摘要
目的:规范含朱砂、雄黄中成药临床调剂技术,明确临床药师工作流程,指导临床合理用药。方法:梳理《中华人民共和国药典》 2020年版(一部)和《国家基本药物目录》(2018版),建立“含朱砂、雄黄中成药数据库”,向南京市中医院和山东中医药大学附属医院药学部多位药师开展调研,结合国内外期刊数据库和问卷调研结果,分析含朱砂、雄黄中成药在临床调剂与使用过程中的痛点和难点问题,构建包括采购验收、贮存养护、处方审核、处方调配、处方复核、发药与用药交代、处方点评、用药监测和用药警戒在内的9项调剂关键技术体系。结果:根据我国现行的药品不良反应关联性评价,73.53%的不良反应可能由含朱砂、雄黄的中成药导致,用药过程中存在的主要问题为长期、超量、超适应症用药;影响含朱砂、雄黄中成药调剂的重点环节包括采购验收、贮存养护、处方审核、处方调配、处方复核、发药与用药交代、处方点评、用药监测和用药警戒等。结论:规范含朱砂、雄黄中成药临床调剂技术对规范影响临床用药安全的调剂流程、促进中医临床药学服务的高质量发展具有重要的指导意义和现实价值。
Objective:To standardize the clinical dispensing technology for Chinese patent medicines containing Cinnabaris and Realgar,clarify the workflow for clinical pharmacists,and provide guidance for rational drug use in clinical practice.Methods:The 2020 edition of the Chinese Pharmacopoeia(Vol.Ⅰ)and the National Essential Drug Catalogue(2018 edition)were reviewed to establish a database of Chinese patent medicines containing Cinnabaris and Realgar.Surveys were conducted with multiple pharmacists from Nanjing Hospital of Traditional Chinese Medicine and the Department of Pharmacy,Affiliated Hospital of Shandong University of Traditional Chinese Medicine.Additionally,pain points and challenges in the clinical dispensing and use of Chinese patent medicines containing Cinnabaris and Realgar were analyzed based on the journal databases in China and abroad and questionnaire surveys.A key dispensing technology system consisting of nine components was constructed,including procurement and acceptance technology,storage and maintenance technology, prescription review technology, prescription dispensing technology, prescription verification technology, dispensing and medication explanation technology, prescription assessment technology, medication monitoring technology, and medication alert technology. Results: According to the current adverse drug reaction association assessment in China, 73.53% of adverse reactions were highly likely to be caused by Chinese patent medicines containing Cinnabaris and Realgar. The main issues during drug use included long-term use, excessive dosages, and off-label use. Key aspects affecting the dispensing of Chinese patent medicines containing Cinnabaris and Realgar included procurement and acceptance, storage and maintenance, prescription review, prescription dispensing, prescription verification, dispensing and medication explanation, prescription assessment, medication monitoring, and medication alert. Conclusion: Standardizing the clinical dispensing technology for Chinese patent medicines containing Cinnabaris and Realgar has significant guidance and practical implications for standardizing dispensing technology that affects clinical drug safety and promoting the high-quality development of clinical pharmacy services in traditional Chinese medicine.
作者
赵思进
张囡
赵学龙
马传江
刘国秀
金世元
翟华强
ZHAO Si-jin;ZHANG Nan;ZHAO Xue-long;MA Chuan-jiang;LIU Guo-xiu;JIN Shi-yuan;ZHAI Hua-qiang(School of Chinese Materia Medica,Beijing University of Chinese Medicine,Beijing 100029,China;Standardization Research Center of Traditional Chinese Medicine Dispensing,Beijing University of Chinese Medicine,Beijing 100029,China;Nanjing Hospital of Traditional Chinese Medicine,Nanjing 210006,China;Department of Pharmacy,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250011,China)
出处
《中国现代中药》
CAS
2023年第9期1992-2001,共10页
Modern Chinese Medicine
基金
国家重点研发计划项目(2019YFC1712000,2019YFC1712002)。
关键词
毒性
中成药
朱砂
雄黄
调剂技术
药学服务
toxicity
Chinese patent medicine
Cinnabaris
Realgar
dispensing technology
clinical pharmacy service
