Pharmaceutical Care by Clinical Pharmacists can Effectively Improve the Use of Antibacterials and Hepatoprotective Drugs during Perioperative Period in Urology Department: A Retrospective Study.

BACKGROUND: The management of medication for patients undergoing urological surgery is a subject of ongoing controversy, especially in elucidating the effect of clinical pharmacists on medication rationality. This study aims to assess the influence of clinical pharmacist service on the utilization of antibacterial and hepatoprotective drugs in urological surgery patients during the perioperative period. METHODS: Patients undergoing urological surgery in our hospital from January 2020, to January 2023, were consecutively selected. The patients were divided into control group (routine procedure) and observation group (routine procedure + clinical pharmacist service). The baseline data were balanced by 1:1 propensity score matching (PSM). The t test and chi-square test were used to compare the drug use, adverse reactions, and hospitalization-related indicators between the two groups. RESULTS: A total of 292 patients were included, with 100 patients in each group after PSM. No significant difference was found in the baseline data between the two groups (p > 0.05). The rationality of drug use (drug type, administration time, course of treatment, and combination) in the observation group was significantly better than that in the control group (χ2 = 8.489, 10.607, 10.895, 10.666; p = 0.004, 0.001, 0.001, 0.001). The incidence of adverse reactions (6.00%) and postoperative complications (7.00%) was significantly lower (χ2 = 4.903, 5.531; p = 0.027, 0.019). The length of hospital stay and total cost were similar (p > 0.05). The use time and cost of antibacterial and hepatoprotective drugs in the observation group were lower than those in the control group (t = 2.935, 3.450, 3.243, 3.532; p = 0.004, 0.001, 0.001, 0.001). The types and rates of antibacterial and hepatoprotective drugs in the observation group were significantly lower than those in the control group (p < 0.05). CONCLUSIONS: Clinical pharmacist service can effectively improve the rationality of drug use in urological surgery patients and reduce adverse reactions and postoperative complications, hence its clinical promotion value.

A real-world data analysis of the use of hepatoprotective drugs in outpatients in six cities of China from 2015 to 2019 / 临床肝胆病杂志

Objective To investigate the use of hepatoprotective drugs in China in recent years, and to put forward related suggestions. Methods The outpatient prescription data of hepatoprotective drugs were collected from 85 hospitals in 6 cities of China from 2015 to 2019, and a real-world data analysis was performed to analyze the payment method, issuing department, drug category, and use of hepatoprotective drugs. Results A total of 1 113 575 prescriptions were extracted, involving 38 hepatoprotective drugs such as compound glycyrrhizin, polyene phosphatidylcholine, and bicyclol. Hepatoprotective drugs were mainly in tertiary hospitals, and the highest number of prescriptions containing hepatoprotective drugs were observed in department of infectious diseases, department of gastroenterology, and department of tuberculosis. Anti-inflammatory hepatoprotective drugs accounted for the highest proportion of all prescriptions, mainly compound glycyrrhizin, polyene phosphatidylcholine, and bicyclol. Of all prescriptions, 253 429 (22.76%) had the combination of multiple hepatoprotective drugs, with the highest number of 6 drugs, among which polyene phosphatidylcholine combined with bicyclol accounted for the highest proportion. Conclusion There are large quantities of hepatoprotective drugs used by outpatients in China. At present, the hepatoprotective drugs are clinically applied rationally, but there are still some problems to be solved, such as the combination of drugs.

Liver injury in COVID-19: A minireview.

In December 2019, an outbreak of unexplained pneumonia was reported in Wuhan, China. The World Health Organization officially named this disease as novel coronavirus disease 2019 (COVID-19). Liver injury was observed in patients with COVID-19, and its severity varied depending on disease severity, geographical area, and patient age. Systemic inflammatory response, immune damage, ischemia-reperfusion injury, viral direct damage, drug induce, mechanical ventilation, and underlying diseases may contribute to liver injury. Although, in most cases, mild liver dysfunction is observed, which is usually temporary and does not require special treatment, the importance of monitoring liver injury should be emphasized for doctors. The risk of COVID-19 infection of liver transplantation recipients caused more and more concerns. In this article, we aimed to review the available literature on liver injury in COVID-19 to highlight the importance of monitoring and treating liver injury in COVID-19.

