药店经营基本药物现状调查

应用社会调查和文献研究的方法调查沈阳市文化路沿线药店经营基本药物现状。调查表明,零售药店对基本药物的配备是有选择性的,销售利润高低是决定药店配备或不配备某种基本药物的主要原因。     

构建我国合理用药知识传播机制的研究

如今,我国居民的自我药疗比例逐渐升高,但是从诸多调查数据来看,其自我药疗水平并不高,在这种情况下,开展药物知识的宣传教育是非常有必要和有意义的。文章从信息通讯技术的角度出发,构建了基于信息通讯技术的我国合理用药知识传播机制的基本框架。     

Illegal drugs and public corruption: Crack based evidence from California

Do illegal drugs foster public corruption? To estimate the causal effect of drugs on public corruption, we adopt the synthetic control method and exploit the fact that crack cocaine markets emerged in California in 1981, before reaching any other U.S. state. Our results show that public corruption more than tripled in California in the first three years following the arrival of crack cocaine. We argue that this resulted from the particular characteristics of illegal drugs: cheap technology and rigid demand, which fosters a convergence of interests between criminals and corrupted public officials resulting in a positive causal impact of illegal drugs on corruption.     

The short- and long-run relationship between the illicit drug business and terrorism

We study the effect of the illicit drug business on terrorism for a sample of 58 countries for the 1984–2007 period. Consistent with the notion of a crime-terror nexus, we find that in the long run, higher drug prices are associated with more terrorism. In the short run, however, increases in drug prices lead to less terrorism, potentially because terrorist groups respond to higher drug business attractiveness by prioritizing criminal over terrorist activity.     

Recent trends in brand-name and generic drug competition

Objective:

To provide evidence on recent trends in: (1) market exclusivity periods (MEPs, the time between launch of a brand-name drug and its first generic competitor) for new molecular entities (NMEs); (2) the likelihood and timing of patent challenges under Paragraph IV of the Hatch-Waxman Act; and (3) generic drug penetration.

Methods:

IMS Health National Sales Perspectives data were used to calculate MEPs for the 257 NMEs experiencing initial generic entry between January 1995 and September 2012 and the number of generic competitors for 12 months afterwards, by level of annual sales prior to generic entry and time period. The likelihood and timing of Paragraph IV challenge were calculated using data from Abbreviated New Drug Approval (ANDA) approval letters, the FDA website, and public information searches to identify drugs experiencing Paragraph IV filings, and the first filing date.

Results:

For drugs experiencing initial generic entry in 2011–2012, the MEP was 12.6 years for drugs with sales greater than $100 million (in 2008 dollars) in the year prior to generic entry, 12.9 years overall. After generic entry, the brand rapidly lost sales, with average brand unit share of 16% at 1 year; 11% for NMEs with pre-generic entry sales of at least $250 million (in 2008 dollars). Over 80% of NMEs experiencing 2011–2012 initial generic entry had faced at least one Paragraph IV challenge from a generic manufacturer. These challenges were filed relatively early in the brand-name drug life cycle: within 7 years after brand launch, on average.

Limitations:

Analyses, including Paragraph IV calculations, were restricted to NMEs where generic entry had occurred.

Conclusion:

Pharmaceutical competition continues to evolve; while the average MEP below 13 years for 2011–2012 remains consistent with prior research, Paragraph IV challenges are increasingly frequent and occur earlier, and generic share erosion has intensified.     

采取有效措施促进抗菌药物合理使用

目的为促进医院抗菌药物的合理使用,降低抗菌药物使用强度和在药品总金额中所占的比例。方法实施对抗菌药物分级管理;控制医师处方权限;临床药师进入临床科室,进行专项培训和督察。结果 2009～2011年抗菌药物销售金额占药品总金额比例分别为22.1%、22.3%、19.2%,使用强度分别是80、76、68。结论采取以上措施,有效地降低了抗菌药物使用的各项指标。     

厦门市社区卫生服务机构用药情况分析

目的：了解厦门市社区卫生服务机构用药现状及存在的主要问题并提出建议。方法：抽取厦门市的8个社区卫生服务中心和12个社区卫生服务站的门诊处方,统计分析每100张处方中的用药个数,含静脉点滴、激素、抗生素以及二联以上抗生素的处方数量,并对其主要影响因素进行分析。结果：厦门市社区卫生服务机构每100张处方平均用药数为246．80个,100张处方中平均含静脉点滴处方14．30张,激素处方4．50张,抗生素处方4（）．50张,二联以上抗生素处方7．55张。结论：厦门市社区卫生服务机构抗生素、激素的使用存在着不合理的趋势,社区卫生服务机构用药情况存在一定的地区差异。建议提高卫生行政部门对不合理用药问题的重视,加强对社区医师合理用药知识的培训,发挥执业药师的作用,加强对社区居民合理用药知识的健康教育。     

非甾体抗炎药物联合氨基葡萄糖治疗膝骨性关节炎的临床研究

目的观察非甾体抗炎药物联合氨基葡萄糖治疗膝骨性关节炎的疗效及患者不良反应,探讨治疗骨性关节炎临床用药。方法选取本院80例临床诊断为膝骨性关节炎患者,按照随机分配原则分为非选择性非甾体抗炎药治疗组20例;COX-2非甾体抗炎药治疗组20例;非选择性非甾体抗炎药联合氨基葡萄糖治疗组20例;COX-2非甾体抗炎药联合氨基葡萄糖治疗组20例。分别于治疗6周后进行临床疗效评定并观察其不良反应,确定最佳用药方案。结果药物治疗6周后,四组患者的疗效经多组间检验差异有统计学意义（P〈0.05）,联合氨基葡萄糖治疗组患者疗效优于非联合氨基葡萄糖;COX-2非甾体抗炎药联合氨基葡萄糖治疗组临床缓解比率与非选择性非甾体抗炎药联合氨基葡萄糖治疗组比较差异有统计学意义（P〈0.05）。COX-2非甾体抗炎药联合氨基葡萄糖治疗组不良反应率与其它三组比较,差异有统计学意义（P〈0.05）。结论膝骨性关节炎使用COX-2非甾体抗炎药联合氨基葡萄糖治疗,能够显著缓解骨性关节炎患者的症状,疗效确切,不良反应少,患者耐受性好,避免了短期内复发的可能。     

合理用药的管理研究

不合理用药现象在临床中时常发生,不合理用药的因素较多,因此要解决这个现象就要采取各种不同的措施。     

伊曲康唑对合用药物药代动力学的影响机制初探

目的探讨伊曲康唑对合用药物药代动力学的影响机制,为临床上安全合理地利用合成药物提供依据。方法利用健康成人的肝细胞微粒体,将其分为加入不同浓度伊曲康唑的10个小组,浓度梯度为0.0、0.4、0.8、1.6、3.2μg/ml,每组做5个平行组,之后在其中五组加入肝细胞微粒体细胞色素的P450的同功酶1A2的底物非那西丁,在另外五组中加入同工酶3A4的底物睾酮,测量不同伊曲康唑下的同功酶1A2和3A4的相对活性。结果各浓度伊曲康唑组对同功酶1A2作用效果无明显差异,各浓度伊曲康唑组对同功酶3A4的作用较明显,同功酶3A4的活性随着伊曲康唑的浓度增大而减小,其减小到本实验的最大活性一半时的伊曲康唑的浓度为0.7μg/ml。结论伊曲康唑对健康成年人肝细胞微粒体细胞色素酶同功酶1A2的活性无显著影响;但是它对同功酶3A4的活性有明显抑制作用,极大地影响了同功酶3A4对合用药物药代动力学的各种参数。