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1.
China Pharmacy ; (12): 1647-1652, 2022.
Article in Chinese | WPRIM | ID: wpr-929706

ABSTRACT

OBJECTIVE To evaluate the effects of pharmaceutical interventio n led by clinical pharmacists on medication appropriateness of elderly inpatients. METHODS A non-randomized concurrent controlled trial was carried out. Elderly patients admitted to two treatment groups in the geriatric department of Yancheng First People ’s Hospital since June 2021 were selected as the research objects. According to the inclusion and exclusion criteria ,the first 40 patients were selected from each of the two treatment groups (according to the order of admission time )and set as the control group or the intervention group. The control group received routine treatment and nursing services ,and the intervention group additionally received pharmaceutical intervention led by clinical pharmacists on the basis control group. Clinical pharmacists found potential inappropriate medication (PIM)and put forward suggestions on optimization of medication regimen. American Geriatrics Society 2019 Updated AGS Beers Criteria ® for PIM Use in Older Adults (hereinafter referred to as “Beers criteria ”)and the Criteria of PIMs for Older Adults in China 2017 Edition (hereinafter referred to as “Chinese criteria ”)were used as reference tools for drug use review. The medication appropriateness index (MAI)total scores (main evaluation indicator ),the number of PIMs ,the number of drugs used ,the length of hospital stay ,the number of drug-related adverse events during hospital stay ,the number of drug regimen optimization suggestions by pharmacists , and implementation rate of E-mail:zhihuadou@163.com optimization suggestions adopted by clinicians were compared between 2 groups at admission and at discharge. RESULTS At admission ,there were no statistically differences in MAI total scores,the number of PIMs based on Beers criteria ,the number of PIMs based on Chinese criteria or the number of drugs used between 2 groups(P>0.05). At discharge ,there were no statistically differences in the number of PIMs based on Chinese criteria and the length of hospital stay between 2 groups(P>0.05),but the MAI total scores ,the number of PIMs based on Beers criteria and the number of drugs used in the intervention group were lower than those in the control group (P<0.05). In the intervention group,the proportion of drugs recorded as “inappropriate medication ”at admission (34.5%)was significantly higher than that at discharge(19.5%)(P<0.05). The difference between the number of drugs discharged from hospital and the number of drugs admitted to hospital in the control group [ 3(1-4.8)] was significantly higher than that in the intervention group [ 1(0-2.8)](P= 0.012). Compared with admission ,the proportion of drugs recorded as “inappropriate medication ”in the intervention group at discharge was significantly decreased on the basis of “effectiveness”dimension and “course”dimension (P<0.05). During hospitalization,clinical pharmacists put forward 70 optimization suggestions of drug regimen for the intervention group ,among which 39 suggestions were adopted and implemented by clinicians ,with an implementation rate of 55.7%. CONCLUSIONS The pharmaceutical intervention led by clinical pharmacists can improve overall appropriateness of drug use in the elderly inpatients using MAI as main evaluation indicator.

