OBJECTIVE:To probe into the perioperative use of drugs in epileptic patients.METHODS:By a retrospective analysis,the general condition,and drug use before,during and after operation of 117 epileptic inpatients in our hospital in 2006 was analyzed statistically.RESULTS:71(60.7%)epileptic patients before operation versus 83(70.9%)after operation received blood routine test and biochemical test.105(89.7%)received anti-epileptic drugs alone versus 12(10.3%)received combined drugs.The mean administration duration was 6.5 d for antibiotics versus 4.3 d for hormones.CONCLUSION:Great importance should be attached to the perioperative drug use in epileptic patients to standardize the use of antibiotics and hormones and follow the rational drug use principle so as to keep seizure under control and improve the quality of life for epileptic patients.

OBJECTIVE: To discuss the method of training clinical pharmacists.METHODS: The experience of training clinical pharmacists was introduced.RESULTS: We can train clinical pharmacists to learn basic theories through finding problems from the clinical practice.Clinical pharmacists' level of basic knowledge could be improved by adhering to clinical practice.The basic skills of clinical pharmacists in communicating with patients can be learned by applying the methods such as examining,companying,encouraging and complementing.CONCLUSION: Basic theories,basic knowledge and basic skills should be emphasized in the training of clinical pharmacists.

OBJECTIVE:To study the damage of drugs to the nervous system.METHODS:154cases of adverse reactions of nervous system drugs collected from1999to2003in our hospital were analyzed statistically.RESUTLS:ADR of nervous system accounted for14.27%of all the ADR cases in our hospital;there were18kinds of drugs involved in ADR,which in?cluded the anti-infection drugs,Chinese drugs preparation,cardiovascular system drugs,nervous system drugs,antipyretic analgesic etc.CONCLUSION:It is of great clinical significance to keep alert,to identify and avoid the adverse effects of drugs on nervous system.

OBJECTIVE:To discuss the training method for clinical pharmacists working in Neurology Intensive Care Unit. METHODS: The characteristics of the specialty of neurology were analyzed and out experiences in training clinical pharmacists were summarized. RESULTS: With a good and systematic learning method, clinical pharmacists can adapt to clinical work and become one of the members in the treatment corps as soon as possible. CONCLUSION: With a specialty characteristic, clinicians' participating in the training of clinical pharmacists is of great important for the quick transformation of pharmacists' working model.

OBJECTIVE:To investigate the methods and breakthrough point of clinical pharmacist participating in the consulta-tion for Acinetobacter baumannii infection cases,in order to improve the level of clinical rational drug use. METHODS:The con-sultation records of 39 A. baumannii infection cases in neurology department of our hospital during 2013-2014 were analyzed retro-spectively. The patients’general condition,site of infection,bacterial culture and drug sensitivity test were analyzed statistically as well as drug regimen before and after consultation,disease condition,lab indexes and nutritional status. RESULTS:A. baumannii were found in sputum culture of all patients,among which there were 11 cases of multiple resistant bacteria(28.2%),13 cases of pan resistant bacteria (33.3%),8 cases of drug resistant A. baumannii (20.5%) and 7 cases of non-multiple resistant bacteria (17.9%). The most widely used drug was minocycline (average dose of 0.2 g/d),followed by cefoperazone-sulbactam (average dose of 9 g/d),ceftazidime (average dose of 6 g/d), etimicin (average dose of 0.27 g/d),amikacin (average dose of 0.4 g/d). The antibacterial daily doses were higher than before. 3 patients were recommended to use fosfomycin. Before consultation,2 pa-tients didn’t received antibiotics (5.1%),and there were 13 cases of single drug (33.4%),22 cases of two-drug combination (56.4%)and 2 cases of three-drug combination(5.1%). After consultation,none of patients didn’t received antibiotics(0),and there were 7 cases of single drug (17.9%),26 cases of two-drug combination (66.7%) and 6 cases of three-drug combination (15.4%). After the consultation,body temperature,symptom and infection indexes of patients got better. Clinical pharmacists ad-justed nutrition program of 12 patients (30.8%) and expecterant program of 9 patients (23.1%). Compared with before consulta-tion,oubumin level of 11 patients (28.2%) and prealbumin level of 20 patients (51.3%) were all increased. CONCLUSIONS:Clinical pharmacist should formulate reasonable therapeutic regimen and reduce irrational drug use according to infection and physi-cal condition. They should provide anti-infective regimen,at the same time,pay attention to the adjustment of expectorant regimen and nutrition support program.

