 mg/kg，ivgtt，q8 h）for combined anti-infective treatment ，and hospital infection treatment was carried out at the same time. After the infection index was stable ，all antibiotics were stopped. When E. coli infection occurred later，clinical pharmacists suggested that Piperacillin tazobactam sodium for injection （75 mg/kg，ivgtt，q8 h）should be used. After the infection aggravated ，Piperacillin tazobactam sodium for injection was stopped and Imipenem cilastatin sodium forinjection（20 mg/kg，ivgtt，q8 h）was used instead. The child received ladder treatment after the decline of infection index ，and Ceftazidime for injection （50 mg/kg，ivgtt，q12 h）was used. RESULTS ：The doctors adopted the above suggestions. After treatment ，the prognosis of the child was good ，the vital signs were stable ，and the body weight reached 3 000 g at discharge. CONCLUSIONS ：For preterm infants as special group ，before using antibiotics ，clinical pharmacists should focus on the vital signs ，infection indicators and laboratory test results of the child ，so as to help doctors improve the treatment plan and ensure the effectiveness and safety of their medication.

Analysis of the Utilization of Antidepressant Drugs in 11 Hospitals from Zhejiang Province during 2013-2017 / 中国药房

OBJECTIVE： To investigate the application of antidepressants in Zhejiang province and to provide reference for rational drug use in clinic. METHODS： WHO-recommended defined daily dose （DDD） method was used to statistically analyze consumption sum， main types， defined daily dose system （DDDs）， daily drug cost （DDC） and ranking ratio （B/A value， i.e. consumption sum rank/DDDs rank， B/A＜1 means the price of drugs was higher， whereas the price of drugs was lower） of antidepressant drugs in 11 hospitals from Zhejiang province during 2013-2017. RESULTS： The consumption sum of antidepressants was increased year by year in 11 hospitals from Zhejiang during 2013-2017， and increased from 3 235 200 yuan in 2013 to 4 569 100 yuan in 2017； the proportion of consumption sum of antidepressants in total consumption sum of all drugs kept stable， ranging from 0.47％ to 0.50％. The top 5 drugs by consumption sum were fluoxetine， duloxetine， olanzapine and venlafaxine； consumption sum of escitalopram accounted for a larger increase （proportion ration increased from 8th place in 2013 to first place in 2017）. Within 5 years， DDDs of fluoxetine， paroxetine and sertraline took up the first 3 place； DDC of olanzapine， quetiapine and duloxetine took up the first 3 place； the drugs with B/A value＜1 included duloxetine， olanzapine， venlafaxine and quetiapine， etc； the drugs with B/A value＞1 were paroxetine and sertraline. CONCLUSIONS： The use of antidepressant drugs in 11 hospitals from Zhejiang province is rational in structure； selective 5-hydroxytryptamine （5-HT） reuptake inhibitors （SSRI）， selective 5-HT and noradrenaline reuptake inhibitor （SNRI） take up the predominant place. New antidepressant drug escitalopram shows a good clinical prospect.

Special Review on Rational Drug Use in Children with Common Cold / 医药导报

Objective To understand drug use in children with common cold through comments on prescription and drug analysis,and to provide theoretical basis for standardizing medical treatment and promoting rational drug use.Methods A retrospective survey method was applied.Prescriptions of common cold in the department of pediatrics from Oct.to Dec.2015 were reviewed,and Excel 2013 was used for statistical analysis.Rationality of drug use was evaluated based onhospital prescription review management specification (try out),instructions and consensus of related experts at home and abroad.Results The utilization rate of antibacterial drugs was 93.4％in children with common cold of our hospital,utilization rate of antiviral drugs was 59.7％,utilization rate of compound cold medicine was 96.4％,and the rate of combined utilization of more than two kinds of compound medicine was 65.7％.Excessive medicine for common cold existed and abuse of cold medicine,antimicrobial and antiviral drug,irational drug combination in this hospital.Conclusion Clinical doctors lack cognition to common cold and cold medicines.Hospital pharmacy department should take effective pharmaceutical interventions to improve the level of rational drug use.