2.
Clin. biomed. res ; 42(2): 112-120, 2022.
Article in Portuguese | LILACS | ID: biblio-1391470

ABSTRACT

Introdução: A pediatria apresenta um cenário bastante específico devido ao uso de medicamentos off-label e carência de estudos científicos direcionados à utilização de medicamentos por essa população. Assim, o farmacêutico clínico pode contribuir na identificação e prevenção de problemas relacionados a medicamentos.Métodos: Estudo de coorte retrospectivo realizado em uma unidade de terapia intensiva pediátrica de um hospital universitário do Rio Grande do Sul. Foram analisadas as intervenções farmacêuticas realizadas entre março de 2016 a julho de 2018 por farmacêuticos clínicos. Tais intervenções foram reclassificadas conforme os critérios de um instrumento de acompanhamento farmacêutico (bundle) utilizado na rotina. Foi realizada análise estatística descritiva das variáveis estudadas.Resultados: Das 582 intervenções farmacêuticas analisadas, as categorias mais prevalentes foram dose (n = 97; 16,7%), necessidade (n = 92; 15,8%) e forma farmacêutica (n = 56; 9,6%). Após reclassificação das intervenções farmacêuticas utilizando o bundle, os critérios mais prevalentes foram: critério 1 (revisão da farmacoterapia; n = 285; 49%), critério 4 (analgesia; n = 78; 13,4%) e critério 10 (antimicrobianos; n = 65; 11,2%). As classes de medicamentos mais frequentes foram os do sistema nervoso (n = 213; 36,6%) e os anti-infecciosos gerais para uso sistêmico (n = 115; 19,8%). A taxa de adesão das intervenções farmacêuticas pela equipe médica foi de 85,1%.Conclusão: A classificação das intervenções farmacêuticas utilizando o bundle pode contribuir no aperfeiçoamento do instrumento tornando-o mais viável para uso na unidade de terapia intensiva pediátrica e direcionar o trabalho do farmacêutico clínico nas situações que geram mais problemas relacionados a medicamentos.


Introduction: Pharmaceutical interventions in the pediatric setting are highly peculiar due to the use of off-label drugs associated with the lack of scientific studies on the use of drug therapies in this population. Thus, clinical pharmacists may help identify and prevent drug-related problems.Methods: We conducted a retrospective cohort study in the pediatric intensive care unit of a teaching hospital in Rio Grande do Sul, Brazil. Pharmaceutical interventions conducted between March 2016 and July 2018 were analyzed by clinical pharmacists. These interventions were reclassified according to the criteria of a routine pharmaceutical monitoring instrument (care bundle). We conducted a descriptive statistical analysis of study variables.Results: Of 582 pharmaceutical interventions analyzed, the most prevalent categories were dose adjustment (n = 97; 16.7%), need for drug therapy (n = 92; 15.8%), and dosage forms (n = 56; 9.6%). After reclassification of pharmaceutical interventions, the most prevalent criteria were criterion 1 (review of drug therapy; n = 285; 49%), criterion 4 (analgesia; n = 78; 13.4%), and criterion 10 (antimicrobials; n = 65; 11.2%). The most common drug classes were nervous system agents (n = 213; 36.6%) and anti-infectives for systemic use (n = 115; 19.8%). The rate of adherence to pharmaceutical interventions by the medical team was 85.1%.Conclusions: The classification of pharmaceutical interventions according to the pharmaceutical care bundle may help improve the instrument, allowing its use in the pediatric intensive care unit and guiding clinical pharmacists in situations causing drug-related problems.


Subject(s)
Humans , Child , Pharmaceutical Services/statistics & numerical data , Drug-Related Side Effects and Adverse Reactions/drug therapy , Disease Prevention , Intensive Care Units, Pediatric/organization & administration , Cohort Studies
3.
Braz. J. Pharm. Sci. (Online) ; 58: e18943, 2022. graf
Article in English | LILACS | ID: biblio-1364427

ABSTRACT

Abstract The objective of this study was to evaluate drug interactions based on medical records of patients hospitalized in University Hospital Lauro Wanderley (UHLW) in João Pessoa-PB, Brazil. This was a quantitative, descriptive study with a cross-sectional design. This research was conducted in the medical clinic of the above hospital by analyzing pharmaceutical intervention in medical records. The investigated samples consisted of all medical profiles with drug interaction information of patients hospitalized from June 2016 to June 2017. Most of these drug interactions were determined and classified by Micromedex® Solutions database. This research was approved by the Ethics Committee in Institutional Human Research, protocol number 2.460.206. In total, 331 drug interactions were found in 131 medical profiles. Dipyrone, enoxaparin, sertraline, ondansetron, quetiapine, tramadol, bromopride, amitriptyline, and simvastatin were medications that showed highest interactions. According to Anatomical Therapy Classification (ATC), drugs that act on the central nervous system result in more interactions. The most prevalent interaction was between dipyrone and enoxaparin. Some limitations of this study are the lack of notifications and data on drug interactions.


