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为了摸清我院门诊处方用药情况,在门诊处方中,随机选择200张,对不合理用药情况进行分析,结果报告如下。1 处方分布及问题 本次抽查处方200张,主要涉及抗生素、解热镇痛药、心脑血管用药、消化系统用药、降压药和维生素等。不合理处方共98张(49.0％),其中内科32张(16.0％),外科30张(15.0％),妇科23张(11.5％),儿科13张(6.5％)。在调查的处方中,合并用药的处方有172张(86％),使用2～5种药物的处方有117张(58.5％),使用5种以上的处方57张,占处方总数的28.5％。由于我院为企业医院,患者点名要药者较多,加上药品回扣等不正之风,不合理用药现象较为严重。如一高血压患者,其处方中同时出现了复方降压片、怡那林、尼莫地平、卡托普利。这些药虽然都有不同程度的降压作用,但具体到哪种药对患者的疗效最满意就很难说清了。在同一处方中,还有同时使用几种抗生素的,如利君沙每日4次,每次0.25g;螺旋霉素每日4次,每次0.15g。由于这几种药物同属于大环内酯类,抗菌谱相似,互相合用既增加了药物的不良反应,又造成了药品的浪费。
In order to find out our hospital outpatient prescription medication, outpatient prescriptions, randomly selected 200, the analysis of irrational drug use, the results are reported as follows. 1 Prescription distribution and problems The spot checks 200 prescriptions, mainly related to antibiotics, antipyretic analgesics, cardiovascular medicine, digestive system drugs, antihypertensive drugs and vitamins. There were 98 unreasonable prescriptions (49.0%), of which 32 were internal medicine (16.0%), 30 were surgery (15.0%), 23 were gynecology (11.5%) and 13 were pediatrics (6.5%). Among the prescriptions investigated, there were 172 (86%) prescriptions for combination therapy, 117 (58.5%) prescriptions for 2 to 5 drugs and 57 (5) prescriptions, accounting for 28.5% of the total number of prescriptions. As our hospital for the hospital, the patient name to the drug more, coupled with drug rebates and other unhealthy practices, the phenomenon of irrational use of drugs is more serious. Such as a hypertensive patients, the prescription at the same time appeared compound antihypertensive tablets, Yi Lin, nimodipine, captopril. Although these drugs have different levels of antihypertensive effect, but which specific drugs on the patient’s most satisfactory effect is difficult to say. In the same prescription, there are several antibiotics, such as Lijun sand 4 times a day, each 0.25g; spiramycin 4 times a day, each 0.15g. As these types of drugs belong to macrolides, the antibacterial spectrum is similar to each other both to increase the adverse drug reactions, but also resulted in the waste of medicines.