Our hospital pharmacy applications Analysis of narcotic drugs

[Abstract] Objective To me the use of narcotics and drug trends for the rational use of narcotic drugs to provide the clinical basis. Way to use my books of narcotics to extract data, hospital statistics prescription narcotic drugs in 2010, recording drug name, dosage, usage, amount and number of drugs. Conclusions of statistics and analysis.

[Keywords] Narcotic Drugs
Continuous use of narcotic drugs is likely to produce physical dependence after, it can become a hidden addiction to drugs. The one hand, these drugs have a strong analgesic effect, the drug is medically necessary, while not standardized continuous use and easy to produce dependence and addiction.

Table 1 composition ratio of the amount of drugs narcotic drugs

Discuss
Our hospital is a hospital, narcotic pain drugs mainly used for the treatment of liver cancer patients by Table 1 shows that our hospital pharmacy narcotic drugs total amount of 7819.56 yuan medication from the prescription point of view, the first three clinical use of narcotic drugs bits, respectively, the controlled-release morphine sulfate tablets, fentanyl citrate injection, morphine injection.

Fentanyl injection of potent analgesics, the role is similar to morphine, morphine analgesic potency of about 75-125 times faster onset, peak time is short, generally not used solely for pain, mainly used for anesthesia adjuvant and general anesthesia combined with our hospital with a sedative often it injection of midazolam for ICU patients with ventilator during anesthesia and sedation. morphine injection as potent analgesic, used for other analgesics invalid acute sharp pain, such as severe trauma, burns, surgery, advanced cancer pain by Table 1, Table 2 shows the amount of morphine controlled-release tablets or medication regardless of the number of drugs are ranked first in morphine controlled-release tablets major for patients with advanced cancer pain, oral medication easy to maintain for a long time, safe, addiction is small, adverse reactions, long-term oral controlled-release formulations of morphine treatment of pain is recognized as the best solution, according to WHO << three-step analgesic treatment of cancer pain guidelines>> in the provisions on individual drugs, use of morphine for cancer pain analgesic doctors should decide according to the disease and the tolerance measure, the State Drug Administration has abolished the use of morphine for cancer patient The maximal limit. long-term use in patients with morphine formulations may be tolerated or physical dependence, but should not be classified as caused by drug abuse addiction. The main clinical use of controlled, sustained-release preparations, orally, on time delivery, to avoid excessively high peak plasma concentration, the occurrence of a very small risk of addiction. Links to free download http://www.hi138.com the past that the pain will be with morphine addiction, so they are reluctant to patients with morphine Now that this view is wrong. for the analgesic effect of initial poor should gradually increase the dose should be taken from every 12 hours beginning 10 or 20mg, depending on the analgesic effect of dose adjustment, rather than shorten the dosing interval with the full dose to prevent the medication too frequently, is not conducive to continuous pain relief, but will form a drug dependency. norms and adequate use of morphine analgesia, the use of appropriate adjuvant, not only can effectively alleviate the pain, but also can reduce the morphine adverse reactions and improve the quality of life of cancer patients. pethidine injection for the short-acting analgesic, with pharmacological effects similar to morphine, the analgesic effect of morphine equivalent to only 1 / 10 to 1 / 8, mainly for the kinds of acute severe pain, its demethylated metabolite of pethidine with central nervous system toxicity, is not suitable for patients with moderate to severe chronic pain treatment in recent years, the treatment of advanced cancer pain in patients with morphine has been increasingly slow, controlled-release formulations of the alternative. Table 2 shows that, in our hospital the amount of pethidine injection and basically the same amount of morphine injection, there is the phenomenon of irrational drug use, does not meet the three-step analgesic treatment of cancer, the principles of clinical medicine physicians should update the concept, change the prescription habits, to further strengthen three-step analgesic treatment of cancer pain guidelines for the study. Transdermal fentanyl for the development of new formulations in recent years, its unique formulation, use of simple, analgesic effect, duration up to 72h, a low incidence of adverse reactions, especially for eating difficulties, severe nausea and vomiting of cancer patients. Administered through the skin, avoiding the first pass effect, reducing the adverse effects of the liver, liver cancer is more suitable for patients with pain, but much more expensive, to a certain extent, limited its widespread application. Codeine is a weak opioid analgesic effect of morphine is only 1 / 12 ~ 1 / 7, for moderate pain. is a potent central antitussive for severe cough caused by a variety of reasons, mainly for the liver in our hospital dry cough caused by lung cancer metastasis.

To relieve the suffering of cancer patients and improve their quality of life, while preventing drug abuse, clinicians need to improve on the three step analgesic ladder principle of understanding and awareness, updating the concept of medicine and improve the level of medication, follow the three step treatment guidelines, the preferred oral to drug, Administration time, Administration by step, individual Administration, attention to the details of medication, in the course of treatment for patients more prone to problems, make the appropriate treatment. With the hospital operating room will be completed soon, the new Technology continues to carry out, the type of use of narcotic drugs, the number will increase in use will gradually expand the scope of Pharmacy staff should be constantly updated knowledge of narcotics drugs, strict control of narcotic drugs indications, and seriously implement the management of narcotic drugs regulations, strengthen the management of narcotic drugs clinical applications, rational use of narcotic drugs for clinical guidance.

References
[1] Narcotic Drugs guidelines for clinical application.

[2] WHO three-step treatment of cancer pain, the basic principles.

[3] Tan Kaili, Zhang Xiaolin. Our hospital pharmacy application of analysis of narcotic drugs, Chinese medicine and clinical, in March 2010, Volume 10 No. 3. Links to free download http://www.hi138.com