Rational use management standards of national key monitoring drug / 中国药房

At present， there is a lack of unified and standardized management for the rational use of national key monitoring drugs. According to the relevant requirements of the state， based on the relevant literature published at home and abroad in recent years and combined with the management practice of many medical institutions across the country on the national key monitoring drugs， in order to make the national key monitoring drugs more reasonable use and standardized management in medical institutions at all levels， the Clinical Pharmacy Branch of the Chinese Medical Association， the Pharmaceutical Epidemiology Special Committee of the Chinese Pharmaceutical Association and the Pharmaceutical Epidemiology Special Committee of the Sichuan Pharmaceutical Association organized experts to fully discuss， and to form this management standard. This standard mainly provides relevant opinions and suggestions on the basic principles of rational use of key monitoring drugs and the regulatory measures for key monitoring drugs， especially on how to strengthen the pharmaceutical management and use management of key monitoring drugs， further promoting the standardized use of key monitoring drugs.

Investigation and Analysis on the Drug-related Problems in Clinical Application of Antiepileptic Drugs in Hospitalized Patients of One Hospital / 中国药师

Objective:To discuss the causes and characteristics of drug-related problems(DRPs) of antiepileptic drugs by the in-vestigation of antiepileptic drugs' use in our hospital in order to provide reference for the rational clinical application of antiepileptic drugs. Methods:A retrospective analysis on 878 inpatients' records including antiepileptic drug application in our hospital from Janu-ary to December 2016 was carried out. The gender,age,etiology,application of antiepileptic drugs,usage,combination and adverse reactions were statistically analyzed in order to analyze the epidemiological characteristics of antiepileptic drugs in our hospital. At the same time,the necessity,safety and validity of the DRPs of antiepileptic drugs were studied by the international generic Spanish drug related research method(Granada-Ⅱclassification method). Results:Among the 878 cases,most were male patients(60.71%) and the proportion of patients over 50 years old was 69.02%. Patients with cerebrovascular diseases accounted for the most (323 cases, 36.79%),and 7 varieties of antiepileptic drugs were involved, and sodium valproate was with the largest proportion (489 cases, 51.75%). The DRPs were classified as DRP2(49 cases),DRP5(22 cases) and DRP6(8 cases). Conclusion:In view of the epi-demiological characteristics of antiepileptic drugs and DRPs specific issues in clinical applications, clinical pharmacists need to strengthen the intervention in DRPs of antiepileptic drugs in order to promote the safety and reasonability of clinical application.

Practices of a hospital to control of medical expenses / 中华医院管理杂志

Measures have been taken by the hospital to control drug expense proportion and consumables expense proportion, in addition to such actions as ceiling pricing for individual diseases, clinical pathways and better incentive mechanisms. All these measures help to curb unreasonable growth of medical expenses, and ease patients' burden. The study proves that the goal of expense control set in the healthcare reform can be achieved by setting multiple control indexes, strengthening pharmaceutical affairs management, normalizing procedure of consumables circulation, reforming the compensation incentive mechanism, giving the best play of cost control role of medical insurance, and introducing new technologies or programs.

Management Effect of Clinical Pharmacist on Antibiotics Use during Perioperative Period of Great Saphe-nous Varicose Veins Surgery / 中国药师

Objective:To evaluate the management effect of clinical pharmacist on antibiotics use during perioperative period of great saphenous varicose veins surgery. Methods:The medical records of all the patients undergoing simple great saphenous vein strip-ping, great saphenous vein high ligation plus simple stripping and saphenous vein ligation plus endovenous laser treatment between June and September in 2010 ( before the intervention) , 2011 ( after the intervention) and 2014 ( consolidation period) were selected, and the rationality of prophylactic use of antibiotics during perioperative period was evaluated. Results: After the management of clinical pharmacists, the preventive application of antibiotics during perioperative period was markedly improved in the indication, medicine va-riety choice,application and dosage, administration route, solvent and solvent dose, administration time, course of treatment and drug combination when compared with that before the intervention. Antibiotics use ratio, average hospitalization days, antibiotics ratio, drug ratio and infusion ratio were reduced obviously, which could be consolidated. Conclusion: The intervention of clinical pharmacists in antibiotics use during perioperative period of great saphenous varicose veins surgery improves the reasonable use ratio of antibiotics, and makes certain significance in the cost reduction for patients and the specification for hospital management.

