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Objective: This study assessed the distribution of "lethal dose/pharmaceutical product strength" in high-risk drugs.Methods: In 707 pharmaceutical products (312 ingredients) that had been defined as high-risk drugs in Japan, we collected acute toxicity information from these products on single dose toxicity studies conducted in mice, including median lethal dose (LD50) and approximate lethal dose (aLD). The LD50 and aLD were then divided by the strength (quantity of active ingredients) of the pharmaceutical product, after which the LD50or aLD values having an inequality sign was excluded.Results: We collected data on the acute lethal dose of 707 products (312 ingredients) from high-risk drugs. Data with an inequality sign, which was 143 of 495 products (28.9%) in tablets and capsules, then 43 of 212 items (20.3%) in injections, were excluded from the analysis. As observed, median (Q1, Q3) of "LD50/pharmaceutical product strength" and "aLD/pharmaceutical product strength" for tablets or capsules was 36.8 tablet/kg (11.5 tablet/kg, 144 tablet/kg) and 16.7 tablet/kg (6.9 tablet/kg, 65 tablet/kg), respectively. However, median (Q1, Q3) of "LD50/pharmaceutical product strength" and "aLD/pharmaceutical product strength" for injections were 1.3 bottle/kg (0.6 bottle/kg, 4.7 bottle/kg) and 0.8 bottle/kg (0.4 bottle/kg, 15 bottle/kg), respectively. In both cases, injections were distributed at a lower value than oral products.Conclusion: From this study, the distribution of "lethal dose/pharmaceutical product strength" in high-risk drugs was clarified. This information will therefore help pharmacists assess risks associated with individual pharmaceutical products.
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OBJECTIVE: To analyze the features of high-risk drugs prescriptions for elderly outpatients in our hospital, so as to provide references for establishing the prescription comment method of high-risk drugs used by elderly outpatients and promote the rational drug use. METHODS: The number and amount of money of high-risk drugs prescriptions for elderly outpatients were counted, and the amount of high-risk drugs were sorted, so as to find out the features of high-risk drugs use in elderly outpatients and determine the prescription comment catalogue. According to "The hospital prescription comment management specification (Trial)", and combined with the use of high-risk drugs and physical characteristics of elderly patients, the prescription comment technical manual of high-risk drugs used by elderly outpatients was established, and the key drugs were commented for demonstration purpose. RESULTS: Elderly patientsoccupied a high proportion in our hospital, and the amount of money of single prescription was also high, which indicated that the elderly patients had more complex drug use. Through analysis of high-risk drugs prescriptions, the comment catalogue was established. And through empirical review of the prescriptions of key drugs, it was found that the proportion of unreasonable prescriptions was high, with variousproblems among different prescriptions. CONCLUSION: This study established the prescription comment technical manual of high-risk drugs used by elderly outpatients, which should become an important measure to prevent and reduce drug-induced diseases in elderly patients, and improve the effectiveness and safety of clinical medication.
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Objective To explore the effect of labels management on high-risk drugs. Methods Labels management group was established, to be responsible for use and storage of high-risk drugs. The management methods included taking analysis on adverse nursing events, designing and making labels in drug storage and use, and making a field survey on adverse nursing events before and after the management. Result After manipulation of the labels management, the number of adverse nursing events of drug use fell from 35 to 0. Conclusion Drug storage and use with special, standard labels is effective in preventing nursing adverse events in high risk drugs.
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OBJECTIVE:To reduce the risk of high-risk drugs dispensing in PIVAS. METHODS:Main measures of risk con-trol of high-risk drugs in PIVAS of our hospital were introduced,i.e. establishing high-risk drug risks control group and high-risk drugs list,pharmaceutical staff undertaking all job of PIVAS except finished product distribution,information management of high-risk drugs application procedure,clinical pharmacist's participation,etc. The effects of error and ADE evaluation and manage-ment in PIVAS were analyzed statistically to summarize the experiences. RESULTS & CONCLUSIONS:During 2012-2014,the in-cidence of high-risk drugs related error was in low level in PIVAS of our hospital(0.009‰,0.004‰,0.002‰)and decreased year by year. The number of error decreased from 8 in 2012 to 3 in 2013 and 2 in 2014. It is important for risk control to enhance drug check,new staff training and PIVAS staff professionalization in pharmaceutical,and extablishing warning mark of high-risk drugs.