ObjectiveTo research on the advances of stress ulcer drug prophylaxis. MethodsGuidelines for stress ulcer prophylaxis in and out of China were searched and analyzed. Risk factors for stress ulcer, recommended prevention drugs and safety of medicines were summarized. ResultsThe risk factors for stress ulcer included mechanical ventilation, coagulopathy, severe sepsis, multiple organ failure, shock, severe head injury, burns, major trauma, older than 65 and drug use. The recommended prevention drugs included proton pump inhibitors, H2-receptor antagonist and misoprostol, which played a role in the reduction of bleeding in intensive care units. However, recommended drugs had little function in the reduction of bleeding in general patients outside the intensive care units, which was even not recommended or supported in the clinical literature. Related adverse effects of these drugs also needed careful consideration. ConclusionExistence of risk factors for stress ulcer does not necessarily indicate the use of preventive drugs. Drug prophylaxis is used only for critically ill patients. This view summarized by the author provides a reference for physicians and pharmacists.
ObjectiveTo retrospectively investigate the medication structure and evaluate the rationality among over-60-year outpatients with lung cancer in the West China Hospital of Sichuan University in 2011. MethodsThe data was extracted from the hospital information system (HIS). Excel 2010 software was used for statistical analysis. Resultsa) The total of over-60-year outpatients with lung cancer were 17 296 person-times, of which 12 606 persons-times patients with no medication accounted for 72.88%. The monotherapy in patients with medication accounted for 75.76%. b) There were 5 types of tumour related drugs, including 56 kinds of different drugs, and the total frequency was 6 460 and the average cost was 2 219.38 yuan. The first three drugs classified by 5 types were traditional Chinese drugs (TCM, 28.50%), other therapy (24.91%), and etiological treatment (22.23%). c) For etiological treatment, tyrosine kinase inhibitors (TKI) accounted for 59.96%, and the first three drugs were gefitinib, recombinant human endostatin, and erlotinib. d) For symptomatic treatment, analgesic drugs accounted for 43.65%; and the first three drugs were tramadol hydrochloride sustained-release tablets, sodium zoledronic oxycodone, and acetaminophen. e) For ADR therapy, liver drugs accounted for 40.97%; and the first three drugs were palonosetron hydrochloride, licorice, and diammonium pantoprazole. f) Other treatment involved immunopotentiating drugs and hematopoietic growth factors, the ratios were 62.65% and 37.35%, and the first three drugs were thymalfasin, thymopentin, and recombinant interleukin-11. g) Huisheng, Banao capsule and Bailing capsule were at the first three usage in TCM, the ratios of which were 51.06%, 15.37%, and 13.91%. h) The top ten drugs were Huisheng oral liquid, gefitinib and thymus AFP, thymopentin recombinant interleukin-11, chelating compound spot capsules, recombinant human endostatin, tramadol hydrochloride extended release tablets, sodium, zole dronic, and Bailing capsule. ConclusionThe antitumor therapies were mainly TKI single drug regimen for over-60-year outpatients with lung cancer in the West China hospital of Sichuan University in 2011. The most frequently used adjuvant therapies are antalgic, antitussive and skeletal related events prevention drugs. Besides, Chinese patent medicines are in common use as well.
ObjectiveTo retrospectively investigate the drug use of over-60-year inpatients with lung cancer in the West China Hospital of Sichuan University in 2011, and to compare with outpatients with lung cancer concurrently, so as to evaluate the rationality of drug use among over-60-year inpatients with lung cancer in the West China Hospital. MethodsThe information of over-60-year inpatients with lung cancer as initial diagnosis in the West China Hospital in 2011 was collected from the hospital information system (HIS), including patient information, drug use information, cost information, etc. Data rearrangement and analysis by classes and costs were carried out using Microsoft Excel 2010 software. Resultsa) There was 2 215 person-times of over-60-year inpatients with lung cancer in the West China Hospital of Sichuan University in 2011. A total of 5 classes, 63 kinds of anti-tumor and adjuvant therapy drugs were involved. The total drug use frequency was 12 398 person-times. The average medicine cost was 774.93 yuan. b) The ratio of patients using 1 to 4 kinds of drugs was 34.31%, 5 to 10 kinds was 41.9%, and 11 to 15 kinds was 12.63%. c) For etiological treatment, the ratio of chemotherapy drugs was 99.45%, and the most used was cisplatin. d) For symptomatic treatment, the ratio of analgesics was 66.69%; the ratio of antitussive drugs was 21.33%; and the ratio of skeletal related events prevention drugs was 11.98%. e) For anti-ADR treatment, the ratio of antiemetic drugs was 55.07%; the ratio of stomach protection drugs was 32.63%; and the ratio of hepatic protection drugs was 12.30%. f) For other treatment, the ratio of immunopotentiating drugs was 59.46%; and the ratio of hematopoietic growth factor was 25.42%. g) For Chinese patent medicine, drugs used over 400 person-times were Diyushengbai tablet, Javanica oil emulsion injection, Aidi injection, and Huisheng oral liquid. h) For single/combined treatment, the ratio of two-drug combined chemotherapy was 78.38%, one analgesics drug treatment was 66.21%, one hepatic protection drug treatment was 83.41%, two-drug combined antanacathartic treatment was 45.88%, one stomach protection drug treatment was 90.53%, one immunopotentiating drug treatment was 90.53%, one hematopoietic growth factor treatment was 82.31%, and one Chinese patent medicine treatment was 37.39%, respectively; and antitussive and skeletal related events prevention drugs were used alone. i) The use frequency of the top 10 drugs were: pantoprazole, tropisetron, ondansetron, diphenhydramine, thymopentin, cisplatin, Diyushengbai tablet, tramadol, Javanica oil emulsion injection, and Aidi injection. j) Compared with outpatients, inpatients drug use frequency was higher in chemotherapy, analgesics, antiemetic, stomach protection, hepatic protection drugs, and Chinese patent medicine; but lower in skeletal related events prevention drug; and similar to the drug use situation of outpatients in immunopotentiating drugs and hematopoietic growth factor drugs. ConclusionThe antitumor therapies were mainly the combination of two chemotherapy drugs or single drug regimen for over-60-year inpatients with lung cancer in the West China hospital of Sichuan University in 2011. The most frequently used adjuvant therapies are antalgic, antiemetic and stomach protection drugs. Chinese patent medicine and immunopotentiating drugs are in common use as well.