Résumé
OBJECTIVE To analyze the compatible stability of commonly used intravenous drugs in the intensive care units （ICU）， and to provide a reference for improving medication safety in clinic. METHODS The commonly used intravenous drugs in the ICU of Hebei General Hospital were investigated and confirmed in April 1-30， 2022， and used as keywords to retrieve the relevant literature about compatible stability from PubMed， CNKI， Wanfang Data and other databases， and manually filtered with Micromedex database at the same time. Then， the compatible stability results of the included literature were analyzed descriptively. RESULTS Totally 32 commonly used intravenous drugs and 39 mixed infusion combinations were collected from ICU of this hospital. A total of 40 studies were included， only 2 studies followed all quality requirements； 18 studies validated their methods to guarantee correct reproducibility； 33 studies evaluated physical stability， including precipitate formation and pH changes； 32 studies evaluated chemical compatibility， mainly content/concentration changes. A total of 666 possible two-drug combinations were obtained from the included literature， of which 254 combinations of stability data were available， including 176 were stable， 68 were unstable， and 10 were contradictory. Totally 412 combinations had no stability results. Among two-drug combinations in ICU of this hospital， 42 combinations were stable， 14 combinations were unstable， and 2 combinations were contradictory. CONCLUSIONS The pH， solvent， excipients and preparation concentration are the factors that affect the stability. There are drug combinations with unstable compatibility of commonly used intravenous drugs in ICU of this hospital. The stability study methods are limited， and the stability data cannot meet the actual clinical needs.
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OBJECTIVE:To provide a reference for reducing adverse events due to off-label use of drugs and promoting ratio-nal use of intravenous drugs in Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine. METHODS:The pre-scriptions of intravenous drugs in 42 wards of our hospital from Jul. 2013 to Jun. 2014 were reviewed,and then off-label use of drugs were analyzed,where statistics was made mainly to drug overdose,the use of drugs at the concentration beyond the standards (including concentrations too high and too low) and associated conditions. RESULTS:There were 622 irrational prescriptions,in-cluding 60 concerning off-label use of drugs,accounting for 9.6% of irrational prescriptions,in which 40 were involved with the concentration which was too high,accounting for the highest percentage(66.7% of prescriptions related to off-label use of drugs), 17 were related to drug overdose(28.3% thereof),and 3 were in relation to the concentration which was too low(5.0% thereof). CONCLUSIONS:Pharmacy intravenous admixture service may,through the communication between the pharmacist and the doc-tor,refuse to make up the above-mentioned prescription which was found to be irrational(including that involving in off-label use of drugs)or make up such prescription after it is modified according to the requirements as specified in the label to reduce the occur-rence of off-label use of drugs so as to promote rational drug use.
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OBJECTIVE:To promote the safety and effectiveness of clinical medication.METHODS:In drug dispension process,operation procedure was carried out strictly and different dispensing methods were adopted according to the characteristics of drugs.RESULTS & CONCLUSIONS:Dispensing guidelines for common injection,insoluble drug and chemotherapy drugs were summarized and improved to promote quality of intravenous drugs dispension.
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OBJECTIVE:To promote effective development of services in the intravenous drugs allocation centre and to bring the pharmacists'function into full play in the hospital pharmacy.METHODS:Information concerning services in the intravenous drugs allocation centre of our hospital and experiences from which was introduced,some problems and difficulties in the pharmacy services were analyzed.RESULTS&CONCLUSION:The centralized allocation and management of intra-venous drugs have ensured the safety and effectiveness of the clinical intravenous drug use and which have become the essential part of the pharmaceutical care with a core of rational drug use.