Subject(s)
Humans , Male , Female , Research , Medical Records/classification , Drug Interactions , Evaluation Studies as Topic , Inpatients/classification , Universities , Pharmaceutical Preparations , Dipyrone/adverse effects , Enoxaparin/supply & distribution , Simvastatin/supply & distribution , Sertraline/supply & distribution , Quetiapine Fumarate/supply & distribution , Amitriptyline/supply & distribution , Hospitals, University/organization & administration
4.
Clin. biomed. res ; 41(1): 18-26, 2021. tab, graf
Article in English | LILACS | ID: biblio-1255087

ABSTRACT

Introduction: Care bundles help healthcare professionals provide the best care possible in a structured and reliable way. The purpose of this study was to develop and apply an instrument for inpatient follow-up by clinical pharmacists, and evaluate its results. Methods: The care bundle was based on previously validated instruments. Population consisted of patients monitored by clinical pharmacists at a general hospital. The study was conducted in two phases: the first involved the development and implementation of the bundle, and the evaluation of pharmaceutical interventions; the second involved analyzing data from patients treated with the bundle over one year. Results: The bundle included fourteen pharmaceutical follow-up criteria used in different patterns by each area of care. In the first phase of the study, 3263 patients were monitored and 536 pharmaceutical interventions were performed, with an 85.3% compliance rate. In the second phase of the study, follow-up data was collected from 21,214 patients. The bundle criteria were used in a similar way in clinical, surgical and cancer patients. Pharmacotherapy review was the most prevalent intervention in all cases (60.1%). Hospital discharge planning and medication reconciliation were performed with a similar frequency in clinical, surgical, pediatric and general patients. Conclusions: The development and validation of a bundle aimed at guiding the clinical activities of pharmacists helped standardize procedures and interventions. Pharmacotherapy review was the bundle criterion with the highest rate of application and interventions due to the hospital's complexity and the need to consider individual patient needs and follow institutional policies. (AU)


Subject(s)
Humans , Pharmaceutical Services , Continuity of Patient Care , Patient Care Bundles , Medication Adherence
5.
REVISA (Online) ; 8(2): 153-159, 2019.
Article in English, Portuguese | LILACS | ID: biblio-1095691

ABSTRACT

Objetivo: Definir fluxos de trabalho multidisciplinares para padronização do serviço. Definição do elenco de medicamentos a ser monitorado e estudar resultados preliminares. Métodos: Criação de grupo de trabalho e tabulação dos dados em planilhas Excel ® com as principais intervenções executadas em fevereiro/2019. Resultados: Observou-se que 35% dos tratamentos foram mantidos conforme prescrição inicial. 18% tiveram a duração de tratamento reduzida e 9% não foram autorizados pela CCIH devido a inconformidades. Também foi feita a correção de dose para função renal em 8% das prescrições. Calculou-se o valor do tratamento/dia para cada antimicrobiano. As intervenções descritas representam uma economia direta de R$ 1905,08 reais. Não foram contabilizadas as despesas com materiais médico-hospitalares, transporte/logística e recursos humanos. O percentual de intervenções da farmácia clinica ocorre principalmente na etapa de prescrição devido ao rastreio pela dose individualizada. Também foram realizadas intervenções nas etapas de preparo, diluição e estabilidade. Reações adversas foram detectadas, notificadas e monitoradas devido a necessidade de manejo clínico. Conclusões: Este trabalho demonstra a economia financeira gerada pela atuação da equipe multidisciplinar e também reforça a necessidade de ampliação dos serviços farmacêuticos clínicos e logísticos, já que o trabalho no controle de dispensação individualizado associado a intervenções clínicas são mais eficazes. A complexidade do processo exige monitorização interdisciplinar em todas as etapas do tratamento visando a segurança do paciente.


