Journal Detail Information

1

Cite

Share

Effects of MDR1 C3435T Polymorphism on the Dose of Analgesia Agents after Joint Replacement

China Pharmacy.2017;28(14):1876-1880. doi:10.6039/j.issn.1001-0408.2017.14.02

OBJECTIVE:To investigate the effects of multidrug resistance gene 1(MDR1)C3435T polymorphism on the dose of analgesia agents(dezocine combined with sufentanil)after joint replacement. METHODS:300 patients receiving joint replace-ment were selected from Tianjin People's Hospital and Tianjin Port Hospital during Jan. 2014-Feb. 2016. They were given dezocine and sufentanil for postoperative analgesia. PCR-RFLP was used to determine MDR1 C3435T polymorphism;VAS scores,Ramesy scores,the dose of dezocine+sufentanil and the occurrence of ADR were compared among different genotypes. RESULTS:Among 300 patients,there were 100(33.3%),102(34.0%)and 98(32.7%)cases of MDR1 C3435T CC,CT and TT genotype,respec-tively,the frequencies of which were all in line with Hardy-Weinberg balance (P>0.05). There was no statistical significance in VAS scores and Ramesy scores among different genotypes 0,24,48 h after surgery(P>0.05). No excessive sedation was found. The dose of dezocine+sufentanil in CT and TT genotype were all significantly lower than CC genotype 0-24 h,>24-48 h after sur-gery,with statistical significance(P<0.05). There was no statistical significance in drug dose between CT and TT genotype during above periods (P>0.05). The incidence of postoperative nausea and vomiting (PONV),ADR in TT genotype were significantly lower than CC and CT genotypes,with statistical significance (P<0.05). There was no statistical significance in the incidence of PONV and ADR between CC genotype and CT genotype,and in the incidence of itch among different genotypes(P>0.05). CON-CLUSIONS:With similar sedation and analgesic effect,MDR1 mutant type have lower resistance to dezocine+sufentanil,and smaller drug dose is need,the incidence of ADR is lower. MDR1 genotype can be regarded as an important indicator of clinical in-dividualized treatment.

2

Cite

Share

Practice of Medication Reconciliation among Chronic Renal Insufficiency Patients by Clinical Pharmacists

Linlin WU ; Xinru ZHANG ; Jiqiu HOU ; Dongxue WANG

China Pharmacy.2017;28(14):2002-2005. doi:10.6039/j.issn.1001-0408.2017.14.37

OBJCETIVE:To investigate the role of clinical pharmacists in medication reconciliation. METHODS:Totally 200 inpatients admitted or transferred to nephrology department of our hospital during Aug.-Oct. 2015 were selected. Within 48 h after admission,1-year medication history were collected by reviewing electronic medical records,consultation,querying self-prepared drugs and medical history;and then medication reconciliation was conducted by clinical pharmacists. RESULTS:Among drug lists collected by clinical pharmacists,there were 987 kinds of drugs,but only 9.63%(95 kinds) drugs were recorded in the medical records. There were 5 cases of ADR in total,and only 40.00% of them (2 cases) were recorded in the medical records. Among 200 patients,medication reconciliation was needed in 45 cases with reconciliation rate of 22.50%. Among 492 medical orders of 200 patients,medication errors were found in 103 medical orders;the number of medication errors per case was (2.3 ± 1.8), mainly including wrong dose,repeated medication,wrong solvent,drug interactions;the potential risk degree was mainly degree 1 (53 orders,51.46%). Among 103 medication reconciliation orders,main plans were drug withdrawal (78 cases,75.73%), followed by drug change(17 cases,16.50%)and drug supplement(8 cases,7.77%). A total of 90 reconciled medical orders were adopted by physicians,with success rate of 87.38%. CONCLUSIONS:Compared with physicians,clinical pharmacists can obtain more detailed and accurate drug list. It can reduce medication error and guarantee the safety of drug use to maximum extent that clinical pharmacists conduct medication reconciliation.

