Objective To analyze the effect of diltiazem on blood concentration of tacrolimus(TAC)retrospectively,and to provide reference for individual administration of tacrolimus in patients with nephrotic syndrome(NS).Methods The patients with NS who were treated in the outpatient/inpatient department of our hospital from January 2018 to December 2022 were collected,and the general information,combined drug use,blood drug concentration and other information of the patients were recorded.The patients were divided into two groups according to whether diltiazem was used or not:TAC group alone and TAC group combined with diltiazem.The effect of diltiazem on tacrolimus concentration was analyzed.Results A total of 45 patients with NS were included in this study,and 21 patients in the TAC group were treated with TAC alone.The mean blood concentration of TAC after medication was(5.77±2.87)ng·mL-1,which reached the effective therapeutic concentration range.The average blood concentration of TAC+Diltiazem group in the 24 patients was(2.90±1.29)ng·mL-1 before combined treatment,and increased to(5.74±2.46)ng·mL-1 after combined with diltiazem,with a growth rate of(127.34±119.57)％.The increase range was from 10％to 288％,and there was significant difference(P＜0.05).According to the observation within 6 months after the combination of the two drugs,the average blood concentration of TAC continued to increase,especially in the 5th month after the administration of TAC,and the concentration tended to be stable after 5 months.By compare with the effect of diltiazem dosage on the blood concentration of TAC,90 mg·d-1 and 180 mg·d-1 had little difference in improving the blood concentration of TAC.At the same time,the combination of the two drugs did not cause adverse reactions.Conclusion A daily dose of 90 mg of Diltiazem can significantly increase the TAC blood concentration in patients with NS who cannot reach the effective therapeutic concentration with conventional doses.It can reach the effective clinical therapeutic concentration without increasing the dose of tacrolimus.The combination of the two drugs were generally safe and effective.

Objective To analyze the effect of diltiazem on blood concentration of tacrolimus(TAC)retrospectively,and to provide reference for individual administration of tacrolimus in patients with nephrotic syndrome(NS).Methods The patients with NS who were treated in the outpatient/inpatient department of our hospital from January 2018 to December 2022 were collected,and the general information,combined drug use,blood drug concentration and other information of the patients were recorded.The patients were divided into two groups according to whether diltiazem was used or not:TAC group alone and TAC group combined with diltiazem.The effect of diltiazem on tacrolimus concentration was analyzed.Results A total of 45 patients with NS were included in this study,and 21 patients in the TAC group were treated with TAC alone.The mean blood concentration of TAC after medication was(5.77±2.87)ng·mL-1,which reached the effective therapeutic concentration range.The average blood concentration of TAC+Diltiazem group in the 24 patients was(2.90±1.29)ng·mL-1 before combined treatment,and increased to(5.74±2.46)ng·mL-1 after combined with diltiazem,with a growth rate of(127.34±119.57)％.The increase range was from 10％to 288％,and there was significant difference(P＜0.05).According to the observation within 6 months after the combination of the two drugs,the average blood concentration of TAC continued to increase,especially in the 5th month after the administration of TAC,and the concentration tended to be stable after 5 months.By compare with the effect of diltiazem dosage on the blood concentration of TAC,90 mg·d-1 and 180 mg·d-1 had little difference in improving the blood concentration of TAC.At the same time,the combination of the two drugs did not cause adverse reactions.Conclusion A daily dose of 90 mg of Diltiazem can significantly increase the TAC blood concentration in patients with NS who cannot reach the effective therapeutic concentration with conventional doses.It can reach the effective clinical therapeutic concentration without increasing the dose of tacrolimus.The combination of the two drugs were generally safe and effective.

Drugs under special management include narcotic drugs,psychotropic drugs,toxic drugs for medical use,radiopharmaceuticals,and pharmaceutical precursor chemicals.Supervising and guiding the clinical use of drugs under special management is one of the important responsibilities of the Pharmaceutical Management and Drug Therapy Committee(Group)of medical institutions.The standard for drugs under special management is led by the Pharmaceutical Professional Committee of the China Hospital Association,which standardizes 16 key elements of organizational management,process management,and quality control management drugs under special management in medical institutions.It can guide the standardized implementation of Pharmaceuticals under special control work in various levels and types of medical institutions.This article elaborates on the methods and contents of formulating standards for Pharmaceuticals under special management,to provide reference and inspiration for medical institutions to carry out special drug drug management and daily related work.