Analysis of the Utilization of Endocrine Therapy Drugs in Breast Cancer Patients from 11 Hospitals of Zhe-jiang Province during 2010-2015 / 中国药房

OBJECTIVE:To investigate the status quo and tendency of endocrine therapy drugs in breast cancer patients from 11 hospitals of Zhejiang province during 2010-2015. METHODS:The prescriptions of breast cancer patients in 11 hospitals of Zhe-jiang province were analyzed retrospectively in respects of consumption sum,DDDs,DDC,etc. RESULTS:The consumption sum of endocrine therapy drugs in breast cancer patients from 11 hospitals of Zhejiang province during 2010-2015 increased from 2530192.33 yuan to 6201691.54 yuan,and its proportion in total consumption sum increased from 13.93％ to 17.40％,showing in-creasing tendency. The anastrozole always took up the first place in the list of consumption sum. Tamoxifen,anastrozole and letro-zole took up the top 3 places in the list of DDDs. Goserelin took up the first place in the list of DDC. CONCLUSIONS:The pre-scription amount and consumptionsum of endocrine therapy drugs in breast cancer patients from 11 hospitals of Zhejiang province during 2010-2015 show year-on-year growth trend;and those drugs which are safe,effective,economical and convenient predomi-nate in clinic.

Investigation and analysis of anti diabetic drugs in our hospital during 2012 to 2016 / 中国生化药物杂志

Objective To use in our hospital during 2012 to 2016 anti diabetic drugs were investigated in the analysis, and provide the basis for clinical treatment.MethodsThe drug collected in our hospital during 2012 to 2016 anti diabetic drug name, manufacturer, specifications, quantity, amount, amount, using Excel 2007 for data processing, calculation of DDDs (DDDs) and daily cost (DDC).ResultsFrom 2012 to 2016, the antidiabetic drugs in our hospital the total expenses increased from 12 million 311 thousand and 500 yuan to 19 million 467 thousand and 800 yuan, up 58.13% The amount of consumption.The top three anti diabetic drugs for insulin, sulfonylurea, biguanides;DDDs three for insulin, sulfonylureas, alpha glucosidase inhibitors;DDC three drugs was the highest in Epalrestat Tablets, Insulin Glargine Injection, Insulin Aspart 30 Injection.ConclusionThe treatment of diabetes in our hospital during 2012 to 2016 drug use is more reasonable, the insulin dosage, some new oral proportion is increasing.

Analysis of Drug Utilization in Herpes Zoster Patients from 22 Hospitals of Shanghai Area during 2013-2015 / 中国药房

OBJECTIVE:To investigate the utilization and trend of drugs for herpes zoster patients from 22 hospitals of Shanghai area,and to provide reference for rational use of drugs.METHODS:The utilization of drugs for herpes zoster patients from 22 hospitals of Shanghai area during 2013-2015 was analyzed statistically in respects of proportion of patients,consumption sum,DDDs,DDC,etc.RESULTS:Herpes zoster was more likely to occur in adults,mostly in more than 45 year-old group (＞75％).The proportions of patients of neurotrophic antivirals,anti-herpes virus and acesodyne drugs ranked in the top three.Topical,immu nomodulatory and glucocorticoid drugs accounted for a certain proportion.Among antivirals,the consumption sum and DDDs of valaciclovir ranked the first place,and DDC of brivudine was the highest.Among acesodyne,the proportions of patients of antiepileptic drugs was the highest (13.78％),and its compound growth rate was also the highest (30.77％);the number of patients of gabapentin was the largest.Among neurotrophic drags,the proportions of patients of mecobalamine was the highest (32.98％).Among immunomodulatory drugs,the number of patients of thymalfasin was the largest,which may be irrational.CONCLUSIONS:The treatment of herpes zoster in Shanghai area is basically in accordance with the guidelines.The irrational use of immunomodulatory drugs should be paid attention to and supervised.