Discussion on Reasonable Medication Work Mode in Pharmacy Intravenous Admixture Service (PIVAS) / 中国药师

Objective:To discuss the effect and significance of reasonable medication review mode for intravenous medical advice on the platform of pharmacy intravenous admixture service( PIVAS) . Methods:The effect of prescription review interference in intrave-nous drugs on the platform of PIVAS was studied through analyzing irrational prescriptions before and after the performance of PIVAS for 25 departments in our hospital. Results:The real-time review and interference procedure for intravenous transfusion was established, which could significantly increase the percentage of reviewed medical advice and the correction rate of irrational medical advice, and re-duce the percentage of irrational medical advice. The medical advice review quality was also increased, which could guarantee the med-ication safety in patients. Conclusion:The real-time review and interference procedure for intravenous transfusion on the platform of PIVAS can significantly improve the rational medication level of intravenous drugs and avoid the hidden danger of irrational medical ad-vice to the maximum extent to ensure the medication safety in patients, which is also beneficial to the provision of medication service and new platform establishment for the development of clinical pharmacy in hospitals.

Analysis of the Utilization of Tripterygium Glycosides Tablet in Outpatient Department of Our Hospital / 中国药房

OBJECTIVE:To provide for rational use of Tripterygium glycosides tablet clinically. METHODS:The utilization of Tripterygium glycosides tablet were collected from hospital information system(HIS)in our hospital during Jun. 2012-Jun. 2014. Then the data about the basic information,patients’age,departments and diagnosis,were analyzed by the Excel. RESULTS:The application of Tripterygium glycosides tablet remained stable since Jun. 2012. There were 4 600 prescriptions in average every year, and the age of patients was distributed from 11 to 90. Tripterygium glycosides tablet was mainly used in rheumatology department (52.11%),followed by TCM rheumatology department(20.62%),skin disease and venereal disease department(18.15%),ne-phrology department(3.52%)and integrated traditional and western medicine cardiology department(1.77%). It was mainly used to treat rheumatoid arthritis,Sjogren's syndrome,polymyalgia rheumatica,osteoporosis and nephrotic syndrome. CONCLUSIONS:The application of Tripterygium glycosides tablet as immunosuppressant is widely used,but the age of patient is with wide distribu-tion;the narrow gap exists between minimum effective dose and minimum lethal dose;so ADR should be concerned closely.

Analysis of the Application of Oral Tablet Splitting in Inpatients of Our Hospital in 2014 / 中国药房

OBJECTIVE:To provide reference for clinical rational drug use. METHODS:The medical orders of oral tablet in the inpatients collected from our hospital in 2014,and the application of oral tablet splitting was analyzed statistically. RESULTS:There were 220 specifications in total,and 93 tablets were split for use,accounting for 42.27%. Of all split tablets,there were 52 kinds with split mark on surface,accounting for 55.91%. There were 357 602 medical orders of tablet and 15 202 of tablet split-ting,accounting for 4.25%. The top three categories in frequency of splitting were Benserazide tablets,Digoxin and Clonazepam tablet. CONCLUSIONS:To meet the demand of clinical treatment,tablet splitting has its rationality. It is necessary to enhance com-munication among pharmacists,doctors and nurses to weigh the pros and cons before treatment.

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.

Status quo and legitimacy analysis for temporarily dispensed drugs used in hospitals / 中华医院管理杂志

Availability of appropriate drugs for children has been a bottleneck both at home and abroad for years.As a result, drugs for adults that are market available emerge a choice of convenience for children's treatment instead.For unique physiological and psychological characteristics of children, these drugs must be dispensed on individual basis before usage to children in question.Such drugs play a key role in children's treatment, and incur many problems on the other hand in their use and practice, such as drug stability, dosage accuracy, potential risks, as well as legitimacy in drug dispensing and use.A safe, reasonable and normalized use of such drugs calls for an orchestrated effort among pharmacists, trade associations and drug regulators as well.

Standardization of Antibiotics Sales and Promotion of Reasonable Drug Use / 中国药房

OBJECTIVE:To promote the reasonable use of antibiotic drugs.METHODS:the causes of antibiotics drug abuse were analyzed.The regulation on standardizing antibiotic drug sales by State Food and Drug Administration as well as its influence were discussed.RESULTS&CONCLUSION:some conceptions and suggestions are tentatively put forward.