Practical Research On Applying A Variety Of Pharmaceutical Service Technologies To Promote Clinical Rational Drug Use

Objective:Through the multi-faceted pharmaceutical service technologies such as monitoring and control of key monitoring drugs and therapeutic drug monitoring,the laws and characteristics of irrational drug use are summarized.To explore the effectiveness of clinical interventions such as prescription reviews and vancomycin plasma concentration monitoring for rational drug intervention,and provide reference for clinical rational,standardized,safe and effective drug use.Methods:1.Using the method of prescription reviews to focus on monitoring drug control:According to ABC-VEN analysis method and the results of hospital surveillance,a total of 9 drugs of three types were selected as the key monitoring drug varieties.A retrospective analysis method was used to select the cases using key surveillance drugs in 2016 from January to June in the hospital information system(HIS).The cases of key monitoring drugs in January to June were the control group and the cases of key monitoring drugs in July to December were controlled group.Using EXCEL software for data processing analysis of medication projects.2.Using HPLC method to detect the concentration of vancomycin.Results:1.Salbutamol injection and Terbutaline injection route of administration unreasonable basically corrected.The irrational drug use index of fructose injection and sodium acetate injection was statistically significant(one-way ANOVA,P<0.05).2.After the control,the number of used cases of 9 drugs and the number of drugs used in various departments were statistically significant(Paired sample t-test,P<0.05).There was no statistically significant in the number of 9 key monitoring drugs used after statistical analysis(Paired sample t-test,P>0.05).3.Through regulatory control,the cost of controlled drugs in the second half of 2016 decreased by approximately RMB9,629,600.4.A method for the determination of vancomycin in human plasma by HPLC was established.After system validation,the method was applied to the determination of plasma concentration of clinical samples.The results were accurate and reliable and applied to clinic.The monitoring results of 52 patients showed that the pass rate of trough concentration was 34.61% and the pass rate of peak concentration was 45.00%.There was no significant difference in renal function,serum creatinine and urea nitrogen before and after treatment with vancomycin(P> 0.05).Compared with the vancomycin plasma concentration in different age groups,as age increasing,the trough concentration is on the rise,the incidence of adverse reactions increased.Clinical pharmacists focused on 4 patients and monitored 1 patient with sepsis.The drug concentration of vancomycin was determined three times in a row and the dose of clinical drug was adjusted to ensure the efficacy of drugs and reduce the toxicity of drugs.Conclusion:1.The management and control methods for communicating the results of prescription reviews with departments can effectively reduce the number of unreasonable drugs used,reduce the economic burden on patients,and save the national medical insurance expenses.2.Clinical pharmacists participate in clinical work through blood concentration monitoring of vancomycin,providing valuable clinical reference data and meaningful pharmaceutical advice,individualized drug treatment,and promotion of rational drug use.3.The multi-faceted pharmacy service technology can effectively promote the rational use of drugs in the clinic and make the patients safe,effective,economical and appropriate.