2008—2010年我院门急诊麻醉性镇痛药应用分析

目的:分析我院麻醉性镇痛药的应用情况及用药趋势,为麻醉性镇痛药的科学管理和合理应用提供参考。方法:以用药频度(DDDs)、限定日费用(DDC)及药物利用指数(DUI)为指标,对2008—2010年我院的门急诊麻醉性镇痛药使用情况进行数据统计分析。结果:盐酸吗啡缓释片使用频率最高(DDDs=6 690.0),其次是盐酸哌替啶注射液(DDDs=5 391.0),枸橼酸芬太尼注射剂使用频率最低(DDDs=1.2);限定日费用最高的是盐酸羟考酮控释片(DDC=383.4),盐酸布桂嗪片的限定日费用最低(DDC=1.1)。结论:我院麻醉性镇痛药的使用基本合理,管理符合规定,无滥用现象。     

Response to Article Critique by Jerome F. X. Carroll

Abstract

Driving under the influence remains one of society's greatest public health issues. Continued progress in reducing impaired driving will require an integrated community-based approach, with combinations of sanctions and treatments, working together as part of a comprehensive system of care. In this article, we summarize and evaluate each of the major points within two DUI models, proposed by White and Gasperin and DiStefano and Hohman, providing suggestions for further consideration. Each of the approaches may be an important component of such an integrated community Strategy.     

我院门诊第二类精神药品应用分析

目的了解本院门诊第二类精神药品的使用情况,评价其用药合理性。方法对本院2007年门诊1-12月处方16875张,采用限定日剂量（DDD）和药物利用指数（DUI）为指标,对处方分类统计、分析。结果本院使用的第二类精神药品的DUI均不大于1．0。结论本院门诊第二类精神药品应用情况基本合理。     

2006～2007年我院门诊麻醉处方调查分析

目的：了解我院麻醉药品使用情况,为临床合理应用提供参考。方法：采用限定日剂量（DDD）和药物利用指数（DUI）为指标对我院2006年1月～2007年12月门、急诊11 963张麻醉药品处方进行调查与分析。结果：11种麻醉药品中,2006年7种药品DUI〈1,2007年9种药品DUI〈1。结论：我院门诊麻醉药品2007年的使用情况明显较2006年合理。     

2006-2008年我院第二类精神药品应用分析

目的：了解我院第二类口服精神药品的使用情况。方法：对我院2006-2008年第二类口服精神药品的用药总量、使用频度（DDDs）和药物利用指数（DUI）进行分析。结果：医院第二类口服精神药品的用量比较平稳。最常用的药品是阿普唑仑、氯硝西泮、艾司唑仑。结论：我院精神药品使用基本合理。     

2005～2007年我院麻醉药品的应用分析

目的 了解我院麻醉药品应用情况,为l临床合理用药提供参考。方法收集我院2005—2007年住院患者的麻醉处方,对各品种的用量及用药天数进行统计和分析。结果我院麻醉药品的销售金额逐年增加,芬太尼贴剂增幅最大;哌替啶注射液的用药频度（DDDs）逐年递减,而吗啡制剂的DDDs逐年增加;药物利用指数（DUI）均小于1。结论本院麻醉药品应用情况基本合理,但癌症止痛治疗中存在不合理用药现象。     

Brief Motivational Interviewing for DWI Recidivists Who Abuse Alcohol and Are Not Participating in DWI Intervention: A Randomized Controlled Trial

Background: Driving while impaired (DWI) recidivists with unresolved alcohol use problems pose an ongoing risk for traffic safety. Following conviction, many do not participate in mandated alcohol evaluation and intervention programs, or continue to drink problematically after being relicensed. This study investigated if, in DWI recidivists with alcohol problems and not currently involved in DWI intervention, Brief Motivational Interviewing (BMI) produced greater reductions in risky drinking at 6‐ and 12‐month follow‐up compared to an information‐advice control condition. Additional analyses explored whether BMI was associated with greater readiness to change, subsequent substance abuse treatment service utilization, and satisfaction compared to the control condition. Methods: Male and female recidivists with drinking problems and not currently engaged in DWI intervention were recruited, evaluated, and then randomly assigned to receive 1 of 2 manualized interventions: 30‐minute BMI session or information‐advice. Participants, interviewers, researchers, and statisticians were blind to assignment. Outcomes were changed in: percent of risky drinking days (i.e., ≥3 standard drinks/d for males; ≥2 for females) in the previous 6 months derived from the Timeline Followback, biomarkers of alcohol abuse (GGT, AST, ALT, MCV) by blood assay, and alcohol abuse‐related behaviors using the MMPI‐Mac scale. Data from the Readiness to Change Questionnaire, a substance abuse service utilization questionnaire, and the Client Satisfaction Scale were also collected. Results: Analyses revealed significant declines in risky drinking with both interventions. BMI (n = 92) resulted in a 25% reduction in risky drinking days at 12‐month follow‐up, which compared to the control intervention (n = 92) represented a significant decline from 6‐month levels. Exposure to BMI also produced significantly greater improvement at 6‐month follow‐up in a biomarker of alcohol abuse and a behavioral measure related to recidivism risk. Exploration of readiness to change, substance abuse service utilization, and satisfaction with intervention indicated a perception of BMI being more useful in coping with problems. Conclusions: Brief MI approaches warrant further implementation and effectiveness research as an opportunistic DWI intervention strategy to reduce risks associated with alcohol use outside of clinical and DWI relicensing settings.     

门诊药房麻醉药品使用情况分析

目的评估麻醉药品的应用情况。方法采用药物利用指数（DUI）作为分析判断标准,对门诊3084张麻醉药品处方进行分析。结果常用药物有4种,共2种剂型;吗啡用量最大,符合世界卫生组织推荐吗啡治疗晚期癌痛的首选原则,所用药品的DUI均小于1,大多数药物的DUI未超过0.5。结论本院麻醉药品用于其他止痛使用基本合理,用于治疗晚期癌痛患者,其剂量明显偏小。