Objective:To improve the training quality of neurology clinical pharmacist. Methods:The experience during the training of neurology clinical pharmacists in recent ten years was summarized. Results:The students were taught in groups according to their majors and promoted in stages according to the teaching plans. Besides,various teaching methods were carried out timely. After tutored by the methods mentioned above,the students could quickly raise their working ability to play good roles of clinical pharmacist and work independently with more confidence. Conclusion:The training quality of neurology clinical pharmacists has been effectively improved by teaching in groups,promoting in stages and providing various teaching methods timely.

OBJECTIVE:To guide the rational use of anti-epileptic drugs(AEDs)in clinical practice.METHODS:In a retrospective review,there were733patients in Xuanwu hospital who suffered from poor curative effect or intoxication of AEDs from March2000to March2001.The results of blood concentration of anti-epileptic drugs(AEDs Css)were ana?lyzed.RESULTS:The Css of37.6%of the patients were within the normal Css range,and6.4%were higher and55.9%were lower than the normal.In combined use of AEDs and other drugs,79.1%of the patients had higher or lower Css than nor?mal.In addition,chemosynthetic components were detected in90%of the patients who took Chinese medicine.Among them,86%of the patients had abnormal Css.CONCLUSION:Css monitoring should be done when AEDs were administrated.It is advisable to use only one or two kinds of AEDs,and to pay attention of the chemosynthetic components in Chinese medicine.

Objective: To investigate the rational use of antibiotics in the elderly patients with cerebral infarction complicated with pulmonary infection.Methods: A retrospective investigation was used to analyze the drug resistance of 86 cases of elderly patients with cerebral infarction complicated with pulmonary infection.The data were collected from the consultation records of clinical pharmacists in Xuanwu hospital from February 2013 to November 2015.Results: The pathogenic bacteria mainly distributed to Acinetobacter baumannii and Pseudomonas aeruginosa, and the drug resistance rate was 48.89%.After the consultation, the rate of combination therapy increased from 20.23% to 61.63%.After using sensitive antibiotics, such as cefperazone-sulbactam,piperacillin-sulbactar and amikacin, the infectious indices recovered significantly (P＜0.05).The case proportion with BUN/SrCr＞20 in 27 cases complicated with impaired renal function was 62.9%, and although the patients didn''t use antibiotics with reduced doses, the indices of infection and renal function improved in a certain degree (P＜0.05).The case proportion with ALB and PAB decreasing was 53.49%, and after the consultation, all the infectious indices decreased and protein levels increased (P＜0.05).Conclusion: More attention should be paid to the elderly patients with cerebral infarction complicated with pulmonary infection, and sensitive antibiotics with single or combination drug therapy should be used according to the distribution of resistant bacteria.For the renal failure patients, the kind of renal failure should be clear, and then the appropriate dosage of antibiotics should be adjusted.For the patients with malnutrition, adequate protein intake contributes to the recovery of infection.The clinical symptoms and laboratory indices should be integrated to effectively develop rational treatment for the elderly patients with cerebral infarction complicated with pulmonary infection.

Objective To investigate antiepileptic drug application and the influential factors in patients after epilepsy surgery.Methods During the period from 2002 through 2005,170 patients with intractable epilepsy who received epilepsy surgery in Xuanwu hospital were studied.They were divided into 3 groups according to the stages of operation.Patients in group A received epilepsy surgery during 2002 to October 2003,those in group B received initial phannacentieal care after epilepsy surgery during November 2003 to October 2004,and those in group C received integrated pharmaceutical care after epilepsy surgery during November 2004 to October 2005.The clinical outcomes,factors affecting antiepileptic drugs,safety and compliance with antiepileptic medication were analyzed.Results Patient's clinical outcomes(group B was 71%and group C was 81%),safety and compliance with antiepileptic medication in group B and group C are better than those in group A(46%)with a significance difference(X2=7.08,15.50,P<0.05).Conclusions The integrated pharmaceutical care rendered from the cooperation of neurosurgeon,neurologist and clinical pharmaceutist is a new and effective management mode for postsurgical epilepsy patients.

OBJECTIVE:To understand the safety of Puerarin injection in clinical use.METHODS:The adverse drug re?actions(ADRs)and administration of Puerarin injection at Xuanwu Hospital from Oct.2002to Feb.2003were investigat?ed.RESULTS:According to the dosage in drug intruction,the Puerarin injection was diluted in0.9%sodium chloride of5%glucose solution and infused alone with a infusion rate of40～60drops/min,which would be safe and induce less ADRs,and use in overdose markedly increased the incidence of ADRs.CONCLUSION:Use of this preparation should strictly be in accordance with the specification.