Hospital information system-based pharmacovigilance for elderly patients: practices and results.

OBJECTIVE: To evaluate the effect of a pharmacovigilance system on potentially inappropriate medication prescriptions for elderly patients. METHODS: The retrospective study was conducted at Shaanxi Provincial People's Hospital, China, after approval from the ethics review committee, and comprised data from May 2020 to April 2021, and comprised prescriptions related to elderly patients aged at least 65 years. Number of medication risk assessment entries, number of intervened medical orders on outpatients and inpatients number of medical order prompts, and number of physician communication with prescription-checking pharmacists were noted. Potential drug interaction rate was compared between pre- implementation from May to October 2020 and post-implementation from November 2020 to April 2021. Besides, the usage of sedatives and hypnotics and potentially inappropriate medication was noted for the period from January to June 2021 to evaluate the sustained effect of pharmacovigilance system. Data was analysed using SPSS 19. Results: A total of 118 drugs were involved in the 3911 entries of outpatient prescription warnings, of which 19 drugs accounted for 3156 (80%). Besides, a total of 113 drugs were involved in the 3999 entries of inpatient prescription warnings, of which 19 drugs accounted for 3199 (80%) The overall prevalence of potentially inappropriate medication related to sedatives and hypnotics decreased post-intervention as warning percentage was 16.1% in January and 6.7% in June among outpatients. On inpatients, the warning percentage was 30.6% in January and 6.1% in June. CONCLUSIONS: The pharmacovigilance system could reduce potentially inappropriate medication and provide deeper technical support for the safety of medical behaviour and individualised treatment of patients.

[Study of using shattering extraction with solvent to extract ingredient of three kinds of traditional Chinese medicine].

OBJECTIVE: To prove if it is possible for using the shattering extraction with solvent to extract ingredients of traditional Chinese medicine. METHOD: The shattering extraction with solvent, the refluxing extraction and the ultrasonic extraction were used to extract paeoniflorin from Radix Paeoniae rubra, and to extract baicalein from Radix Scutellariae, and to extract chlorogenic acid from Flos lonicerae japonicae respectively, using ingredient content and extract yield as the measuring indexes. RESULT: The content of each every ingredient obviously higher by using shattering extraction with solvent than using refluxing extraction or the ultrasonic extraction. CONCLUSION: The shattering extraction with solvent is a high efficiency, simple and quick extraction. It may be used to extract the ingredient of three kinds of traditional Chinese medicine.

The quick loss of carbapenem susceptibility in Pseudomonas aeruginosa at intensive care units.

Background Patients colonized with carbapenem-susceptible Pseudomonas aeruginosa (CSPA) strains upon admission to the intensive care unit (ICU) tend to be quickly followed by detected carbapenem-resistant P. aeruginosa strains after admission. Objective To assess the risk factors associated with the quick loss of carbapenem susceptibility and to identify time threshold of prior antimicrobial exposure for the loss during ICU stay. Setting A tertiary-care teaching hospital with 2560 beds located in the northwest region of China. Method A retrospective observational study was conducted between January 2013 and April 2016 at ICUs. Logistic regression analysis was used to assess risk factors, and receiver operating characteristic (ROC) analyses were constructed to identify the time threshold. Main outcome measure The time threshold and risk factors for the quick loss of carbapenem susceptibility. Results Among the 84 patients with CSPA initially, 32 (38.1%) patients were observed to have a loss of carbapenem susceptibility during ICU stay. Logistic regression analyses showed that previous carbapenem exposure was only independently associated with the loss of carbapenem susceptibility (odds ratio 13.16; 95% CI 3.13-55.24; p < 0.001). The optimal cut-off was 3.5 days on ROC curve, indicating the high risk for loss of susceptibility. Conclusion In order to alleviate selective pressure caused by antipseudomonal carbapenems exposure, continued research is needed to determine the most appropriate carbapenems treatment strategies.