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On the issue of rational use of drugs to ensure the safety of

Abstract: The clinical requirements of the drug is not limited to the treatment of the disease, but also requires the same time in the treatment of diseases, the use of drugs should be as little as possible to appear ADR. Keywords: Drug Safety Alliance 0 Introduction China paper finishing. With the development of society, how safe, effective and rational drug use has become the focus of attention. On adverse drug reactions in recent years (adversedrugreaction, ADR) are more reports and discussions, has attracted the attention of all aspects. According to WHO report, the global death toll of nearly 1 / 7 of the patients died of irrational drug use. In China, according to statistics, adverse drug reactions in hospitalized patients occur in approximately 20%, 1 / 4 is due to antibiotics. Every year due to overuse of antibiotics resistant infections caused economic losses reached billions of dollars or more. Rational drug use is always accompanied with the appropriate treatment, is an old and new issues, but also the eternal topic of hospital pharmacy worker. Hospital pharmacy service is the purpose of patient-centered, clinical pharmacy, based on clinical science to promote drugs, the core is to protect the safety of drugs in clinical treatment. Rational use of currently accepted basic elements: the contemporary system of drug and disease knowledge and theory, safe, effective, economical and appropriate use of drugs. 1 irrational drug use is now frequent medical malpractice, iatrogenic or drug-induced events remains high, the high cost of health care and medication, etc., has become the most countries, the problems facing the region, our country in these There are also many similarities. The practice of rational use of drugs falter, slow progress, far from enough to arouse people's attention. In fact, adverse drug reactions have become the main killer of endangering human health, and abuse of antibiotics in the clinic has been very common. Data show that patients of three hospital antibiotic usage is about 70%, 80% in secondary hospitals, one hospital was 90%. Misuse of antibiotics, not only of drug usage is too high, resulting in steep rise in medical costs, but also to bring the clinical treatment of serious consequences. Now, there are few doctors to antibiotics been systematic and comprehensive understanding of the blindness of much use, the choice of antibiotics without thinking, without attention to etiology check, obsessed with dose use of broad spectrum antibiotics, or antibiotics at the same time several applications, resulting in a large number of drug-resistant generation, so that more and more intractable infections, medical costs are increasingly high. Many serious infections of clinical death, mostly because of resistance to infection caused by the use of antibiotics ineffective. ADR to antibiotics top. Example, upper respiratory tract infection, 90% are caused by a virus, but the clinical use of antibiotics is not unusual. The consequences of the abuse is caused by bacteria resistant to macro-enhanced, reduced or loss of effectiveness of antibiotics, resulting in human drug-free available; patients in the micro will cause any drug-induced damage. Because many bacteria inside the body, under normal circumstances their mutual constraints, form a balanced, the overuse of antibiotics may cause damage to certain beneficial bacteria, so take advantage of some harmful bacteria or viruses lead to double infection or even death. In addition, the clinical specialties too small, physician lack of knowledge of the correct antibiotics; correct drug information access difficult; physicians lack of comprehensive knowledge of pharmacology, also led to an important cause of medication errors. For a long time, people have become accustomed to the family's standing as the antibiotic drugs, slightly Toutongnaore to take; and there are some patients take the initiative to require a good medicine, expensive drugs, even resulting in waste of resources and the occurrence of bacterial resistance. Thus seen, the rational use of drugs is not only medical problems, not just clinicians need to pay attention to. To truly rational drug use, doctors, patients, pharmacists, drug regulatory authorities need to collaborate with each other can be achieved. 2 Analysis of adverse drug reactions leading ADR reasons are complex and difficult to predict. Factors including drugs, the patient's own factors and other factors. Drug factors ① 2.1 The role of the drug itself: If a drug has two or more role, a role which could be side effects. Such as: both asthma and stimulant ephedrine, when used for prevention and treatment of bronchial asthma can cause insomnia. ② adverse pharmacological effects: Some of the drug itself on the human body are harmful to certain tissues and organs, such as long-term use of corticosteroids can make a lot of degeneration of blood capillaries, resulting in the skin, mucosa petechia, ecchymosis. ③ drug quality: the production process of mixing impurities or improper storage of drug contamination, can cause adverse drug reactions. ④ dosage: excessive medication, toxic reactions can occur, even death. ⑤ dosage forms of: the same drug in different dosage forms, and its absorption in the body are also different, that is, the bioavailability of different, if not master the dose can also cause adverse reactions. 2.2 ① patient's own reasons for sex: Dermatitis males than females, the ratio is about 3:2; neutropenia were more women than men. ② age: the elderly, children and adults of different drug reactions, the elderly and children due to drug metabolism, excretion is slow,[link widoczny dla zalogowanych], prone to adverse reactions; infants and young children's body not yet mature, more sensitive to certain drugs are also prone to adverse reactions. The survey found that people who are 60 years of age, the incidence of adverse reactions was 5.9% (52/887), and 60 years of age or older, compared with 15.85% (113/713). ③ individual differences: different races on different sensitivity to the same drug, and the same race on the same drug in different individuals respond differently. ④ disease factors: liver, kidney dysfunction, may enhance and prolong drug effects, easy to cause adverse reactions. 2.3 ① unreasonable use of other factors: the misuse, abuse, improper prescription of compatibility, adverse reactions may occur. ② Long-term medication: prone to adverse reactions, or even accumulative poisoning. ③ combination therapy: two or more drug combination, the incidence of adverse reactions was 3.5%, 6 or more drug combination, adverse reaction rate was 10%, 15 or more drug combination, adverse reaction rate was 80%. ④ of medication withdrawal: discontinuation of medication may also cause adverse reactions.