王育琴-药物警戒讲稿2009.10.18.ppt

Adverse reaction reporting 2006-20082006-2008年，药物不良反应报告数量 Adverse reaction reports reached to TUFAM and reported to WHO-UMC ADR报告同时报告给TUFAM和WHO-UMC 2006年: 299 2007年: 355 2008年: 390 2009年1-8月：500 一个药物的召回是由于与药物活性物质相关的安全原因 发现药物新的禁忌症和警示 修改建议剂量 限制适应症 限制药物的使用 Withdrawal of a drug due to safety reasons related with the active substance Emergence of new contraindications or warnings about the drug Modification of recommended dosage Restriction of indications Restriction of drug use Establishing Direct Communication with Healthcare Professionals建立与医务人员的直接沟通 药物警戒中为患者提供信息的重要性 Alex Dodoo 加纳医科大学 热带临床药理和治疗中心 Information is the oxygen of modern age信息是现代社会的氧气 Everybody gets so much infoemation all day long that they lose their common sense—Gertrude Stein Information is the oxygen of modern age.It seeps through the walls topped by barbed wire,It wafts across the electrified bordes—Ronald Reagan 人类每天可以得到很多的信息，然而却失去了最基本的感知- 信息是现代的氧气，它可穿越电网墙，它可以打破电气化的边界。 ——Alex Dodoo 提供给患者信息的重要性the importance of information to patients 提供给患者最重要、清楚和迫切是：Patients need to be urgently, clearly and most optimally provided information on 药物警告 alerts 药物召回 recall 标签的改变 Label change 新近出现的药物相互作用和药物-食物相互作用 newly identified drug-drug or drug-food interaction 药师应该把提供信息看得很重要吗？ 平均每张处方的药物数量：3.5 Average number of drug prescribed 平均处方调配时间60秒 Average dispensing interaction time in most countries=60 sec 处方抗生素的调配率 42.5%Encounter with antibiotic 注射剂使用率 33.5% Encounter leading to injection use:33.5% 平均值 average 标签完整1% adequacy of labeling 1% 患者对所调配药物的知晓率58.13% Patient knowledge of dispensed drugs: 58.13% 不提供信息的后果The consequences of not providing information include 吞服阴道栓剂 Swallowing instead of inserting vaginal pessaries 用鼻吸入气雾剂 Administering inhalers through the nose 插入直肠栓剂时没有剥离封套 Inserting rectal suppositories with wrapper still on 吞服而不是含服制霉菌素药粒 Swallowing instead of sucking nystatin pastilles 咀嚼SR/EC/MR 片剂 Chewing SR/EC/MR tablets 未完成治疗疗程 Not completing course of treatment 吸入依非韦伦 Smoki