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.

OBJECTIVE:To investigate the way to provide suitable pharmacecaical care for antineophastic drug-induced ADR by clinical pharmacists. METHODS:For one case of 5-FU chemotherapy-induced neutropenia associated with fever and diarrhea, clinical pharmacists provided advices on antibacterial treatment,including imipenem/cilastatin 0.5 g,q6 h,ivgtt;norvancomycin 0.4 g,q6 h,po;levofloxacin 0.4 g,qd,ivgtt;loperamide with initial dose of 4 mg for anti-diarrheal medication,maintaining at 2 mg,q4 h. RESULTS:After 22 days of appropriate antibacterial and anti-diarrheal treatment,the patient's body temperature and he-mogram returned to normal,diarrhea stopped and β-HCG decreased to 61.58 U/L;then the patient was discharged from hospital. CONCLUSIONS:It is beneficial to optimize chemotherapy plan and ADR disposal,and ensure the safety of the treatment that clini-cal pharmacists assist physicans to optimize therapy plan and provide pharmaceutical care.

OBJECTIVE:To investigate the breakthrough point of clinical pharmacists participating in the treatment for a child with Mycoplasma pneumonia complicating with Kawasaki disease,and standardize pharmaceutical care mode. METHODS:Taking a case of Mycoplasma pneumonia complicating with Kawasaki disease as example,according to the use of antibiotics,human im-munoglobulin (pH4) for intravenous injection,non-steroidal anti-inflammatory drugs (NSAIDS),glucocorticoids,combined with clinical manifestations and disease,whole course pharmaceutical care was conducted,using drug interaction,ADR,precautions, discharge education as breakthrough points. RESULTS:In view of possible ADR,clinical pharmacists adopted combination mea-sures for early prevention,and monitoring measures for early identification and intervention to find problems in time,prevent the occurrence of ADR and improve patient compliance. CONCLUSIONS:What clinical pharmacists carry out pharmaceutical care in the treatment group is beneficial to improve the level of clinical treatment,so as to better safeguard patients’medication safety.

OBJECTIVE:To explore the role of clinical pharmacists in cancer pain management. METHODS:The cases were presented to investigate the content and method of clinical pharmacists participating in cancer pain management. RESULTS:The clinical pharmacists could provide professional analgesic recommendations and participated in the formulation of individual analge-sic plan. By carrying out pharmaceutical care and patient education,clinical pharmacists could find potential medication risk,cor-rected medication errors and improved patient compliance. By carrying out patient family members training,clinical pharmacists could help to strengthen patient support system and improve cancer pain management effectiveness. CONCLUSIONS:Clinical phar-macists participating in cancer pain management can promote rational use of analgesics,guarantee the safety of drug use,and im-prove cancer pain management.

OBJECTIVE:To ensure the safety of the elderly medication. METHODS:The package inserts of 38 kinds of com-mon oral antihypertensive drugs were collected from our hospital,and analyzed statistically in respects of drug information for the elderly in package inserts of domestic and foreign drugs and those of antihypertensive drugs. RESULTS:In 21 package inserts (55.26%),there were specific dosage for elderly;in 16(42.10%),there were certain matters needing attention in“drug use for the elderly”;in 15,the marked rate of“pharmacokinetics study for the elderly”was 39.47%.Except for ARB antihypertensive drugs, related drug information was hardly labeled in package inserts of other types. The label of“starting at low dose”accounted for 21.05%;the label of“no need to adjust dose,“use drug carefully”,“no age differences”accounted for 15.79%,15.79% and 13.16%,respectively. The label rates of other items were in low level. The drug package inserts at home were lack of information of drug use for the elderly,compare to abroad. CONCLUSIONS:There are some problems in package inserts of common oral anti-hypertensive drugs,such as usage and dosage,matters need attention,pharmacokinetics,poor description in details. Drug informa-tion for the elderly in the package inserts of antihypertensive drug needs to be more detailed;the drug regulatory agency and the drug manufactures should make joint efforts to let drug package inserts more detailed about drug use for the elderly to ensure medi-cation safety.

OBJECTIVE:To probe the role of responsible pharmacist on irrational medical order intervention in Pharmacy Intra-venous Admixture Service (PIVAS),and to improve rational drug use in our hospital. METHODS:501 115 medical orders from PIVAS of our hospital during Jan.-Jun. 2012 were analyzed retrospectively. Irrational medical orders of 499 189 medical orders dur-ing Jul.-Dec. 2013 were classified and summarized after the establishment of responsible pharmacists system and pharmacist inter-vention. RESULTS:The number of irrational medical orders was 918(0.183 2%),and decreased to 448(0.089 7%)after interven-tion. Irrational medical orders of solvent selection reduced from 134(0.026 7%)to 69(0.013 8%);irrational medical orders of sol-vent volume reduced from 435(0.086 8%) to 206(0.041 3%);irrational medical orders of drug dosage reduced from 241(0.048 1%)to 117(0.023 4%);irrational medical orders of drug compatibility reduced from 51(0.010 2%)to 28(0.005 6%);irrational medical orders of dosing frequency reduced from 17(0.003 4%)to 2(0.000 4%). CONCLUSIONS:What responsible pharmacists intervened in the irrational doctor’s orders of intravenous drip was effective and feasible in PIVAS,improved rational drug use and guaranteed the safety of drug use.