Investigation and Analysis of Drug Use in CHD Patients from 8 Medical Institutions in Mianyang Area / 中国药房

OBJECTIVE:To investigate the situation of drug use in CHD inpatients,and to provide reference for relevant decision-making.METHODS:Medical records of CHD patients were collected by medical insurance system from 8 medical institutions of Mianyang area during Jan.2014-Dec.2016.Each 200 medical records were collected from each medical institution and then analyzed statistically by EXCEL 2007,ACCESS 2007,SPSS 19.0 software in respects of patient's gender and age,drug amount,drug type,drug combination.RESULTS:A total of 1 600 patients were included,involving 983 male and 707 female with average age of (73.9 + 10.2) years old.Drug cost ratio was 35.2％ of total hospitalization cost;CHD treatment drugs accounted for 72.4％ of the total drug cost.Among adjuvant therapy drugs,the cost of Chinese patent medicines and 4 chemical medicines containing TCM extracted component which could improve circulation accounted for 37.8％ of cardiovascular drug cost.Among main therapy drugs,the utilization rate of lipid-modulating drugs was 80.8％,and that of ACEI and ARB was 46.9％.The patients receiving antiplatelet drug combined with PPI accounted for 54.9％ of the patients receiving antiplatelet drug.Fourteen patients were treated with short-acting Nifedipine tablets.Forty-two patients were treated with clopidogrel and omeprazole.CONCLUSIONS:The utilization of adjuvant therapy drugs such as L-camitine show high cost ratio.ACEI or ARB,lipid-lowering drugs take up low proportion in CHD patients.The use of short-acting Calcium channel blocker (CCB) and dipyridamole are unreasonable.The indication control of PPIs is lax and the abuse of Chinese patent medicine is obvious.

Practice and Analysis of Clinical Pharmacists Participating in Anti-infection Treatment of a Child with Gas Gangrene / 中国药房

OBJECTIVE:To investigate the role of clinical pharmacists in the anti-infection treatment for gas gangrene chil-dren. METHODS:Clinical pharmacists participated in the anti-infection treatment of a child with gas gangrene;according to clini-cal symptoms and consultation opinions of different departments,it was suggested to use Piperacillin sodium and tazobactam sodi-um for injection for initial anti-infection treatment. After debridement and drainage of left lower limb,removal of necrotic tissue, clinical pharmacists suggested to stop giving Piperacillin sodium and tazobactam sodium for injection and use Benzylpenicillin sodi-um for injection combined with Imipenem and cilastatin sodium for injection instead for anti-infection treatment according to etiolog-ical characteristic of gas gangrene and related guidelines. According to the results of bacterial culture of wound secretion and drug sensitivity test,clinical pharmacists additionally suggested to use Clindamycin hydrochloride and sodium chloride injection 0.6 g, q8 h,ivgtt to inhibit the generation of Clostridium perfringens.According to the changes of patient's signs and etiological results, it was suggested to stop taking Clindamycin hydrochloride and sodium chloride injection,use Vancomycin hydrochloride for injec-tion successively. RESULTS:The physicians adopted the suggestions of clinical pharmacists.After surgical treatment and anti-infec-tion treatment,the patient's condition was improved,the vital signs were stable,and the patient was transferred to the general ward of orthopedics department for further treatment. CONCLUSIONS:Clinical pharmacists participate in the treatment of gas gan-grene child,and assist physicians to formulate and adjust anti-infection treatment plan according to related guidelines,clinical symp-toms,etiological examination results and consultation opinions,so as to guarantee safe and effective drug use.

