安瓿两种消毒法效果的比较研究

安瓶内吸药是护理工作常用的操作之一，吸药前安部的消毒常规采用“两次消毒法”，即用小砂轮锯前、锯后各用酒精棉签消毒1次，但在实际工作中往往难以做到。一般情况下只消毒1次，即用小砂轮在安部颈部锯一锯痕后，用酒精棉签消毒。为了搞清楚1次消毒法是否可行，我们进行了安颌两种消毒法（0．5％强力碘1次消毒法与75％酒精两次消毒法）效果的比较研究，现报告如下。1材料与方法1．1材料（l）2ml安部，为丹参注射液（非抗生素类药物），产地：上海中西药业股份有限公司，新风制药厂，批号：950818o（2）小砂轮（锯安部用）。（3）无菌棉签…     

抽注空气对配制静脉药液影响的实验研究

[目的]探讨抽注空气配制的药液微粒、细菌、内毒素污染情况。[方法]分别在普通治疗室和超净工作台抽注空气与未抽注空气配制液体，监测微粒、细菌、内毒素污染情况。[结果]在普通治疗室抽注空气与未抽注空气配制的液体、在普通治疗室与超净工作台抽注空气配制的液体不同直径的微粒数均为前者高于后者（P〈0．01）；在超净工作台抽注空气与未抽注空气配制的液体微粒数无明显差异（P〉0．05）；在普通治疗室抽注空气所配液体随时间的延长细菌检出率不断增高。[结论]在普通治疗室配制药液尽量避免抽注空气，提倡在超净环境下配制药液。     

一次性三通溶药器的实验研究

目的使静脉用药中由于溶药所产生的微粒降至最少。方法用自行设计的一次性三通溶药器和常规方法分别进行溶药,检测药液中各种粒径的微粒数。结果常规方法在不同溶药环境中所引入药液中的微粒数差异有显著性;用一次性三通溶药器在不同环境中溶药所引入药液中的微粒数差异无显著性。结论一次性三通溶药器在治疗室环境中溶药,其效果近似在净化台操作。     

抽注空气对配制静脉药液影响的实验研究

[目的]探讨抽注空气配制的药液微粒、细菌、内毒素污染情况.[方法]分别在普通治疗室和超净工作台抽注空气与未抽注空气配制液体,监测微粒、细菌、内毒素污染情况.[结果]在普通治疗室抽注空气与未抽注空气配制的液体、在普通治疗室与超净工作台抽注空气配制的液体不同直径的微粒数均为前者高于后者(P＜0.01);在超净工作台抽注空气与未抽注空气配制的液体微粒数无明显差异(P＞0.05);在普通治疗室抽注空气所配液体随时间的延长细菌检出率不断增高.[结论]在普通治疗室配制药液尽量避免抽注空气,提倡在超净环境下配制药液.     

静脉注射药液微粒对家兔肺脏的影像学影响

[目的]探讨小剂量静脉注射药液中的微粒对家兔肺脏的机械性影响。[方法]选8只健康家兔，分别进行肺部计算机断层摄影（CT）及发射式计算机断层摄影（ECT），然后静脉注射药液，每天注射2次，连续注射3d，在注射第1次及注射3d后再进行上述两种成像，分析静脉注射药液微粒对家兔肺脏的影响。[结果]CT片对微粒引起的肺毛细血管梗阻及肺部病理改变显示模糊不清；ECT片可清’楚显示微粒引起的肺毛细血管机械性梗阻，但对微粒引起的肺部病理改变也显示不明显。[结论]小剂量静脉注射药液中的微粒可引起肺毛细血管机械性梗阻，长期注射引起的肺部病理改变有待进一步研究。提示在临床护理工作中选择静脉注射途径给药时应谨慎。     

注射药液快速换算法

注射药液快速换算法８３１３００新疆五家渠卫生学校蒋淑云笔者在３０余年的临床与教学中，总结出一种注射药液快速换算法。该方法简单易学现介绍如下，供同道参考。根据教学原理，一个数随另一个数变化时，可以找出其运算规律，以求得简便运算方法。儿科用药以不足１ｍｌ...     

砂轮的消毒与安瓿药液微粒污染的研究

割锯安瓿的砂轮用不同方法消毒,对引入安瓿药液中微粒数差异有显著性。经实验研究的结果是：将砂轮浸泡在盛有７５％酒精玻璃皿中,既减少护士操作程序,又可减少对砂轮不适当的消毒方法引入安瓿药液中的微粒量。此种方法可取。棉签蘸７５％酒精消毒砂轮的方法引入安瓿药液中微粒量最多,此法需改进或不可取。     

单手法抽吸安瓿药液的研究

为探讨一种省时节力污染少的安瓿药液抽吸手法,将临床护士在抽吸安瓿药液时普遍使用的单手持注射器抽吸法（单手法）改进规范后作为实验组,以教科书所示的双手持注射器抽吸法（双手法）作为对照组,在同等实验条件下进行对比研究,其结果显示：（１）２组对药液的污染,实验组小于对照组,Ｐ＜０．０１,有非常显著性差异;（２）２组对注射器具的污染,Ｐ＞０．０５,无显著性差异;（３）２组抽药时间的对比,Ｐ＜０．０１,实验组较对照组明显省时,且随活塞抽动次数增加,差异的显著性增大。为此,建议改进规范后的单手法可以用于５ｍｌ及其以下的注射器抽吸安瓿药液。     

