应颖秋临床药师基于循证医学对我院静脉用人免疫球蛋白进行调控管理2013课件.pptVIP

临床药师基于循证医学对我院静脉用人免疫球蛋白进行调控管理 北京大学第三医院药剂科 应颖秋 2013年6月 江西南昌 背景 1 IVIG的标准化流程管理 4 IVIG管理与应用制度的确立 3 静脉用人免疫球蛋白（IVIG ）应用指导意见的建立 2 Immune globulin products from human plasma were first used in 1952 to treat immune deficiency. Intravenous immunoglobulin (IVIG) contains the pooled immunoglobulin G (IgG) immunoglobulins from the plasma of approximately a thousand or more blood donors. 背景 immunoglobulin G molecule Noah S Scheinfeld, MD, JD, FAAD; Chief Editor: Emmanuel C Besa, MD ;/article/210367-overview FDA-approved indications Allogeneic bone marrow transplantation Chronic lymphocytic leukemia Common variable immunodeficiency (CVID) - A group of approximately 150 primary immunodeficiencies (PIDs) that have a common set of features (including hypogammaglobulinemia) but that have different underlying causes Chronic inflammatory demyelinating polyneuropathy (CIDP) - Solely Gamunex Kidney transplantation with a high antibody recipient or with an ABO incompatible donor Primary immunodeficiency disorders associated with defects in humoral immunity. Immune-mediated thrombocytopenia Kawasaki disease (see the?Kawasaki Disease Diagnostic Criteria?calculator) Hematopoietic stem cell transplantation in patients older than 20 years (Gamimune-N only) Chronic B-cell lymphocytic leukemia Pediatric HIV type 1 infection 背景 Schroeder HW Jr, Dougherty CJ. Review of intravenous immunoglobulin replacement therapy trials for primary humoral immunodeficiency patients.?Infection. Dec 2012;40(6):601-11.?[Medline] US Food and Drug Administration. Drugs. Available at?/Drugs/default.htm. Accessed Feburary 10, 2013. IVIG. Wikipedia. Available at?/wiki/Intravenous_immunoglobulin.Accessed Feburary 10, 2013. 背景 静脉用人免疫球蛋白（intravenous human immunoglobulin，以下简称IVIG）资源十分紧缺，临床上使用已出现供不应求的局面。 IVIG使用的适应证、用法用量及疗程的把握也有待商榷。 临床药师运用循证医学的方法，检索国际权威数据库，借鉴国外指南的经验；并召集临床各科室的资深专家一同探讨，制定出符合我院情况的静脉用人免疫球蛋白应用指导意见，同时建立我院静脉用人免疫球蛋白管理与应用制度，规范了静脉用人免疫球蛋白在临床的合理使用，最终实现有限资源的合理配置。 背景 1 IVIG的标准化流程管理 4 IVIG管理与应用制度的确立 3 静脉用人免疫球蛋白（IVIG