Practice and Analysis of Clinical Pharmacists Participating in Anti-infection Treatment of a Child with Gas Gangrene / 中国药房

OBJECTIVE:To investigate the role of clinical pharmacists in the anti-infection treatment for gas gangrene chil-dren. METHODS:Clinical pharmacists participated in the anti-infection treatment of a child with gas gangrene;according to clini-cal symptoms and consultation opinions of different departments,it was suggested to use Piperacillin sodium and tazobactam sodi-um for injection for initial anti-infection treatment. After debridement and drainage of left lower limb,removal of necrotic tissue, clinical pharmacists suggested to stop giving Piperacillin sodium and tazobactam sodium for injection and use Benzylpenicillin sodi-um for injection combined with Imipenem and cilastatin sodium for injection instead for anti-infection treatment according to etiolog-ical characteristic of gas gangrene and related guidelines. According to the results of bacterial culture of wound secretion and drug sensitivity test,clinical pharmacists additionally suggested to use Clindamycin hydrochloride and sodium chloride injection 0.6 g, q8 h,ivgtt to inhibit the generation of Clostridium perfringens.According to the changes of patient's signs and etiological results, it was suggested to stop taking Clindamycin hydrochloride and sodium chloride injection,use Vancomycin hydrochloride for injec-tion successively. RESULTS:The physicians adopted the suggestions of clinical pharmacists.After surgical treatment and anti-infec-tion treatment,the patient's condition was improved,the vital signs were stable,and the patient was transferred to the general ward of orthopedics department for further treatment. CONCLUSIONS:Clinical pharmacists participate in the treatment of gas gan-grene child,and assist physicians to formulate and adjust anti-infection treatment plan according to related guidelines,clinical symp-toms,etiological examination results and consultation opinions,so as to guarantee safe and effective drug use.

Drug Analysis and Literature Review of One Patient with Heart Failure and Gouty Attack / 中国药师

Objective: To investigate the principles of rational drug use for the patients suffering from heart failure complicated with diuretic-induced gouty arthritis.Methods: The clinical pharmacist participated in the diagnosis, treatment and drug adjustment of one patient suffering from heart failure complicated with furosemide-induced gouty arthritis.Taking the disease symptoms and potential gouty-inducing drugs into full consideration, clinical pharmacist suggested the withdrawal of related-drugs and the adjustment of treatment plan.Results: Considering the characteristics of the patient, clinical pharmacist adjusted the rational drug treatment.After the adoption of the suggestions, the gouty symptoms were relieved, heart failure was controlled and the condition was improved.Conclusion: Loop diuretics can easily trigger an acute attack of gout, especially for the patients with heart failure and gout history.Clinical pharmacist can make full use of professional advantages to optimize the treatment plan in order to reduce adverse reactions and promote the rational drug use by participating in clinical practice.

Analysis of the Utilization of Antitumor Drugs in 42 Hospitals from 3 Cities during 2012-2016 / 中国药房

OBJECTIVE:To analyze the clinical application and trend of antitumor drugs in 42 hospitals from Beijing,Shang-hai and Chengdu,and to provide reference for rational drug use in clinic. METHODS:The utilization of antitumor drugs in 42 hos-pitals from Beijing,Shanghai and Chengdu during 2012-2016 was analyzed statistically in respects of consumption sum,DDDs. RESULTS:The consumption sum of antitumor drugs in 3 cities,Beijing ranked the first;annual growth rate of Shanghai was the highest. In the list of consumption sum of antitumor drugs of 3 cities in 5 years,immunosuppressive agents as tacrolimus,mycophe-nolate mofetil were among top 10 antitumor drugs in the list of consumption sum. Top 1 antitumor drug in the list of consumption sum in Beijing,Shanghai and Chengdu were thymopentin,tacrolimus and thymalfasin,respectively. Among subtype of antitumor drugs,other antitumor drugs and adjuvant drugs in Beijing and Chengdu during 2012-2014 took up the first place in the list of con-sumption sum;the consumption sum of antimetabolite during 2015-2016 occupied the first place,and that of Beijing was higher than that of Chengdu. The cost of antimetabolite in Shanghai during 2012-2016 was the highest. The consumption sum of other antitumor drugs and adjuvant drugs were the highest in 3 cities during 2012-2014;that of antimetabolite was the highest during 2015-2016. Among related drugs,immune enhancer,immunosuppressive agents and analgesics ranked the top in the list of consumption sum. Among top 10 antitumor drugs in the list of DDDs,most were antineoplastic medicine,and only cyclophosphamide among alkylat-ing agents entered the ranking. CONCLUSIONS:The growing trend of antitumor concumption sum is stable. Antimetabolite,hor-mones and plant-derived antitumor are becoming larger. Molecular targeted therapies have a good prospect for application.