3

Cite

Share

Evaluation of Improvement Effects about Prescription Checking and Intervention Skills of Pharmacists in a Hospital

Ping FAN ; Yangyang GAO ; Yuezhou HUANG ; Meimei YANG ; Ting XU

China Pharmacy.2017;28(14):1998-2001. doi:10.6039/j.issn.1001-0408.2017.14.36

OBJECTIVE:To evaluate the improvement and rectification effects about prescription checking and intervention skills of pharmacists. METHODS:By retrospective investigation,2417 outpatient prescriptions and 1698 outpatient prescriptions were respectively selected from some one hospital during Oct.-Dec. 2015 (before improvement and rectification) and Jan.-Mar. 2016 (after improvement and rectification). According to standards,guidelines and references as Prescription Administrative Poli-cy,Prescription Review Management Standard(trial)and drug instructions,irrational drug use and prescription checking and inter-vention skills of pharmacists were compared before and after the implementation of rectification measures as optimizing hospital in-formation system,improving comprehensive skills of pharmacists,strengthening pharmacists'concept,establishing feedback mech-anism. RESULTS:After the implementation of rectification measures,unsuitable indications,clinical diagnosis inconsistent with medication,antibiotics use without indications,unsuitable usage and dosage,unsuitable drug combination and irrational drug use were all decreased,but repeated drug use was increased,without statistical significance (P>0.05). The number of non-standard prescriptions and unsuitable prescriptions checked by pharmacists were decreased,without statistical significance(P>0.05). The in-cidence of checking missing,excessive checking and checking error were all increased from 2.40%,0.99%,3.39% before im-provement and rectification to 0.47%,0.29%,0.77%,with statistical significance(P<0.05). CONCLUSIONS:The improvement and rectification measures of the hospital can improve comprehensive prescription checking and intervention skills of pharmacists. Ir-rational drug use should be further standardized.

4

Cite

Share

Effects Evaluation and Analysis of Clinical Pharmacists'Intervention on Prophylactic Use of Antibiotics in Removal of Internal Fixation Device for Fracture

Jing WEI ; Xiaoluan SUN ; Wanqi CHEN ; Xin LI

China Pharmacy.2017;28(14):1994-1998. doi:10.6039/j.issn.1001-0408.2017.14.35

OBJECTIVE:To evaluate the effects of clinical pharmacists'intervention on prophylactic use of antibiotics in re-moval of internal fixation device for fracture. METHODS:Totally 117 patients underwent removal of internal fixation device for fracture were selected from some on third grade class A hospital during Mar.-Jul. 2015 as pre-intervention group. Totally of 266 pa-tients underwent removal of internal fixation device for fracture were selected during Aug. 2015-May 2016 as post-intervention group. Clinical pharmacists performed interventions based on Rationality Evaluation Criteria for Prophylactic Use of Antibiotics in Removal of Internal Fixation Device for Fracture. The prophylactic use of antibiotics was compared between 2 groups before and af-ter intervention. RESULTS:No unreasonable single dose or additional drug during surgery was found before and after intervention. After intervention,utilization rate of antibiotics for prophylactic use,the proportion of patients receiving antibiotics without indica-tions,the proportion of medication duration more than 24 h decreased from 84.6%,71.8%,48.7% to 17.3%,9.8%,4.9%,re-spectively. Average antibiotics cost,the proportion of total drug cost in hospitalization cost,the proportion of antibiotics cost in to-tal drug cost were all decreased significantly compared to before intervention,with statistical significance(P<0.05). There was no statistical significance in the proportion of patients with unreasonable drug choice,unreasonable initial prophylactic medication tim-ing and unreasonable drug combination,the proportion of different antibiotics types,average hospitalization cost and average drug cost(P>0.05). CONCLUSIONS:Clinical pharmacists'interventions significantly reduce the utilization rate of antibiotics for pro-phylactic use in patients underwent removal of internal fixation device for fracture,improve drug use without indications and ratio-nality of prophylactic use of antibiotics. There still are problems,such as unreasonable medication timing,continuous use time of more than 24 h,etc. It is necessary to continuous follow-up intervention.

5

Cite

Share

Clinical Observation of Tegafur Combined with Three Dimensional Conformal Radiotherapy for Advanced Esophageal Carcinoma