OBJECTIVE:To observe therapeutic efficacy of zoledronic acid in the treatment of acute pain of vertebral compres-sion fractures during different courses. METHODS:207 patients with acute thoracic or (and) lumbar vertebral compression frac-tures were selected and randomly divided into trial group(107 cases)and control group(100 cases). Control group was given calci-um carbonate(1 200 mg/d)diclofenac sodium sustained-released tablet(75 mg/d).Trial group was additionally given zoledronic ac-id 5 mg added into 5%Glucose solution 100 ml,intravenous dripping for 15-30 min,on the basis of control group. RESULTS:Af-ter treatment,VAS score of two group decreased significantly,and trial group the decrease was more significant than control group,with statistical significance (P<0.05),there was no statistical significance in VAS score between course≤one month and one month 0.05);after 4d treatment,there was statistical significance in VAS score between course≤one month and one month 0.05);after one week,there was statistical significance in VAS score between one month 2 months (P<0.05).CONCLUSIONS:Zoledronic acid may partly alleviate the pain of acute vertebral fractures,the analgesic effect is more clear in early stage.

OBJECTIVE:To investigate therapeutic efficacy and safety of linezolid and teicoplanin in the elderly patients with severe MRSA infection. METHODS:97 elderly patients with severe MRSA infection were collected and divided into linezolid group (42 patients) and teicoplanin group (55 patients). Linezolid group was given linezolid 600 mg intravenously,bid;teico-planin group was given teicoplanin 400 mg intravenously,qd,double dose for the first day. Treatment course lasted for 7-21 d. Clin-ical effective rate,bacterium clearance rate and ADR were compared between 2 groups after treatment. RESULTS:The bacterium clearance rate of teicoplanin group was 52.6%,and that of linezolid group was 73.5%;the linezolid group was significantly higher than the teicoplanin group,with statistical significance(χ2=12.57,P=0.034). Clinical effective rate was 78.6% in linezolid group and 58.2% in teicoplanin group;the linezolid group was significantly higher than the teicoplanin group,with statistical significance (χ2=9.56,P=0.018). After 14 days of treatment,APACHEⅡ score of teicoplanin group and linezolid group were (14.56±3.04) and(10.29±4.84),respectively;the teicoplanin group was lower than the linezolid group,with statistical significance(t=10.97, P=0.014). The incidence of ADR was 11.9% in linezolid group and 20.0% in teicoplanin group,with statistical significance(χ2=1.13,P=0.287). CONCLUSIONS:Linezolid has superior curative effect to teicoplanin in the treatment of severe MRSA infection in elderly patients with good safety.

OBJECTIVE:To investigate the effect of thymosin α1 combined with chemotherapy on immune function in patients with advanced gastric cancer and quality of life. METHODS:90 patients with advanced gastric cancer were randomly divided into observation group and control group with 45 cases in each group. Control group was treated with FOLFOX4 chemotherapy plan(so-dium oxaliplatin+calcium folinate+fluorouracil),and observation group was additionally treated with thymosin α1 1.5 mg subcutane-ously,once a day,on the basis of control group. A treatment course lasted for 3 weeks,and both received 3 courses of treatment. The immune function and quality of life were evaluated in 2 groups. RESULTS:The effective rate of observation group was 57.8%,and that of control group was 53.3%;there was no significant difference between 2 groups (P>0.05). The incidence of leukopenia in observation group was 24.4%,which was significantly lower than control group (55.6%),with statistical signifi-cance(P<0.05). There was no statistical significance in CD4+,CD8+ and NK score between 2 groups before chemotherapy(P>0.05). After treatment,above index of observation were all higher than those of control group,with statistical significance (P<0.05). The total health QLQ-C30 EORTC score in observation group was higher than in control group after chemotherapy,with sta-tistical significance(P<0.05). CONCLUSIONS:Thymosin α1 combined with chemotherapy can significantly improve the immune function and quality of life.

OBJECTIVE:To observe the effect of Compound glycyrrhizin on serum VEGF of patients with alopecia areata. METHODS:36 alopecia areata patients were selected as trial group and treated with Compound glycyrrhizin(50 mg/time,3 times/d) for 3 months. Double-antibody sandwich ELISA method was adopted to determine the content of VEGF in serum before and after treatment. 36 healthy volunteers were included in control group,and serum content of VEGF in control group was compared with trial group. RESULTS:Compared with control group,the serum content of VEGF was lower in trial group,with statistical signifi-cance(t=5.863,P<0.05). After treatment,the serum VEGF levels of trial group increased,with statistical significance(t=4.351, P<0.05);there was no statistical significance in VEGF levels between trial group and control group after treatment(t=1.678,P>0.05). CONCLUSIONS:Compound glycyrrhizin can cure alopecia areata through increasing serum level of VEGF.