Objective: Define multidisciplinary protocols for service standardization. Definition of the list of drugs to be monitored and study preliminary results. Methods: Creation of a working group and tabulation of the data in Excel® with the main interventions executed in February / 2019. Results: It was observed that 35% of the treatments were maintained according to the initial prescription. 18% had a reduced treatment duration and 9% were not authorized by CCIH due to nonconformities. Dose correction for renal function was also performed in 8% of prescriptions. The interventions described represent a direct savings of R $ 1905.08. The expenses with medical-hospital materials, transport / logistics and human resources were not accounted for. The percentage of clinical pharmacy interventions occurs mainly at the prescription stage due to individualized dose screening. Conclusions: This work demonstrates the financial economy generated by the multidisciplinary team and also confirm the need for expansion of clinical and logistic pharmaceutical services.


Subject(s)
Anti-Infective Agents
6.
Chinese Pharmaceutical Journal ; (24): 2132-2136, 2018.
Article in Chinese | WPRIM | ID: wpr-858126

ABSTRACT

OBJECTIVE: To strengthen pharmacist intervention in prescribing behavior of doctors, so as to further standardize prescribing behavior.METHODS: Through the review of the advantages and disadvantages of the relevant laws, education training and assessment system for prescription intervention in the USA, a deep analysis was made in combination with the Chinese system and the characteristics of the medical staff.RESULTS: A new clinical pathway was introduced to standardize the intervention of doctors′ prescriptions, so as to improve the level of diagnosis and treatment and the environment for medical treatment in China.CONCLUSION: Improving pharmacists′ professional accomplishment and introducing Internet model and intelligent medical technology can improve the linkage among clinical, community medical institutions and social pharmacies, and also enhance the feasibility and reliability of Internet prescription drug purchase intervention. Promote the closed-loop connection and continuous upgrading of the pharmaceutical industry chain, gradually realize the standardization model of diagnosis and treatment, and then promote the results of the overall medical level.

7.
China Pharmacist ; (12): 1061-1064, 2018.
Article in Chinese | WPRIM | ID: wpr-705664

ABSTRACT

Objective: To explore the effect of clinical pharmacists participating in the clinical pharmacy work in neurosurgery de-partment and the influence on the rational drug use index. Methods: A retrospective analysis on the monthly drug proportion, antibac-terial drug utilization rate and intensity, and the other indicators before and after the intervention performed by clinical pharmacists in neurosurgery department was carried out, and the consumption sum, DDDs and medical records were statistically analyzed in April and June 2017. Results: After the intervention, the proportion of medicine, hospital days per capita, use rate and intensity of antimicrobial drugs, and the other rational drug use indices were significantly improved in neurosurgery department, and the differences in the indi-ces before and after the intervention were significant (P<0. 01). Conclusion: Consultation practice of clinical pharmacists in neuro-surgery department can effectively assist and guide the clinical treatment and improve the level of rational drug use.

8.
China Pharmacist ; (12): 2031-2033, 2017.
Article in Chinese | WPRIM | ID: wpr-705419

ABSTRACT

Objective:To provide reference for the treatment of mixed pathological pain by analyzing the analgesic regimen for one ovarian cancer patient with brain metastases. Methods: The clinical pharmacists could conduct comprehensive and dynamic pain as-sessment,and supply the best evidence by consulting the related literatures and guidelines to assist the clinicians to formulate individu-alized administration regimen. Results: After comprehensive considering the clinical diseases, the characteristics and degree of the pain,the psychological status and the other factors,the analgesic regimen was finally adjusted to be a strong opioid combined with a tri-cyclic antidepressant,an anticonvulsant and a corticosteroid. Consequently, the patient obtained effective analgesic treatment without adverse reactions. Conclusion:The pain caused by ovarian cancer with brain metastasis is often severe and difficult to be treated. In clinics,comprehensive and dynamic pain assessment,standard titration of opioids and rational use of adjuvant drugs based on consider-ing patients' conditions are critical for controlling the pain as soon as possible and improving the quality of life of patients.

