Objective To investigate the labeling of dialysis-related information in the instructions of drugs for systemic use in patients with end-stage renal disease undergoing hemodialysis,and to provide reference for further standardization and im-provement of drug instructions.Methods Collected the information on pharmacokinetics and drug dose adjustment in hemodi-alysis patients with end-stage renal disease from the instructions of chemicals and biologics used systemically in XuanWu hospital's formulary from January to March 2023.Classified and compared the labeling rates of the corresponding information of the originally developed drugs and generic drugs,imported drugs and domestic drugs;Drugs eliminated by non-renal route,or with mo-lecular weight≥5 000,or binding rate of plasma protein ≥ 60％,or drug distribution volume＞360L were classified as"non-dialysis group",and other drugs were classified as"dialysis group",compared the labeling rate of corresponding information of drugs in"dialysis group"and"non-dialysis group";and compared the labeling rate and content with relevant information in Lexicomp and Micromedex.Results Among the 930 drug instructions,the labeling rates of drug dialysis clearance,drug adjustment,and ex-plicit drug adjustment plan were 16.67％,25.16％,and 24.52％.There was no significant difference in the labeling rate of dialysis-related information between original and generic drugs,and imported and domestic drugs.There was a significant difference in the labeling rate of dialysis-related information between the"dialyzable group"and the"non-dialyzable group"(P＜0.01).The differ-ence in the labeling rate of dialysis related information between the investigated drug instructions and the corresponding drugs in Lexicomp or Micromedex was statistically significant(P＜0.01).Conclusion Attention should be paid to the lack of informa-tion and unclear labeling of hemodialysis patients with end-stage renal disease in the drug instructions by relevant departments.

Objective To construct an evaluation index system for rational drug use management of key monitoring drugs,and to provide references for medical institutions.Methods The preliminary index framework was formed by researching the policies and regulations,management norms,and guiding principles related to key monitoring drugs.Two rounds of Delphi questionnaire survey were conducted with 26 experts to improve and optimize the index system.The weights of the indicators were obtained by constructing the judgment matrix by analytic hierarchy process(AHP).Results The recovery rates of the two rounds of questionnaire were both 100％,and the authority coefficient was 0.87.The key monitoring drug rational use management evaluation index system was finally constructed to include three primary indicators[ex-ante management(0.253 6),in-process management(0.503 1),and ex-post management(0.243 2)],15 secondary indicators[including prescription review(0.302 6),formulate rational drug use norms(0.133 1),supernormal early warning management(0.103 2)],and 62 tertiary indicators[inclu-ding formulate strict prescription review rules(0.152 5),pharmacists prescription intervention strength(0.085 7)and effective-ness management(0.052 5)].and the index judgment matrix passed the consistency test.Conclusion The evaluation index system for the rational drug use management of key monitoring drugs constructed can satisfy the closed loop of the supervision and management process,achieve the prior reminder,monitoring,and post-supervision,and provide references for medical institutions to ensure the refinement and standardization of the management process.

Anticoagulants are widely used in the prevention and treatment of thromboembolism.Existing anticoagulants share the common feature of antagonizing or blocking critical steps in the coagulation cascade,which also increases the risk of bleeding.Studies have indicated that factor Ⅺ inhibitors represent a potential therapeutic option for balancing thrombosis and bleeding risks.In recent years,various factor Ⅺ inhibitors,including antisense oligonucleotides(ASOs),monoclonal antibodies,synthetic small molecules,natural peptides,and aptamers,have been extensively researched as potentially exploitable anticoagu-lants.Research findings also suggest that factor Ⅺ inhibitors can reduce bleeding risks while ensuring anticoagulant efficacy,ex-hibiting potential for thrombosis prevention and treatment in patient populations such as those with end-stage renal disease,non-cardioembolic ischemic stroke,and acute coronary syndrome.This article reviewed the mechanisms of action,drug classes,pharma-cological characteristics,and clinical research progress of factor Ⅺ inhibitors,aiming to provide insights into the development of new anticoagulants and clinical anticoagulant therapies.