Analysis of the Application of TCM Injection in 3 Hospitals from Jiangsu Changshu during 2013 to 2015 / 中国药房

OBJECTIVE:To provide reference for rational use of TCM injection in the clinic. METHODS:In retrospective survey,the application of TCM injections in 3 hospitals from Changshu area during 2013-2015 were analyzed statistically in re-spects of consumption sum,annual growth rate,constituent ratio,DDDs,B/A,DDC,etc. RESULTS:During 2013-2015,in the sample hospitals,consumption sum of TCM injections in 2014 and 2015 declined by 5.27% and 15.92%,compared with last year. The proportion of consumption sum of TCM injections in total consumption sum were 4.40% in 2013,3.86% in 2014 and 3.13%in 2015. Top 3 TCM injections in the list of consumption sum and DDDs were blood activating and stasis eliminating drugs,the re-suscitation and reviving yang first aid class drugs and tonic drugs. The top single types in the list of consumption sum were Xing-naojing injection,Shuxuetong injection,Xuebijing injection,Shenmai injection and Xue shuantong for injection;the top single types in the list of DDDs were Shenmai injection,Reduning injection,Shuxuetong for injection,etc. B/A of Shenmai injection and Reduning injection were higher,while DDC of Xuebijing injection was the highest. CONCLUSIONS:The utilization of TCM injec-tion is basically reasonable,and shows decreasing tendency in sample hospitals,but great importance should be attached to the safe-ty and effectiveness of TCM injections and reasonable choice.

Application of Antidepressive Drugs Used in 31 Hospitals of Nanjing Area during 2013 to 2015 / 中国药房

OBJECTIVE:To provide reference for rational use of antidepressive drugs. METHODS:In retrospective study,the utilization of antidepressive drugs in 31 hospitals of Nanjing area during 2013-2015 was analyzed statistically in respects of consump-tion sum,DDDs,DDC,B/A,etc. RESULTS:There were a total of 20 kinds of antidepressive drugs in 31 hospitals of Nanjing ar-ea,and total consumption sum increased year by year,increasing from 76 085 200 yuan in 2013 to 100 812 500 yuan in 2015,in-creased by 17.43% compared to 2014 and by 12.83% compared to 2015. The top 4 drugs in the list of consumption sum and DDDs were paroxetine,escitalopram,sertraline and venlafaxine. The sum of their consumption sum accounted for more than 60% of total consumption sum. The consumption sum of plant antidepressive drugs increased rapidly. B/A and DDC of antidepressive drugs kept sta-ble each year compared to last year,among which DDC of doxepin,clomipramine and amitriptyline was less than 2 yuan,B/A val-ues of sertraline,fluvoxamine,flupentixol and melitracen,doxepin,clomipramine and amitriptyline were all more than 1.00. CON-CLUSIONS:Of antidepressive drugs in 31 hospitals of Nanjing area during 2013-2015,selective serotonin reuptake inhibitors and se-lective serotonin-norepinephrine reuptake inhibitors took up dominant place,and plant antidepressive drugs is promising in the future.