Yanyan LIU ; Yingchuan SUN

China Pharmacy.2017;28(14):1991-1994. doi:10.6039/j.issn.1001-0408.2017.14.34

OBJECTIVE:To observe clinical efficacy and safety of tegafur combined with three dimensional conformal radio-therapy for advanced esophageal carcinoma. METHODS:Totally 88 cases of advanced esophageal carcinoma admitted into Xuchang central hospital during Aug. 2013-Mar. 2016 were selected and divided into control group and observation group according to random number table,with 44 cases in each group. On the basis of anti-inflammatory,relieving asthma and other symptomatic treatment,two groups accepted three dimensional conformal radiotherapy. Control group was given fluorouracil 80 mg/m2,ivgtt,d1+nadeplatin 70 mg/m2,ivgtt,d1-d5. Observation group was given Tegafur capsules 60 mg,bid,continuous use 5 days,rest for 2 days. A treatment course lasted for 3 weeks,and they received 3 courses of treatment. Clinical efficacies of 2 groups were observed as well as serum inflammatory factors(TNF-α,IL-6,IL-8),lab indexes(VEGF,CA125,CA199,CEA),QLQ-C30 scores be-fore and after treatment. The occurrence of ADR was recorded in 2 groups. RESULTS:The total response rate of observation group was 88.64%,which was significantly higher than 68.18%,with statistical significance(P<0.05). Before treatment,there was no statistical significance in serum inflammatory factor levels,lab index levels and QLQ-C30 scores between 2 groups(P>0.05). Af-ter treatment,serum inflammatory factor levels and lab index levels of 2 groups were significantly decreased,while QLQ-C30 scores were decreased significantly;the observation group was significantly better than control group,with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Tegafur combined with three dimensional conformal radiotherapy shows good therapeutic efficacy for advanced esophageal carcinoma,can significantly reduce serum inflammatory factor levels and lab index levels and improve life quality but do not increase the occur-rence of ADR.

6

Cite

Share

Clinical Observation of Xuebijing Injection in the Treatment of Chronic Obstructive Pulmonary Disease Complicated with Community-acquired Pneumonia

Hui ZHOU ; Feng LIU

China Pharmacy.2017;28(14):1979-1981. doi:10.6039/j.issn.1001-0408.2017.14.30

OBJECTIVE:To investigate clinical efficacy and safety of Xuebijing injection in the treatment of chronic ob-structive pulmonary disease (COPD) complicated with community-acquired pneumonia (CAP). METHODS:A total of 88 COPD patients with CAP selected from our hospital during Feb. 2013-Jan. 2015 were divided into control group and observa-tion group according to random number table,with 44 cases in each group. Control group received routine treatment as an-ti-infection,reducing phlegm,fluid replacement,nutritional support,etc. Based on control group,observation group was ad-ditionally given Xuebijing injection 50 mL added into 0.9% Sodium chloride injection 100 mL,ivgtt,for 30-40 min,bid, for consecutive 10 d. Clinical efficacy,application time of antibiotics,pulmonary function indexes [FEV1,FVC,FEV1/FVC,VC] were observed in 2 groups. The occurrence of ADR was recorded. RESULTS:Total response rate of observation group was 88.64%,which was significantly higher than 70.45% of control group,with statistical significance(P<0.05). The application time of antibiotics in observation group was significantly shorter than control group,with statistical significance (P<0.05). There was no statistical significance in FEV1,FVC,FEV1/FVC,VC between 2 groups before treatment (P>0.05). After treatment,FEV1 and VC of 2 groups were improved significantly,and the observation group was better than the control group,with statistical significance(P<0.05). There was no statistical significance in FVC,FEV1/EVC before and af-ter treatment and betwean the two groups (P>0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Xuebijing injection has significant therapeutic efficacy for COPD complicated with CAP and can significantly shorten the use time of an-tibiotics,improve pulmonary function with good safety.

7

Cite

Share

Clinical Study on the Application of Alanyl-glutamine Dipeptide-intensified Early Enteral Nutrition Sup-port in Sepsis Patients