9.
Herald of Medicine ; (12): 926-929, 2017.
Article in Chinese | WPRIM | ID: wpr-615526

ABSTRACT

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.

10.
China Pharmacy ; (12): 3281-3284, 2017.
Article in Chinese | WPRIM | ID: wpr-612232

ABSTRACT

OBJECTIVE:To investigate the effects of clinical pharmacists participating in the implementation of clinical path-way under the condition of disease diagnosis related groups-prospective payment system(DRGs-PPS),and to provide reference for promoting rational drug use in the clinic. METHODS:Patients with femoral neck fracture in the clinical pathway were collected from our hospital as research objects. The patient collected during Jan.-Dec. 2015 were included in control group(52 patients includ-ed,41 patients completed)and those collected during Jan.-Dec. 2016 were included in observation group(58 patients included,46 patients completed). Clinical pharmacists participated in the implementation of clinical pathway in observation group,and provided technological intervention and administrative intervention. No intervention was performed in control group. Hospitalization time, hospitalization cost,drug cost and ADR were observed in 2 groups. The rationality of antibiotics for prophylactic use,analgesic drugs,adjuvant drugs,anti-osteoporosis drugs and anticoagulant were compared between 2 groups. RESULTS:After clinical pharma-cists participating in the implementation of clinical pathway in observation group,there was no statistical significance in hospitalization time or the incidence of ADR between 2 groups(P>0.05); hospitalization cost and drug cost of observation group were significantly lower than those of control group,with statistical significance(P<0.05). Medication time and cost of antibiotics for prophylactic use,cost of analgesic drugs,medication time of adjuvant drugs in observation group were significantly shorter/lower than control group;type of anti-osteoporosis drugs was significantly more than control group,with statistical significance(P<0.05). CONCLUSIONS:Under DRGs-PPS,the participation of linical pharmacists participating in the implementation of femoral neck fracture clinical pathway can play an important role in regulating the clinical rational use of 5 kinds of drugs and ensuring the safety,effectiveness and econom-ics of drug use.

11.
China Pharmacy ; (12): 1126-1129, 2017.
Article in Chinese | WPRIM | ID: wpr-510078

ABSTRACT

OBJECTIVE:To investigate the effects of pharmaceutical intervention after discharge on medication compliance and prognosis of patients with coronary artery disease after percutaneous coronary intervention(PCI) in primary hospital.METHODS:One hundred and eighty patients with coronary artery disease selected from our hospital after PCI during Jan.2012 to May 2015 were divided into test group and control group according to whether the patients received pharmaceutical intervention after discharge,with 90 cases in each group.Control group received conventional pharmaceutical care and discharge education.Test group additionally received pharmaceutical intervention (pharmaceutical service files,telephone follow-up,patient education,etc.) after discharge.Medication compliance and occurrence of cardiovascular events were compared between 2 groups in 1 year after discharge.RESULTS:Within 1 year after discharge,the proportion of patients showing good compliance in test group was higher than control group,the proportion of patients showing partial and non compliance in test group were lower than control group;the inci dence of heart failure and repeated revascularization,hospitalization mortality and total mortality of test group were significantly lower than control group,with statistical significance (P<0.05).CONCLUSIONS:Pharmaceutical intervention after discharge can improve the medication compliance of coronary artery disease patients after PCI in primary hospital,reduce the occurrence of cardiovascular events and improve the clinical prognosis.