Analysis of the Application of Leucocyte Increasing Drugs in Lung Cancer Patients of 11 Zhejiang Hospi-tals during 2009-2014 / 中国药房

OBJECTIVE:To provide reference for rational use of leucocyte increasing drugs in patients with lung cancer. METHODS:The application of drugs in lung cancer patients in 40 d each year were collected from 11 Zhejiang hospitals during 2009-2014,and then analyzed retrospectively in consumption sum,DDDs,DDC and department distribution,etc. RESULTS:The proportion of consumption sum of leucocyte increasing drugs in total consumption sum decreased generally in 11 Zhejiang hospital during 2009-2014,decreasing from 781 995.50 yuan in 2009(3.28%)to 626 792.80 yuan in 2014(1.53%). Top 3 departments in the list of consumption sum of leucocyte increasing drugs were oncology department(29.00%),radiotherapy department(27.08%) and respiratory medicine department(9.93%). Top 3 drugs in the list of consumption sum during 2009-2014 were recombinant hu-man granulocyte colony-stimulating factor,Coenzyme complex for injection and Leucogen tablets;top 3 drugs in the list of DDDs were Leucogen tablets,Berbamine tablet and recombinant human granulocyte colony-stimulating factor;Coenzyme complex for in-jection,recombinant human granulocyte colony-stimulating factor and human GM-CSF took the first three place in the list of DDC during 2009-2013,and Leucogen tablets were the top one in 2014. CONCLUSIONS:The application of leucocyte increasing drugs in lung cancer patients is decreasing year by year in 11 Zhejiang hospitals,and those with definite therapeutic efficacy and moder-ate price predominate clinical application predominate in the clinical practive.

Analysis of the Application of TCM Decoction Pieces for Rheumatism in Our Hospital during 2010-2014 / 中国药房

OBJECTIVE:To provide reference for clinical rational use and purchase of TCM decoction pieces for rheumatism. METHODS:Using Excel software,the application of TCM decoction pieces for rheumatism in our hospital during 2010-2014 was analyzed statistically in respects of drug type,consumption quantity and consumption sum,etc. RESULTS:The consumption quan-tity of TCM decoction pieces for rheumatism increased from 46 026 kg to 79 139 kg in our hospital during 2010-2014,and annual growth rate was 14.68%;consumption sum increased from 3 851 300 yuan to 6 403 800 yuan,with annual growth rate was 15.46%;consumption quantity ratio was 2.48%-2.85%. Among antirheumatic drug subtype,the quantity of drugs for antirheumatic and dissipating cold was the largest (accounting for 51.43%-58.42%),followed by drugs for antirheumatic and strengthening the bones and muscles(accounting for 23.05%-28.42%)and drugs for antirheumatic and clearing heat(accounting for 18.53%-21.08%). Top 3 TCM decoction pieces for rheumatism in the list of annual quantity were Viscum coloratum,Cynanchum paniculatum and Clematis chinensis/Chaenomeles sinensis during 2011-2014. Top 3 TCM decoction pieces for rheumatism in the list of consumption sum were Zoacys dhumnades,C. paniculatum and V. coloratum during 2011-2014. CONCLUSIONS:Both consumption quantity and consumption sum of TCM decoction pieces for rheumatism have increased year by year in our hospital,but the ratio of total quantity to total amount and medication structure keep stable,and TCM for expelling wind-damp and dispelling cold is the greatest in consumption quantity which is in line with clinical drug use characteristics. Purchasing staff can purchase drugs predictably ac-cording to the results.

Analysis of the Application of Antibacterials in 36 Secondary Hospitals from Xi’an Area during Second Quarter in 2015 / 中国药房