Fengzhi ZHANG ; Qingfang LI

China Pharmacy.2017;28(14):1975-1978. doi:10.6039/j.issn.1001-0408.2017.14.29

OBJECTIVE:To investigate the effects of alanyl-glutamine dipeptide-intensified early enteral nutrition (EN) sup-port on nutritional indexes,immune indexes,renal indexes and complications of sepsis patients. METHODS:A total of 112 cases of sepsis admitted into our hospital during May 2013-Jan. 2015 were selected and divided into observation group and control group according to random number table,with 56 cases in each group. Both groups received routine antibiotic therapy and early EN support(48 h)with nitrogen supplement 0.2 g/kg,calories 25 kcal/kg and nonprotein calories 19-21 kcal/kg each day. Observation group was additionally given Alanyl-glutamine for injection 0.5 g/kg with 0.9% sodium chloride injection 100 mL,continuous pump within 24 h,for 4 d. The levels of nutritional indexes (ALB,PAB,Hb),immune indexes (CRP,IgG,IgA and IgM), APACHEⅡ scores,SOFA scores,liver and renal function indexes (the levels of ALT,AST,Cr and BUN) were compared be-tween 2 groups before and after treatment. The prognosis and the occurrence of complication were also observed in 2 groups. RE-SULTS:Before treatment,there was no statistical significance in the levels of ALB,PAB,Hb,CRP,IgG,IgA,IgM,ALT, AST,Cr,BUN and APACHEⅡ scores,SOFA scores between 2 groups(P>0.05). After treatment,the levels of ALB and PAB in observation group were increased significantly compared to before treatment,and the observation groups was significantly higher than control group,with statistical significance(P<0.05). APACHEⅡ score and SOFA score of 2 groups were decreased significantly compared to before treatment,and the observation group was significantly lower than the control group,with statis-tical significance(P<0.05). CRP of 2 groups were decreased significantly while IgG were increased significantly;the observa-tion group was significantly better than the control group,with statistical significance (P<0.05). Cr and BUN levels of 2 groups were decreased significantly compared to before treatment,and the level of Cr in observation group was significantly con-trol group,with statistical significance (P<0.05). The time of ICU stay,ventilator supporting time and antibiotics application time in observation group were significantly shorter than control group,and the incidence of diarrhea and gastric retention were significantly lower than control group,with statistical significance (P<0.05). CONCLUSIONS:Alanyl-glutamine dipeptide-in-tensified early EN support can significantly improve immune function and liver and renal function of sepsis patients and reduce the occurrence of complications.

8

Cite

Share

Clinical Observation of 2 Kinds of Glucocorticoid Administration Regimens for Elderly Patients with AE-COPD

Sheng WU ; Ping RAO ; Qingsong WU

China Pharmacy.2017;28(14):1972-1975. doi:10.6039/j.issn.1001-0408.2017.14.28

OBJECTIVE:To investigate the effects and safety of 2 kinds of glucocorticoid administration regimens including 5 d and 15 d on clinical efficacy,pulmonary function,quality of life in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). METHODS:A total of 160 elderly patients with AECOPD selected from Haikou Forth People's Hos-pital during May 2013-Dec. 2015 were divided into group A and B according to lottery method,with 80 cases in each group. Both groups received symptomatic treatment as eliminating phlegm and relieving asthma,controlling infection,etc. Based on it,group A was given Methylprednisolone sodium succinate for injection,40 mg/d for 15 d;group B was given Methylprednisolone sodium succinate for injection,40 mg/d for 5 d. Clinical efficacies were compared between 2 groups as well as the levels of pulmonary ven-tilation function indexes,blood gas analysis indexes,Spitzer life quality index scale (QLI) scores before and after treatment. The occurrence of ADR was also compared between 2 groups. RESULTS:Total response rate of group A was 92.50%,and that of group B was 90.00%,without statistical significance(P>0.05). Before treatment,there was no statistical significance in the levels of pulmonary ventilation function indexes,blood gas analysis indexes,QLI scores between 2 groups (P>0.05). After treatment, FVC,FEV1,FEV1% and PaO2 of 2 groups were significantly higher than before treatment,while PaCO2 was significantly lower than before treatment,with statistical significance (P<0.05);there was no statistical significance between 2 groups (P>0.05). QLI scores of 2 groups were significantly higher than before treatment,and the group B was significantly higher than the group A, with statistical significance (P<0.05). The incidence of ADR in group B (6.25%) was significantly lower than group A (22.50%),with statistical significance(P<0.05). CONCLUSIONS:Glucocorticoid administration regimen including 5 d and 15 d in the treatment of elderly patients with AECOPD possess the same effects in improving lung function;glucocorticoid administra-tion regimen for 5 d application is superior in effectively improving the quality of life of patients,reducing the risk of ADR,and has clinical value.

9

Cite

Share

Clinical Observation of Felodipine Sustained-release Tablets(Ⅱ)in the Treatment of Elderly Essential Hy-pertension