12.
China Pharmacy ; (12): 1133-1135, 2017.
Article in Chinese | WPRIM | ID: wpr-510076

ABSTRACT

OBJECTIVE:To explore the effect of clinical pharmacist intervention on the rational use of Alanyl-glutamine injection.METHODS:Referring to package inserts of Alanyl-glutamine injection,Clinical Pharmacy Consensus of Parenteral Nutrition,ASPEN Nutrition Therapy Guidelines for Critically Ill Patients,related domestic and foreign literatures,evaluation criteria for Alanyl-glutamine injection rational use was formulated.After collecting Alanyl-glutamine injection cases (497 cases) in the second quarter of 2015 and those cases (385 cases) in the second quarter of 2016,rational use of Alanyl-glutamine injection were analyzed comparatively before and after intervention.RESULTS:The utilization rate and irrational rate of Alanyl-glutamine injection were 4.6% and 52.9% before intervention as well as 2.9% and 10.9% after intervention,with statistical significance (P<0.05).There was statistical significance in hyper-indication,excessive concentration of drug liquid,excessive supply of amino acid,irrational compatibility and solvent selection,long treatment course before and after intervention (P<0.05).CONCLUSIONS:Clinical pharmacists reduce irrational rate of drug use and guarantee safe and effective drug use through formulating evaluation criteria for Alanyl-glutamine injection rational use and providing pharmaceutical intervention on rational use of Alanyl-glutamine injection.

13.
Article in Chinese | WPRIM | ID: wpr-606030

ABSTRACT

Objective To explore the effect of clinical pharmacist intervention on the rational use of alanyl-glutamine injection.Methods Refer to the second quarter of 2015 and the second quarter of 2016 in the General Hospital of Shanxi Datong Coal Group using alanyl-glutamine injection discharge instructions for special comment, compared and analyzed the changes in the use of the drug before and after the intervention.Results Before intervention, the usage rate and the irrational rate of alanyl-glutamine injection were 4.6% and 52.9%,those were 2.9% and 10.9% after intervention.The differences were statistically significant(χ2 =49.209,169.200,all P<0.05).There were significant differences before and after intervention compared in the choice of drug suitability,the high concentration of the medicine liquid,the excessive supply of amino acid and the incompatibility of the compatibility (χ2 =38.882, 31.348,26.242,4.286,all P<0.05 ).Conclusion The pharmacy intervention is feasible and effective for the rational use of alanyl-glutamine injection,and it can reduce irrational using rate.

14.
Herald of Medicine ; (12): 439-441, 2017.
Article in Chinese | WPRIM | ID: wpr-609588

ABSTRACT

Objective To investigate the role of clinical pharmacist in anti-infection therapy for patients with augmented renal clearance (ARC).Methods A case with multi-site severe infection after traffic accident was treated with anti-infection therapy.According to the characteristics of infection and pharmacokinetics,clinical pharmacist discussed the intervention by clinical pharmacist in terms of formulating anti-infection program and adjustment of individual dose.Results After consultation and evaluation by clinical pharmacist,the patient was diagnosed as ARC.According to pharmacokinetics characteristics reported by literature,vancomycin was adjusted to 1 g (once per 8 h).Based on detection result of pathogenic bacteria,meropenem was replaced by cefoperazone/sulbactam,and the dose was increased to 3 g (once per 6 h).And then,vancomycin concentration was detected again,and it reached > 10 μg· mL-1;pathogenic bacteria culture result was negative.This patient obtained good therapeutic effect.Conclusion Clinical pharmacist could assist physician on anti-infection treatment and dose adjustment of ARC patient,and improve ARC patient's therapeutic effect.

