First, commonly used clinical data
Pharmaceutical information resources are very rich, including books, periodicals, information retrieval tools and online pharmaceutical information service systems in the fields of pharmacy, biology and medicine.
(1) Original documents and data
Primitive medical literature generally refers to all kinds of articles published in continuous publications (medical journals), such as research papers, reviews, experience introductions, industry news, etc. It also includes the first-hand information of medication actually produced in medical practice in our unit.
(2) core books of pharmacy
Refers to the most commonly used pharmaceutical works with the strongest academic authority in pharmaceutical information service, including complete works, monographs, manuals and standards.
1, encyclopedia
2. Drug category
3. Monographs and textbooks
4, drug standard class
5. Reference books
(3) Medical literature retrieval tools
1, China Pharmaceutical Abstracts
2. International Pharmaceutical Abstracts
3. Chemical abstracts
4. Biological Abstracts
5. Medical index
6. Medical abstracts
Second, the consulting service method
(1) Ask a clear question
(2) Classification of problems
(3) Obtain additional information
(4) access to literature
(5) Answer questions
(6) Follow-up consultant
Third, medication consultation
(1) provides physicians with information on new drugs, rational drug use, adverse drug reactions, drug interactions, incompatibility and contraindications.
(2) Participate in the formulation of drug treatment plan.
(3) Provide nurses with the dosage and usage of drugs for injection, and indicate the appropriate solvent, dissolving or diluting volume, concentration, dropping speed and compatibility changes of commonly used drugs for injection.
(4) Providing convenient information on the use, storage, transportation, carrying and packaging of drugs.
Medication guidance
First, common minor adverse reactions and their disposal methods
(1) Constipation: increase the fiber content in the diet; Drink plenty of water; Exercise.
(2) reduce sweating: avoid working or exercising in the sun or hot environment.
(3) Diarrhea: Drink plenty of water to replenish lost water; If the diarrhea lasts for more than 3 days, you should see a doctor.
(4) dizziness; Avoid operating potentially dangerous equipment or driving vehicles.
(5) Sleepiness: Avoid operating potentially dangerous equipment or driving vehicles.
(6) Dry mouth: sucking candy or ice cubes, or chewing sugar-free chewing gum.
(7) Dry nose or throat: use a humidifier or atomizer.
(8) Fluid retention (mild): Do not put salt in food, and raise your legs if possible.
(9) Headache: Keep quiet and take aspirin or acetaminophen (consult a doctor).
(10) Insomnia: Get up early every day and take the last dose of medicine; Drink a cup of hot milk while sleeping; Ask the doctor about the exercise plan.
(1 1) Itching: frequent bathing or showering or wet compress.
(12) Nasal congestion: use nasal drops if necessary.
(13) Palpitation (mild): frequent rest; Avoid nervousness; Don't drink coffee, tea or coke; Quit smoking.
(14) Stomach upset: take medicine with milk or food.
Therapeutic drug monitoring
Therapeutic drug monitoring is one of the important contents of clinical pharmacy.
It uses modern analytical techniques to quantitatively determine the concentration of drugs or their metabolites in biological samples, and according to the principle of pharmacokinetics, discusses the relationship between drug concentration in body fluids and drug efficacy and toxicity, and formulates a reasonable administration plan, so as to individualize the administration plan, improve the drug efficacy, avoid or reduce adverse reactions, and also provide valuable laboratory basis for the diagnosis and treatment of drug overdose.
(A) the work content of the laboratory
1, determination of blood drug concentration
2. Data processing
3. Interpretation of the results
4. Clinical pharmacokinetic study.
(B) TDM consulting services
(iii) Scope of application
Under the premise that the drug concentration-effect relationship has been established, it is meaningful to determine the blood drug concentration under the following circumstances:
1, a drug with low toxicity in therapeutic index;
2. Drugs whose poisoning symptoms are easily confused with the symptoms of the disease itself;
3, the clinical effect is not easy to quickly detect drugs;
4. Drugs with nonlinear pharmacokinetic characteristics;
5. Drugs with the same dose, but there may be great differences between individuals in blood concentration and cause great differences in pharmacokinetics;
6. When patients with liver or renal insufficiency or failure use drugs mainly excreted by liver metabolism or kidney, gastrointestinal dysfunction occurs after some drugs are taken orally;
7, newborns, infants and elderly patients with drugs;
8. Poor patient compliance; Long-term use of some drugs produces tolerance; Due to the weakening or strengthening of the drug effect of liver drug enzyme and unknown reasons, the drug effect change of liver drug enzyme is induced or inhibited;
9, combined drug interaction and affect the curative effect or produce serious adverse reactions.