Analysis of Hemostatic Drugs Used for Orchidopexy in Children during the Perioperative Period / 中国药师

Objective:To analyze the hemostatic drugs use for orchidopexy in children during the perioperative period to promote the rational use of hemostatic drugs for orchidopexy in children. Methods:The perioperative prophylactic use of hemostatic drugs for orchi-dopexy in 138 children from June 2015 to December 2016 was retrospectively analyzed. The difference of clinical data and outcome indica-tors were compared between hemostatic drugs group(drug group) and without hemostatic drugs group (control group),and the rational use of hemostatic drugs in the drug group was analyzed. Results:The operation time,amount of bleeding and the length of hospital stay showed no statistical differences between the groups during the perioperative period in our hospital. There were 44.9% of children under-going orchidopexy treated with hemostatic drugs,and the unreasonable rate was 51.6% in the drug group. Among them,35.5% of chil-dren were with too long medication time,11.3% of children were with unreasonable initial treatment time, and 4.8% of children were with single overdose. Conclusion:The perioperative hemostatic drugs use for orchidopexy in children still has several problems, inclu-ding excessive medication duration,inappropriate administration time and single overdose etc,and clinicians should pay attention to above situations.

A new era of thromboelastometry / A nova era da tromboelastometria

ABSTRACT Severe hemorrhage with necessity of allogeneic blood transfusion is common complication in intensive care unit and is associated with increased morbidity and mortality. Prompt recognition and treatment of bleeding causes becomes essential for the effective control of hemorrhage, rationalizing the use of allogeneic blood components, and in this way, preventing an occurrence of their potential adverse effects. Conventional coagulation tests such as prothrombin time and activated partial thromboplastin time present limitations in predicting bleeding and guiding transfusion therapy in critically ill patients. Viscoelastic tests such as thromboelastography and rotational thromboelastometry allow rapid detection of coagulopathy and goal-directed therapy with specific hemostatic drugs. The new era of thromboelastometry relies on its efficacy, practicality, reproducibility and cost-effectiveness to establish itself as the main diagnostic tool and transfusion guide in patients with severe active bleeding.

RESUMO A hemorragia grave com necessidade de transfusão de sangue e componentes é uma complicação frequente na unidade de terapia intensiva e está associada ao aumento da morbidade e da mortalidade. A identificação adequada e o tratamento precoce da causa específica da coagulopatia tornam-se fundamentais para o controle efetivo da hemorragia, racionalizando a utilização de sangue e componentes, e desta forma, prevenindo a ocorrência de efeitos adversos. Testes convencionais da coagulação (tempo de ativação de protrombina e tempo de tromboplastina parcial ativada) apresentam limitações para prever sangramento e guiar a terapia transfusional em pacientes graves. Testes viscoelásticos como a tromboelastografia e tromboelastometria rotacional permitem a rápida detecção da coagulopatia e orientam a terapia de forma individualizada, alvo dirigida com drogas hemostáticas específicas. A nova era da tromboelastometria confia na sua eficácia, praticidade, reprodutibilidade e custo-eficácia para se firmar como a principal ferramenta diagnóstica e guia transfusional em pacientes com sangramento ativo grave.

Analysis of the Utilization of Perioperative Haemocoagulase Hemostatic Drugs in Our Hospital in 2014 / 中国药房

OBJECTIVE:To provide reference for the rational use of haemocoagulase hemostatic drugs in the clinic by under-standing the perioperative utilization. METHODS:In retrospective study,1 200 discharge records of perioperative prophylactic ap-plication of haemocoagulase hemostatic drugs were collected randomly during Jan.-Dec. 2014.,and then analyzed statistically in re-spects of consumption sum and amount,application,irrational drug use,etc. The cost of hemocoagulase accounted for 7.39% of total drug cost,among which Haemocoagulase agkistrodon for injection had the highest consumption amount and sum,with utiliza-tion ratio of 51.44%. Average medication time of hemocoagulase during perioperative period was 2.36d;maximal average cost of hemocoagulase was 684.52 yuan in ENT and head and neck surgery department/ stomatology department;ENT and head and neck surgery department/ stomatology department,urinary surgery department had long average medication time,being 3.85d and 3.50d. RESULTS:Only 39.42% haemocoagulase hemostatic drugs were reasonably used during perioperative period. The unreasonable manifestation included:improper medication time(52.15%), too long medication course after operation(35.75%),wrong usage (5.61%)and replacing various haemocoagulase hemostatic drugs without reason(5.06%). CONCLUSIONS:The striking phenome-non of irrational use of haemocoagulase hemostatic drugs during perioperative period is severely worrying,so we need to strength-en the standard management and pharmaceutical supervision and intervention by clinical pharmacists.

Marketing Analysis of Hemostatic Drugs in China from 2006 to 2008 / 中国药房

OBJECTIVE:To evaluate the marketing of hemostatic drugs use in China from 2006 to 2008.METHODS:By reviewing literature both at home and abroad and combining the data of the sales volume and consumption sum of hemostatic drugs from 2006 to 2008 and in the first 3 quarters of 2008 available in the "State Medicine Economy Information Network",the drug variety and manufacturers were analyzed statistically.RESULTS & CONCLUSIONS:Hemopexin assumed a dominate place in the market of hemostatic drugs,accounting for 38% of total in sales value,followed by tranexamic acid and aprotinin.Switzerland Sugao pharmaceutical factory ranked at the first place in terms of sales value of hemostatic drugs.