15.
China Pharmacy ; (12): 3298-3300, 2016.
Article in Chinese | WPRIM | ID: wpr-504894

ABSTRACT

OBJECTIVE:To provide reference for the rational use of TCM injections. METHODS:487 medical records using TCM injection in our hospital from Jul. to Dec. 2014 were selected as control group,another 500 from Jan. to Jun. 2015 were inter-vention group. Utilization,rationality and adverse reactions of TCM injection between 2 groups were compared. RESULTS:Accord-ing to the intervention by clinical pharmacists,the sales amount and utilization rate of top 10 TCM injection in our hospital were lower significantly. The irrational utilization rate of 5 types (totally 26 varieties) in intervention group decreased (21.60% vs. 43.33%),incidences of adverse reactions reduced(3.00% vs. 7.39%),compared with control group,the differences were statisti-cally significant (P<0.05). Treatment cost per capita [(217.17 ± 22.64) yuan vs. (480.77 ± 21.35) yuan] and hospitalization time [(6.50 ± 1.99)d vs. (10.02 ± 3.25)d] in intervention group were significantly lower or shorter than control group,the differences were statistically significant (P<0.05). CONCLUSIONS:Implementing pharmaceutical interventions can strengthen the sense of clinicians’rational use of TCM injection,raise the level of rational use of drugs and reduce adverse reactions and medical errors.

16.
Chinese Pharmaceutical Journal ; (24): 646-649, 2015.
Article in Chinese | WPRIM | ID: wpr-859410

ABSTRACT

OBJECTIVE: To carry out pharmaceutical intervention on a complicated patient with oophoroma, lymphatic tuberculosis and regular hemodialysis to achieve better therapeutic effect. METHODS: Clinical pharmacists developed anti-tuberculosis and anti-tumor schemes, optimized carboplatin dosage, determined free platinum concentrations, calculated AUG of platinum and monitored adverse drug effect by using their pharmaceutical expertise. RESULTS: Hospital-wide consultation recommended this patient with prior anti-TB treatment, and continue with ovarian cancer chemotherapy after somewhat lymphatic tuberculosis is controlled. The final anti-TB treatment scheme is rifampicin 0.45 g, once daily, morning empty stomach; isoniazid, 0.3 g, once daily, administrated after dialysis on dialysis day; ethambutol, 0.75 g, administrated after each dialysis. The first course of anti-tumor schemes is paclitaxel 0.15 g·m-2 and carboplatin 0.15 g calculated according to Calvert formula, dialysis was carried 24 h later and kept 3 h. Then determined free platinum concentrations, and calculated out the following 2nd-4th courses of anti-tumor treatment, which is paclitaxel 0.15 g·m-2 and carboplatin 0.166 g. The patient had no significant adverse reactions throughout the course of therapy, and anti-tuberculosis and anti-tumor treatment achieved good effect and well tolerance by patients. CONCLUSIONS: According to pharmacokinetic and pharmacodynamic characteristics of the drug combined with patient pathophysiological conditions, clinical pharmacist designs the best treatment schemes for patients, prevents adverse reactions and held treatment monitoring. This patient can get the best treatment as a result.

17.
China Pharmacist ; (12): 291-292,306, 2015.
Article in Chinese | WPRIM | ID: wpr-671095

ABSTRACT

Objective: To evaluate the intervention effect of clinical pharmacists in hypertension chronic disease management. Methods:All the patients with hypertensive chronic diseases from Ziyang community, Xingan Street, Beilun district were involved in the study. Combined with community doctors, clinical pharmacists provided pharmaceutical care for the patients, such as regular face-to-face medication guide, telephone communication, home follow-up, special lectures on health and so on. The cognitive level, blood pressure control level and medication compliance were statistically analyzed and compared before and after the pharmacy intervention. Results:After the intervention of clinical pharmacists, the level of hypertension cognition and the level of antihypertensive drug under-standingof the patients was improved significantly (P<0. 05 or 0. 01), the level of blood pressure control and medication compliance of the patients were improved significantly (P<0. 01), and unscheduled outpatient rate, emergency rate, hospitalization rate and fre-quency were decreased (P<0. 05 or 0. 01). Conclusion: Pharmacy intervention carried out by clinical pharmacists for the patients with hypertension chronic diseases can provide reasonable medication security and improve the quality of life, and the pharmacy inter-vention mode for the hypertension chronic disease management is worthy of promotion.

