合理用药调研方法-implementingadrug.ppt

Implementing a Drug Use Indicators Study 合理用药调研方法 翟所迪 zhaisuodi@263.net 北医三院 World Health Organization HOW TO DEVELOP A NATIONAL FORMULARY BASED ON THE WHO MODEL FORMULARY A practical guide Dextran 70 Dextran is a representative plasma substitute. Various preparations can serve as alternatives Infusion (Solution for infusion), dextran 70 6% in glucose intravenous infusion 5% or sodium chloride intravenous infusion 0.9% Uses: short-term blood volume expansion Contraindications: severe congestive heart failure, renal failure; bleeding disorders such as thrombocytopenia and hypofibrinogenaemia Precautions: cardiac disease or renal impairment; monitor urine output; avoid haematocrit falling below 25–30%; where possible, monitor central venous pressure; can interfere with blood group cross-matching and biochemical tests—take samples before start of infusion; monitor for hypersensitivity reactions; pregnancy (Appendix 2) Dosage: Short-term blood volume expansion, by rapid intravenous infusion , adult 500–1000 ml initially, followed by 500 ml if necessary; total dosage should not exceed 20 ml/kg during the initial 24 hours; if required 10 ml/kg daily may be given for a further 2 days (treatment should not continue for longer than 3 days); child total dosage should not exceed 20 ml/kg Adverse effects: hypersensitivity reactions including fever, nasal congestion, joint pains, urticaria, hypotension, bronchospasm—rarely severe anaphylactoid reactions; transient increase in bleeding time Guide to good prescribing 背景不合理用药是一个世界性的课题和难题 International Network for Rational Use of Drugs国际合理用药协作网(INRUD) INRUD 以促进合理用药为宗旨，开发教育培训工具，进行多领域的干预研究，开展国际间的技术合作。其中《如何在医疗机构中进行用药指标调研》由其编写。每年还定期举办培训班。 现在，某个国家或某个地区的促进合理用药（Promoting Rational Drug Use, PRDU）小组，只要符合条件都可申请成为其成员。 举办PRDU培训班的目的Promoting Rational Drug Use 什么是合理用药? 合理用药要求患者接受的药物适合他们的临床需要、药物的剂量符合他们个体需要、疗程足够、药价对患者及其社区最为低廉。 (WHO 1988)  造成不