Objective To establish TLC identification method,HPLC fingerprint,chemical pattern recognition,and multi-components quantitative analysis methods of Spatholobus suberectus,and identify the quality of 16 batches of Spatholobus su-berectus from different origins.Methods The TLC method was used to identify Spatholobus suberectus qualitatively.HPLC fin-gerprint of Spatholobus suberectus was established.The quality of Spatholobus suberectus was evaluated by chemical pattern recogni-tion technologies,and the contents of Gallocatechin,protocatechuic acid,catechin,epigallocatechin and fermononetin were deter-mined by HPLC.Results TLC method of Spatholobus suberectus was established.Ten common peaks were identified in 16 bat-ches of Spatholobus suberectus,and 6 components were identified by reference substances.The similarity of fingerprint was 0.769-0.990,indicating good similarity.The samples were divided into 3 groups by cluster analysis.Results of the principal component a-nalysis showed that the top 3 samples in the list of comprehensive scores were S16、S1 1、S14.Marker compounds that cause the quality difference of Spatholobus suberectus were screened out through the orthogonal partial least squares discriminant analysis,which were fermononetin,peaks 7 and epigallocatechin.Gallocatechin,protocatechuic acid,catechin,epigallocatechin,and ferm-ononetin had a good linearity in the concentration range(r＞0.999).The content determination analysis showed that there were sig-nificant differences in the contents of the 5 index components among Spatholobus suberectus from different origins.Conclusion The established TLC and HPLC fingerprints of Spatholobus suberectus were stable and reliable,and the HPLC method for multiple active components method provides scientific support for improving the quality control method of Spatholobus suberectus.

Objective To summarize a case of latent autoimmune diabetes in adults(LADA)who received medication therapy management(MTM)of pharmaceutical outpatient service,and to provide reference for the treatment of similar diseases.Methods The physician recommended a 61-year-old male patient with LADA to the pharmacy clinic on March 27,2023.The pharmacists provided MTM services for the patient through pharmacy inquiry,medication evaluation,medication reconciliation,medication education,and pharmacy follow-up,return visit or pharmacy follow-up for the patient once a week,and established the patient MTM archives.Results Through fifteen MTM services for over three months,including eight visits to the pharmaceuti-cal outpatient clinic and follow-up seven times.On July 10,2023,the atherosclerotic cardiovascular disease(ASCVD)monitoring indicators,such as fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),blood pressure,heart rate,low density lipo-protein cholesterol(LDL-C),and homocysteine(HCY),reduced from 7.17 mmol·L-1,6.8％,140-150/90-100 mmHg,80-90 times·min-1,2.15 mmol·L-1,16.30 μmol·L-1 to 6.06 mmol·L-1,6.1％,120-130/70-80 mmHg,60-70 times·min-1,1.63 mmol·L-1,8.67 μmol·L-1 after MTM services.The ASCVD monitoring indicators were effectively controlled.After thirty-two weeks,the re-examination of the patient's fasting C-P level remained stable,there was no significant decline in pancreas islet function,and cardiac ultrasound showed that cardiac function had a certain improvement.Conclusion By providing MTM serv-ices and reconciliation the medication regimen for the patient with LADA,the ASCVD monitoring indicators such as blood glu-cose,blood pressure,blood lipids,heart rate,and homocysteine were controlled to meet the standards,effectively protecting the pancreatic β-cell and target organs functions of the patient,and significantly improving his health management level.

The article reported a case of a 40-year-old female patient with unstable angina who was administered in-dobufen tablets 0.1 g orally twice a day,rosuvastatin calcium tablets 10 mg once daily,and sacubitril/valsartan sodium tablets 100 mg once daily.After one month,she developed severe alopecia and multiple oral ulcers.Considering the association with in-dobufen,the drug was discontinued,and the patient's symptoms significantly alleviated within a week.The clinical data of the pa-tient and the association with adverse reactions were analyzed and evaluated.It is believed that indobufen causes adverse reactions such as alopecia and oral ulcers.