OBJECTIVE：To standardize and optim ize the clinical use of Trastuzumab for injection ，and to provide reference for rational use of drugs in the patients. METHODS ：The pharmacy intravenous admixture service （PIVAS）in our hospital took the lead in communication and coordination with financial ，information，medical insurance departments as well as clinicians and nurses，to set up dispensing ，charging and reimbursement mode by dose of trastuzumab. Under that ，doctors could give orders according to the clinical dosage of patients ；PIVAS dispenses drugs according to the actual dose ；the drugs were shared among patients；the charge and reimbursement of drugs are carried out according to the actual dose of patients. At the same time ，the questionnaire survey was conducted among 60 patients about the medical experience and cost savings before and after the implementation of the mode . RESULTS ：The questionnaire survey showed that in terms of solving the potential safety problems of trastuzumab and the inconvenience of patients ’medical treatment ，the solution rate of the mode was 100％；in terms of improving patients’feeling of seeking medical treatment and helping treatment ，the improvement rate was 100％；in terms of saving patients ’ treatment costs ，most（80％）of the patients thought that it could save less than 500 yuan each time ，and rest of the patients thought that it could save more than 500 yuan each time. CONCLUSIONS ：The mode of dispensing ，charging and reimbursement of Trastuzumab for injection in our hospital has solved the problems of drug waste ，occupational injury and inconvenient preservation in clinical use ，and has played a good role in drug safety ，cost saving and patient convenience.

Objective To construct the active monitoring system for adverse drug reactions based on the trigger technology and explore its application value.Methods Based on the DTHealth system and electronic medical records system, using the Brower/Server architecture, DHCMedBase2.0.doc, Ext 3.1-API Documentation technology to design the trigger of the data definition language.The monitoring group selected the adverse drug reactions which can be used to reflect with the laboratory information, 12 triggers were chosen after communicating with the clinical medical staff, the related procedures were embedded in the hospital information system, accordingly, the active monitoring system of adverse drug reaction based on the trigger technology were constructed.By the three pharmacists the full-time work, the monitoring work within 23 wards of the hospital about 800 patients were finished through the triggers of adverse drug reactions monitor, and the suspected adverse drug reactions were filtered, evaluated and reported.Results The active monitoring system of adverse drug reactions based on the trigger technology started operation in January 1st, 2014, and run until the June 30th, 2014, 561 positive patients were monitored by the triggers, and 71 adverse drug reactions which involved 28 kinds of drugs were identified, the total positive rate was 12.7％.The laboratory index of 21 patients were found to have a marked abnormality but not beyond the normal range, among them the 12 patients had to change the treatment to avoid the possible adverse drug reactions.Conclusion The application of the trigger technology successfully constructed the active monitoring system of adverse drug reactions, which can improve efficiency of the active monitoring for adverse drug reactions,at the same time, realize the early warning function.

Objective To construct the active monitoring system for adverse drug reactions based on the trigger technology and explore its application value.Methods Based on the DTHealth system and electronic medical records system, using the Brower/Server architecture, DHCMedBase2.0.doc, Ext 3.1-API Documentation technology to design the trigger of the data definition language.The monitoring group selected the adverse drug reactions which can be used to reflect with the laboratory information, 12 triggers were chosen after communicating with the clinical medical staff, the related procedures were embedded in the hospital information system, accordingly, the active monitoring system of adverse drug reaction based on the trigger technology were constructed.By the three pharmacists the full-time work, the monitoring work within 23 wards of the hospital about 800 patients were finished through the triggers of adverse drug reactions monitor, and the suspected adverse drug reactions were filtered, evaluated and reported.Results The active monitoring system of adverse drug reactions based on the trigger technology started operation in January 1st, 2014, and run until the June 30th, 2014, 561 positive patients were monitored by the triggers, and 71 adverse drug reactions which involved 28 kinds of drugs were identified, the total positive rate was 12.7％.The laboratory index of 21 patients were found to have a marked abnormality but not beyond the normal range, among them the 12 patients had to change the treatment to avoid the possible adverse drug reactions.Conclusion The application of the trigger technology successfully constructed the active monitoring system of adverse drug reactions, which can improve efficiency of the active monitoring for adverse drug reactions,at the same time, realize the early warning function.

ObjectiveTo study the methods,techniques,content about standardized induction training of pharmacists.Methods49 pharmacy recruits are accepted standardized 3-month pre-service training.ResultsThe new team of pharmacists enhance their self-confidence,improve skills and can adapt to the hospital environment faster and enter the role of pharmacists.ConclusionThe implementation of standardized training is conductive to increasing the overall quality of pharmacists and practice skills rapidly,in order to meet the clinical role,avoid health risks and ensure drug safety of patients.