18.
China Pharmacist ; (12): 1757-1759, 2015.
Article in Chinese | WPRIM | ID: wpr-670085

ABSTRACT

Objective:To summarize the participation of clinical pharmacists in the treatment of patients after craniocerebral opera-tion with pulmonary infection. Methods: Clinical pharmacists assisted physicians in identifying infectious bacteria and colonization bacteria of one patient with pulmonary infection after craniocerebral operation and establishing the anti-infection treatment regimen. Re-sults:Clinical pharmacists analyzed various factors such as infection risk factors, clinical and laboratory manifestation and medication history, and effectively selected antibacterial drugs covering the infectious bacteria to timely control the infection. Conclusion: With pharmaceutical knowledge, clinical pharmacists can assist physicians in the interpretation of bacterial culture and drug susceptibility re-ports to promote safer, more timely and effective medication for patients.

19.
Article in Chinese | WPRIM | ID: wpr-455511

ABSTRACT

Objective To investigate the effects of pharmaceutical interventions on parenteral nutrition.Methods Data collection sheet (with data,ward,patient general information,type of irrational prescribing,type of error,process of error,intervention content,and intervention results) for recording pharmaceutical interventions was designed.The prescriptions of total parenteral nutrition in our hospital from January 1st,2013 to December 31st,2013 were retrospectively analyzed.Pharmaceutical interventions were carried out for unreasonable prescriptions.Results A total of 6 454 prescriptions were reviewed during the research period,among which pharmaceutical interventions were provided for 154 prescriptions (2.39%).Totally 160 errors were identified,and 44 were prevented.The intervention acceptance rate was 98.70%.Conclusions Pharmaceutical interventions can adjust unreasonable prescriptions and modify errors.It is useful to promote the clinical drag use in a safe,rational,effective,and economical manner.

20.
Rev. cuba. farm ; 45(1): 50-59, ene.-mar. 2011.
Article in Spanish | LILACS-Express | LILACS | ID: lil-584565

ABSTRACT

Se realizó un estudio retrospectivo durante el periodo comprendido entre noviembre del 2008 y abril del 2009 a partir del sistema de distribución de medicamentos en dosis unitarias, con el objetivo de documentar el valor de la intervención farmacéutica, tanto en datos descriptivos como en datos económicos y de eficiencia, mediante el empleo de un programa de equivalentes terapéuticos. Las intervenciones farmacéuticas se agruparon en dosis/intervalo, sustitución, vía de administración, interacciones, alergias y otros. En cuanto al impacto económico, los valores de precios se obtuvieron a partir de los precios de compra de los medicamentos y del catálogo de especialidades farmacéuticas. Se realizaron un total de 297 intervenciones repartidas en 50 dosis/intervalo, 174 sustituciones, 34 de vía, 25 de interacciones, 3 de alergia y 11 en el apartado de otros. El ahorro real calculado supuso 18 146,39 euros. El registro de las intervenciones se valora como beneficioso para la detección de problemas prioritarios y áreas de actuación, además de constituir una herramienta útil para poder demostrar el coste/efectividad de las acciones.


A retrospective study was conducted from November 2008 to April 2009 in the unit-dose drug distribution system. The objective was to document the value of the pharmaceutical intervention both in descriptive and economic/efficiency data by using a program of therapeutic equivalences. The pharmaceutical interventions were grouped into dose/interval, substitutions, route of administration, interactions, allergies and others. Regarding the economic impact, the values of prices were derived from the drug purchase prices and the catalogue of pharmaceutical specialties. Two hundred ninety seven interventions were performed and distributed as follows: 50 dose / interval, 174 substitutions, 34 routes of administration, 25 interactions, 3 allergies and 11 of other types. Actual estimated savings amounted to 18 146.39 euros. The record of interventions is considered advantageous for the detection of priority problems and areas for action, in addition to being a useful tool to prove the cost-effectiveness of actions. Key words: Pharmaceutical intervention, clinical impact, economic impact.

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