One patient who underwent mechanical aortic valve replacement was in good condition after surgery,and was discharged with warfarin(2.25 mg·d-1 and 3 mg·d-1 alternatively)and INR 1.91 under the guidance of the pharmacist.After discharge,in addition to taking warfarin and other medication for heart failure treatment,he purchased Huangjing(astragalus)o-ral liquid at the pharmacy and took it everyday.Twelve days later,he developed recurrent gingival bleeding and INR was 4.95.Warfarin and astragalus oral liquid were stopped immediately,and warfarin was restarted 3 days later.INR was monitored and the dose was adjusted.The maintenance dose of warfarin was 3 mg·d-1 and the INR was around 2.0.It was considered that the abnor-mally elevated INR was caused by the interaction between warfarin and astragalus extract oral solution.

The patient,male,69-year-old,was given 10mg of dapagliflozin tablets qd for type 2 diabetes mellitus.He de-veloped hemolytic anemia with jaundice about 7 days after oral administration.The occurrence,diagnosis,treatment and follow-up of the adverse drug reactions were retrospectively analyzed.The correlation between dapagliflozin and adverse drug reactions was e-valuated,and the possible mechanism of the adverse drug reactions was discussed through literature analysis.This case of adverse drug reactions is rare.We suggested that the monitoring of the adverse reactions of blood system should be strengthened to ensure the safety of clinical use of dapagliflozin.

Objective To evaluate the effectiveness and feasibility of a remote medication treatment management model for elderly patients with chronic disease at home based on mobile technology.Methods A convenient and elderly-friendly mo-bile application(hereinafter referred to as Yaoshiyi APP)was developed,and a remote medication treatment management team consisting of clinical pharmacists from tertiary hospitals,community pharmacists,and community physicians was formed.Patients from communities were selected for practical research,led by pharmacists.Based on the Yaoshiyi APP,patients were subjected to 6 months of medication treatment management practice,and the effectiveness and feasibility of the practice were evaluated.Re-sults The Yaoshiyi APP can be integrated with a variety of medical-grade wearable devices to realize the functions of automati-cally uploading monitoring data,abnormal value reminding,medication reminding,medication consultation,and medication sci-ence popularization.A total of 302 elderly patients with chronic disease at home completed the study.The results showed that phar-macists have identified and intervened in 695 cases of medication-related problems.According to the classification of medication-related problems,the top three were 247 cases(35.5％)of additional treatment,97 cases(14.0％)of unnecessary drug treat-ment,and 93 cases(13.4％)of medication compliance problems.The patient's medication adherence score(Morisky medication adherence scale-8,MMAS-8)increased from(5.85±1.57)at enrollment to(6.74±1.23)6 months after enrollment(P＜0.01).After 6 months of enrollment,the patient's satisfaction with the pharmacist's work reached a score of(4.99±0.08)out of 5.The average reduction in drug costs for patients caused by pharmacists intervening in irrational medication is(20.9±18.0)％.At the end of follow-up,93.4％of patients were proficient in using the Yaoshiyi APP.Conclusion The remote medication treatment management model for elderly patients with chronic disease at home based on mobile technology constructed in this study can ef-fectively improve patient compliance with disease monitoring and medication,ensure rational drug use,reduce medical resource waste,and receive high patient acceptance.

To standardize the management of high-alert medications in medical institutions and ensure their safe and ef-fective use,based on relevant national regulations and normative documents,international high-alert medication management guidelines,and expert opinions,the Pharmaceutical Specialized Committee of the Chinese Hospital Association led the develop-ment of the Pharmaceutical Supply Services—Key Drugs Management—High-alert Medications.This article elaborated on the for-mulation process of this standard and provides an in-depth analysis of its key contents.It aimed to offer guidance and reference for medical personnel,helping them to thoroughly understand and master the management requirements of high-alert medications,thereby enhancing the management level of high-alert medications and ensuring the safe and effective use of medications for pa-tients.