OBJECTIVE:To investigate the effectiveness of antibacterial clinical application special rectification activity,and to provide reference for rational use of antibacterials. METHODS:Referring to rational antibacterials application index stated in Na-tional Antibacterial Clinical Application Special Rectification Activity in 2013,the utilization of antibacterials in 36 secondary hospi-tals from Xi’an area during 2nd quarter in 2015 were analyzed retrospectively in terms of drug use index,types,consumption sum,DDDs and DDC,etc. RESULTS:Among 36 secondary hospitals from Xi’an area,there were only 3 hospitals up to the anti-bacterials use indicator standard(8.33%);antibacterial use of 91.66% inpatients was up to the standard;55.56%of antibacterials use density was up to the standard;50.00% of outpatient antibacterials drug prescriptions was up to the standard;77.78% of emer-gency antibacterials drug prescriptions was up to the standard;13.89% of antibacterials was used in typeⅠincision surgery for pro-phylactic use. Restricted use antibacterial accounted for 48.53% in consumption sum and Non-restricted use antibacterial accounted for 75.31% in DDDs. The consumption sum(12 771 265.34 yuan)and DDDs(291 542.31)of cephalosporin ranked first,mainly were second generation cephalosporin(accounting for 35.22% of consumption sum and 42.98% of DDDs). Top 10 drugs in the list of consumption sum were all injection;there was no special class of antibacterials but some antibacterias with high price and poor efficacy in top 10 ones. Top 10 drugs in the list of DDDs were non-restricted use and restricted use antibacterials with low price and good efficacy,among which there were 6 oral dosage forms. CONCLUSIONS:The application of antibacterials is still can not reach national standard in 36 secondary hospitals from Xi’an area. It is necessary to be further strengthen the management of inpa-tient antibacterial use density,the proportion of antibacterials used in outpatient and emergency patients,prophylactic application of antibacterials in type Ⅰ incision,the application of antibacterials with high price and poor therapeutic efficacy should be monitored closely.

Application analysis of antihypertensive drugs in outpatient / 药学实践杂志

Objective To study the application of outpatient oral antihypertensive drugs in Shanghai Meishan Hospital, and provide a guide for clinical rational drug use.Methods The utilization of antihypertensive drugs in outpatients of our hos-pital was analyzed statistically by using defined daily dose (DDD) recommended by WHO.Results ① The most commonly used antihypertensive drugs in outpatients was calcium antagonist (51.98% ), followed by angiotensin receptor blockers (16.60% ),fixed-dose combination (13.23% ),β-blockers (11.93% ),diuretics (3.67% ),angiotensin-converting enzyme in-hibitors (2.40% ),and α,β-blockers (0.19% ). ② The combination therapy was fewer in outpatients than monotherapy (32.99% versus 67.01% ).Conclusion The application of antihypertensive drugs is basically reasonable in outpatient of our hospital,but the combination therapy was inadequate.

Analysis of the Utilization of TCM Injection in 34 Hospitals from Nanjing Area during 2012-2014 / 中国药房

OBJECTIVE:To provide reference for rational use of TCM injection in the clinic. METHODS:The utilization of TCM injections in 34 hospitals from Nanjing area during 2012-2014 was analyzed statistically in respects of consumption sum, DDDs,DDC. The occurrence of ADR induced by TCM injections was also analyzed statistically in the First Affiliated Hospital of Nanjing Medical University. RESULTS:The consumption sum of TCM injections in 34 hospitals from Nanjing area during 2012-2014 increased year by year;top 10 kinds of TCM injections mainly were anti-tumor drugs and cardio-cerebrovascular drugs in 2014,and each of them involved 4 categories and their consumption sum accounted for 46.08% and 32.59%,respectively. Total consumption sum of anti-tumor TCM injections increased slowly,while those of cardio-cerebrovascular drugs,antibiosis and anti-phlogosis increased rapidly. Lentinan injection steadily took up the top in the list of consumption sum and DDDs of single type,its DDC was the lowest and B/A=1.00. In the First Affiliated Hospital of Nanjing Medical University,most of ADR was induced by Xiyanping injection (27 cases,45.00%). CONCLUSIONS:The type of TCM injections keep stable in 34 hospitals from Nanjing area during 2012-2014,mainly involving anti-tumor drugs and cardio-cerebrovascular drugs which were used widely. Clinic should strengthen dialectial therapy close monitoring and attch improtance to the rational use of TCM injections.