Analysis of Influential Factors for Drug-induced Liver Injury Caused by Routine Lung Cancer Chemotherapy Plan and Ra- tionality Evaluation of Hepatoprotective Drugs in Our Hospital / 中国药房

OBJECTIVE： To evaluate the influential factors for drug-induced liver injury （DILI） caused by routine lung cancer chemotherapy plan and the rationality of hepatoprotective drugs. METHODS： The information of lung cancer patients receiving routine chemotherapy in our hospital from Feb. 1st， 2018 to Jan. 31st， 2019 were selected. The occurrence of DILI induced by different routine chemotherapy plans， the correlation of each influential factor with DILI and the rationality of hepatoprotective drugs were analyzed retrospectively. RESULTS： A total of 325 patients were involved in this study， among which 126 patients （38.77％） suffered from DILI， involving 109 first-level cases （33.54％） and 17 second-level cases （5.23％）. Routine chemotherapy plan included etoposide+cisplatin， gemcitabine+cisplatin， docetaxel+platinum， pemetrexed disodium+platinum. The clinical classification of DILI included hepatocyte injury type 44 cases （14.52％）， cholestasis type 38 cases （12.54％） and mixed type 37 cases （12.21％）. Totally 174 patients （53.54％） received hepatoprotective drugs during chemo-therapy， among whom 49 patients （28.16％） suffered from first-level DILI and 6 patients （3.45％） second-level DILI， with total incidence of 31.61％. Among patients without hepatoprotective drugs， 60 patients （39.74％） suffered from first-level DILI， and 11 patients （7.28％） suffered from second-level DILI， with total incidence of 47.02％. The incidence of DILI in patients without hepatoprotective drugs was significantly higher than those with hepatoprotective drugs （P＜0.05）. Among patients with hepatoprotective drugs， 23 patients （13.22％） used hepatoprotective drugs unreasonably， including 5 patients （2.87％） received 3 kinds or more hepatoprotective drugs； 3 patients （1.72％） received drugs with same mechanism repeatedly； 11 patients （6.32％） received 3 kinds or more drugs and drug with same mechanism repeatedly； 4 patients （2.30％） used drugs contrary to contraindication. Influential factor correlation analysis showed that there was a positive correlation between DILI and the dosage of chemotherapeutic drugs， treatment course and KPS before chemotherapy （P＜0.05）. CONCLUSIONS： KPS before chemotherapy， dosage of chemotherapeutic agents and treatment course are the main factors of DILI. There is still unreasonable use of drugs such as repeated use， unreasonable drug combination， violation of drug contraindications. The use of hepatoprotective drugs during chemotherapy can reduce the risk of DILI occurrence. Clinicians should be more aware of the methods and indications of hepatoprotective drugs in order to improve the effectiveness and safety of drug use.

Clinical analysis of thymosin combined with liver protecting drugs in the treatment of primary hepatocellular carcinoma / 中国基层医药

Objective To investigate the clinical effect of thymosin combined with liver gland peptide drugs in the treatment of primary liver cancer.Methods 138 cases of primary hepatocellular carcinoma (HCC) were seleted as the research subjects,and they were divided into observation group (n=69) and control group (n=69) according to the number table method.The control group was treated with simple hepatoprotective drugs,the observation group was treated with thymosin on the basis of the control group.The clinical curative effect of the two groups,quality of life improvements were observed.Results In the observation group,the total effective rate was 81.16%,which in the control group was 43.47%,the difference was statistically significant between the two groups (χ2=8.362,P<0.05).The rate of life quality improvement of the observation group was 60.86%,which of the control group was 23.18%,there was statistically significant difference between the two groups (χ2=9.726,P<0.05).Conclusion The primary HCC patients treaed with thymosin combined with hepatoprotective drugs can effectively improve the patients' life quality,with good clinical curative effect,and it is worth clinical promotion and application.