Zhuodong ZHOU ; Dezhi YANG ; Ying WEI

China Pharmacy.2017;28(14):1965-1968. doi:10.6039/j.issn.1001-0408.2017.14.26

OBJECTIVE:To observe clinical efficacy of Felodipine sustained-release tablets(Ⅱ)in the treatment of elderly es-sential hypertension and its improvement effect on arterial elasticity,left ventricular remodeling and the quality of life. METHODS:A total of 96 elderly patients with essential hypertension in our hospital during Aug. 2014-Dec. 2015 were divided into observation group (50 cases) and control group (46 cases) according to random number table. Observation group was given Felodipine sus-tained-release tablets(Ⅱ)5 mg orally,qd,with empty stomach in the morning;control group was given Irbesartan tablets 150 mg, qd,with empty stomach in the morning. Both groups received treatment for 12 weeks. Clinical efficacies of 2 groups were observed as well as 24 h ambulatory blood pressure (ABP),indexes of arlerial elasticity [carotid-radial pulse wave velocity (CR-PWV),carot-id-femoral pulse wave velocity (CF-PWV)], indexes of left ventricular remodeling [diastolic interventricular septum thickness (IVST),diastolic left ventricular posterior wall thickness(LPWT),left ventricular end diastolic diameter(LVIDd)] before and after treatment. The physiological function (PF),social function (SF),role-physical (RP),body pain (BP),mental health (MH),role-emotional(RE),vitality(VT)and general health(GH)score of SF-36 were observed in 2 groups before and after treatment. The occurrence of ADR was compared between 2 groups. RESULTS:There was no statistical significance in total response rate be-tween 2 groups (P>0.05). There was no statistical significance in 24 hABP,CR-PWV,CF-PWV,IVST,LPWT,LVIDd,SF-36 score between 2 groups before treatment(P>0.05). After treatment,the levels of 24 hSBP,24 hDBP and 24 hMAP in 2 groups were decreased significantly,and 24 hSBP and 24 hMAP of observation groups were significantly lower than those of control group,with statistical significance (P<0.05). There was no statistical significance in 24 hDBP (P>0.05). The levels of CR-PWV,CF-PWV, IVST and LPWT in observation group were decreased significantly,and the levels of CR-PWV and LPWT in control group were also decreased significantly. The levels of CR-PWV,CF-PWV,IVST,LPWT and LVIDd in observation group were significantly lower than control group,with statistical significance (P<0.05). SF-36 scores of 2 groups were increased significantly,and the scores of BP,VT,MH and GH in observation group were significantly higher than control group,with statistical significance (P<0.05). There was no statistical significance in scores of PF,SF,RP and RE. There was no statistical significance in the incidence of ADR be-tween 2 groups(P>0.05). CONCLUSIONS:Felodipine sustained-release tablets(Ⅱ)exhibit significant effect and small blood pres-sure fluctuation in the treatment of elderly essential hypertension,and can improve the quality of life with good safety.

10

Cite

Share

Effects of Compound Biejia Ruangan Tablets Combined with Entecavir Tablets on Liver Function and He-matoidin of Patients with Chronic Hepatitis B Blood Stasis Syndrome

Ze WANG ; Xianyong LI ; Guojun WANG ; Mingqun WANG

China Pharmacy.2017;28(14):1962-1965. doi:10.6039/j.issn.1001-0408.2017.14.25

OBJECTIVE:To observe the effects of Compound biejia ruangan tablets combined Entecavir tablets on liver func-tion and hematoidin of patients with chronic hepatitis B(CHB)blood stasis syndrome. METHODS:Totally 110 patients with CHB blood stasis syndrome were selected from Neijiang Second People's Hospital,the Affiliated Hospital of Southwest Medical Univer-sity and Yibin First People's Hospital during Jan.-Dec. 2015. They were divided into control group and observation group by strati-fied blocked randomitation,with 55 cases in each group. Control group was given Entecavir tablets 0.5 mg,po,qd;observation group was additionally given Compound biejia ruangan tablets 2.0 g,po,tid. Both groups received treatment for 12 months. TCM syndrome scores,the levels of liver function indexes(AST,ALT,ALP,GGT),serum bilirubin(TBIL,DBIL,IBIL),liver fi-brosis indexes(LN,HA,PⅢP,Ⅳ-C)and Fibroscan(FS)were observed in 2 groups before and after treatment. The occurrence of ADR was recorded. RESULTS:In observation group,2 patients withdrew from the study,and 3 patients of control group with-drew from the study. Before treatment,there was no statistical significance in TCM syndrome scores,the levels of liver function in-dexes,serum bilirubin,liver fibrosis indexes and FS between 2 groups(P>0.05). After treatment,TCM syndrome scores,the lev-els of TBIL,IBIL,LN,HA,PⅢP,Ⅳ-C and FS in 2 groups were significantly decreased,while DBIL level was increased signifi-cantly,and the observation group was significantly better than control group,with statistical significance(P<0.05). The levels of AST and ALT in observation group were decreased significantly,while the levels of ALP and GGT were increased significantly, and the observation group was significantly better than control group,with statistical significance(P<0.05). There was no statisti-prove liver function indexes and bilirubin level,and inhibit liver fibrosis with good safety.

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share