擦拭材料对引入安瓿药液微粒量的影响

对擦拭材料引入安瓿药液中微粒量的影响进行了实验室研究。其结果是：医用纸本身脱落的微粒量较少，吸附微粒的性能较强，且微粒沾贴在医用纸上不易脱落。故医用纸蘸７５％酒精擦拭消毒安瓿颈部，徒手掰开后，引入药液中微粒数量少于一次性棉签，更优于纱布蘸７５％酒精的擦拭消毒。从病人的安全和节省棉纱资源的角度考虑，最好避免使用棉纱擦拭消毒安瓿，更不要垫纱布去掰安瓿，以减少微粒的污染和给病人带来的损害。     

静脉用药器具与压力对药液微粒污染的实验研究

为探讨注射器具和注射压力对静脉用药中药液微粒污染的影响，采用ZWF-4型注射液微粒分析仪检测静脉输注联合静脉注射的器具及加压后药液中不溶性微粒的数目。结果：一次性注射器及一次性头皮针对药液微粒污染的影响无统计学意义；一次性输液三通管在无加压的情况下有滞留药液微粒的作用，加压后微粒显著增加，提示；应重视静脉用药时压力对药液微粒污染的影响，尤其是静脉输注联合静脉推注药液时应加过滤装置，以提高用药的安全性。     

控制粉针剂药物静脉输注过程中的损失量

为进一步探讨静脉输注粉针剂药物过程中药物损失量,以头孢唑啉钠为例,对静脉输注过程、定量溶媒稀释、空药瓶及输液瓶冲中洗1次后药物损失量,采用紫外分光光度法进行测定。结果静脉输注全过程药物损失量为0.516g±0.09g,占用药量的12.9％;随机采样药物损失量高于4ml定量溶媒溶解及冲洗1次空药瓶和输液瓶的药物损失量。提示在静脉输注粉针剂药物时,应根据药瓶容积定量溶媒稀释、冲洗1次空药瓶及输液瓶,可减少药物损失量。     

Two methods of single-dose ampule opening and their influence upon glass particulate contamination

Contamination of glass ampules by glass fragments can occur following ampule opening. The intravenous administration of these glass fragments in animal experiments has resulted in insult to the brain, pulmonary, hepatic, renal, and splenic systems of these animals. Thus, it is of clinical importance to determine quantitatively the extent of glass particulate contamination by examining the different methods of glass ampule opening. Twenty, 2-mL single-dose glass ampules were examined for glass fragments following opening. Ten of the ampules were snapped open by hand while 10 were snapped open with the use of a commercial ampule opener. The contents of the ampules were aspirated into a 5-mL glass syringe, attached to an 18-gauge nonfilter needle. The contents of the syringe were filtered, then examined for glass fragments under a microscope. The size and number of glass particles were recorded using a calibrated ocular micrometer. Analysis of variance for repeated measures and Duncan's test showed no significant difference between the two groups. Thus, no significant difference existed in the number and size of glass particles aspirated when comparing these two ampule opening methods.     

Glass ampules and associated hazards

Accessing drugs dispensed in glass ampules is always associated with glass fragment contamination of the ampule contents on opening. In this study, the glass fragment contamination from the external surface of the ampule occurred 60% of the time with 1-ml sized ampules (p less than .01). Glass contamination has been shown to increase with larger ampule size. The glass ampule poses a potential source of microbial infection to the patient, as well as other hazards to the user. Increased precautions and improved drug container design appear to be desirable.     

安瓿割锯长度和擦拭方法对药物微粒污染量的影响

对安瓿开启时的割锯长度和擦拭方法与药液微粒量之关系进行了研究。分析表明：割锯痕长度、开启并消毒擦拭与否、以及采取不同的擦拭方法等，药液中的微粒量差异有显著性。实验提示：采用“易折型”或控制割锯痕长≤１／４周及坚持开启前的消毒是减少药物污染的重要措施。同时发现，在割锯、擦拭方法相同的情况下，２ｍｌ安瓿引入的微粒多于１０ｍｌ安瓿，故建议使用安瓿时应根据剂量选择恰当的包装规格，使药液体积与颈段外周长的比值减至最小，减少开启时微粒的污染量。     

Clinical Interpretation of Urine Drug Tests: What Clinicians Need to Know About Urine Drug Screens

Urine drug testing is frequently used in clinical, employment, educational, and legal settings and misinterpretation of test results can result in significant adverse consequences for the individual who is being tested. Advances in drug testing technology combined with a rise in the number of novel misused substances present challenges to clinicians to appropriately interpret urine drug test results. Authors searched PubMed and Google Scholar to identify published literature written in English between 1946 and 2016, using urine drug test, screen, false-positive, false-negative, abuse, and individual drugs of abuse as key words. Cited references were also used to identify the relevant literature. In this report, we review technical information related to detection methods of urine drug tests that are commonly used and provide an overview of false-positive/false-negative data for commonly misused substances in the following categories: cannabinoids, central nervous system (CNS) depressants, CNS stimulants, hallucinogens, designer drugs, and herbal drugs of abuse. We also present brief discussions of alcohol and tricyclic antidepressants as related to urine drug tests, for completeness. The goal of this review was to provide a useful tool for clinicians when interpreting urine drug test results and making appropriate clinical decisions on the basis of the information presented.     

2008年～2010年神经康复科住院患者用药分析

目的分析本院神经康复科住院患者药物应用情况及特点。方法统计本院2008年~2010年神经康复科用药数据,分别就用药种类、用药金额、用药频度(DDDs)、日均药费(DDC)进行统计分析。结果神经康复科用药金额、DDDs逐年递增,用药金额的前3位为改善神经功能药及促智药,DDDs前3位为促进脑代谢及促智药。DDC值较小的药品为甲钴胺片、硝苯地平控释片和阿司匹林肠溶片。结论我院神经康复科用药基本符合神经康复专科特点。     

Drug utilization and teratogenicity risk categories during pregnancy

A limited number of studies have investigated in detail the use of drugs during pregnancy. Researchers in the present study investigated the details of drug utilization in pregnant women during the month before pregnancy, at the time that they became aware of the pregnancy, and during the first trimester. Face-to-face interviews were conducted with 359 pregnant women who were admitted to the fetal medicine unit at a university hospital for diagnosis and follow-up. A questionnaire was used to document sociodemographic characteristics and details of drug use. Drugs were categorized according to the US Food and Drug Administration fetal risk classification. Mean maternal age was 29.9±5.1 y, and mean gestational age was 19.6±9.5 wk. Many of the pregnant women studied (46.6%) were university graduates, and most (61.9%) had a relatively high annual income. Mean gestational age when participants first learned of their pregnancy was 39.8±16.4 d. One hundred seventeen participants (32.6%) used drugs during the month before conception, 54 (15%) at the time when they learned of their pregnancy, 180 (50.1 %) at the time of the interview, and 289 (80.5%) during the first trimester. The percentages of drugs in categories D and X used by these subjects were 14%, 13.5%, 2.9%, and 5.9%, respectively. Most of the drugs were hormones. The total rate of drug utilization was not high before and during the first trimester of pregnancy. A considerable number of women were using drugs from the D and X categories; however, these numbers decreased significantly when women learned of their pregnancies. Intake of folic acid, vitamins, and iron was very low during the preconception period and was not high enough during the first trimester; this suggests that particular attention should be paid to the use of beneficial “safe” drugs during the preconception and early pregnancy periods.     

Translocation of drug particles in HPMC matrix gel layer: effect of drug solubility and influence on release rate

The aim of this work was to study the release mechanisms of drugs having different solubility (buflomedil pyridoxalphosphate 65%, sodium diclofenac 3.1%, nitrofutantoin 0.02% w/v,) from hydroxypropyl methylcellulose (HPMC) matrices by concomitantly studying swelling, diffusion and erosion fronts movement and drug delivery. The main goal was to clarify the role played by polymer swelling in drug transport. The results showed that the rate and amount of drug released from swellable matrices was dependent not only from drug dissolution and diffusion but also from solid drug translocation in the gel due to polymer swelling. In fact, as drug solubility decreased, the slower drug dissolution rate in the gel layer allowed drug particles to be transported close to the matrix erosion front. The presence of solid particles in the gel reduced the swelling and the entanglement of polymer chains and affected the resistance of gel towards erosion. As a consequence, the matrix became more erodible. The erosive delivery accelerated after the matrix had been completely transformed into the rubbery state, particularly when a considerable amount of solid drug particles remained in the gel phase.     

Laboratory study of the effectiveness of filters used by heroin injectors

Aims: (a) To compare in the laboratory the effectiveness of various filters at removing particles from heroin injections; (b) To measure the amount of heroin retained by the filters; and (c) To describe the relevance of these preliminary findings to future research.

Design: A laboratory‐based investigation. Injections were prepared with street heroin obtained from the police, copying the methods of injectors. Pieces of cigarette filter, hand‐rolling cigarette filter, cotton wool from buds and commercially produced syringe filters were tested. The Coulter Multisizer (IIe) was used to count and size particles; Capillary Zone Electrophoresis was used to measure the amount of heroin retained in the filters.

Findings: All methods of filtration reduced the amount of particles, with the commercially produced syringe filter producing the largest reduction. The syringe filter retained the most heroin after use; however, less drug material was evident on the spoon, suggesting further work is needed with a range of quantities. The cigarette, hand‐rolling and cotton bud filters all retained some drug with no significant difference detected between the different filters.

Conclusions: This preliminary study suggests all the filters tested may convey health benefits. Further work is needed with varying quantities of drug, acid and water and to establish safety in use. Then future studies can establish the health consequences for injecting drug users from the use of such filters.