Working mode of oncology surgical pharmacy in China.

Surgery plays an irreplaceable role in the prevention, diagnosis, staging, reconstruction, and rehabilitation in the overall management of cancer. Nevertheless, it is difficult for surgeons and nurses to take into account the details of medication management, considering the impact of  surgery on the patient's physical function and the complexity of anti-tumor  treatment with comorbidity. The pharmaceutical care services previously  provided by pharmacists in oncology focus more on the internal medicine  system, not widely the surgical field. At present, the pharmaceutical working  mode in oncology surgery has not well been formed around China, and the  whole process medication management needs to be improved. In 2015, the  GuangDong Pharmaceutical Association came up with the concept of  surgical pharmacist in China and subsequently created its position. In 2021, the GuangDong Pharmaceutical Association established a new discipline  termed "surgical pharmacy", which is the knowledge system of surgical pharmacists, and also tried to differentiate surgical pharmacy into  diverse areas, such as oncology surgical pharmacy. This article introduced a  working mode of surgical pharmacists in China that providing pharmaceutical  care services in perioperative period around anti-tumor, anti- infection, anesthesia, anticoagulation, blood pressure, blood glucose, nutrition, and pain management, to improve quality of life for patients.

La cirugía desempeña un papel insustituible en la prevención, diagnóstico, estadificación, reconstrucción y rehabilitación en el tratamiento  global del cáncer. Sin embargo, es difícil que cirujanos y personal de  enfermería tengan en cuenta todos los aspectos de la gestión de la medicación,  como el impacto de la cirugía en la función física del paciente y la  complejidad del tratamiento antitumoral con sus comorbilidades. Los servicios  de atención farmacéutica que anteriormente prestaban los farmacéuticos en  oncología se centraban más en aspectos de la medicina interna, y no  ampliamente en el ámbito quirúrgico. En la actualidad, el modo de trabajo  farmacéutico en la cirugía oncológica aún no está definido en China, y existe  una necesidad de mejorar la gestión de la medicación de todo el proceso  asistencial. En 2015, la Asociación Farmacéutica de GuangDong propuso la  creación del rol de farmacéutico quirúrgico en China y posteriormente creó su  puesto de trabajo. En 2021, la Asociación Farmacéutica de GuangDong  Estableció una nueva disciplina denominada "farmacia quirúrgica", que es el  área de conocimiento de los farmacéuticos quirúrgicos, y también intentó  diferenciar la farmacia quirúrgica en distintas subáreas, como la farmacia  quirúrgica oncológica. Este artículo presenta el modo de trabajo de los  farmacéuticos quirúrgicos en China, que proporciona servicios de atención  farmacéutica en el periodo perioperatorio de los pacientes incorporando los  distintos aspectos del tratamiento antitumoral, control de infecciones,  anestesia, anticoagulación, control de la presión arterial y la glucosa en  sangre, nutrición y tratamiento del dolor, con el objetivo de mejorar la calidad  de vida de los pacientes.

Modelo de trabajo de la farmacia quirúrgicaoncológica en China / Working mode of oncology surgical pharmacy in China

La cirugía desempeña un papel insustituible en la prevención, diagnóstico, estadificación, reconstrucción y rehabilitación en el tratamiento globaldel cáncer. Sin embargo, es difícil que cirujanos y personal de enfermeríatengan en cuenta todos los aspectos de la gestión de la medicación, comoel impacto de la cirugía en la función física del paciente y la complejidaddel tratamiento antitumoral con sus comorbilidades. Los servicios de atenciónfarmacéutica que anteriormente prestaban los farmacéuticos en oncología secentraban más en aspectos de la medicina interna, y no ampliamente en elámbito quirúrgico. En la actualidad, el modo de trabajo farmacéutico en lacirugía oncológica aún no está definido en China, y existe una necesidad demejorar la gestión de la medicación de todo el proceso asistencial. En 2015,la Asociación Farmacéutica de GuangDong propuso la creación del rol defarmacéutico quirúrgico en China y posteriormente creó su puesto de trabajo.En 2021, la Asociación Farmacéutica de GuangDong estableció una nuevadisciplina denominada “farmacia quirúrgica”, que es el área de conocimientode los farmacéuticos quirúrgicos, y también intentó diferenciar la farmaciaquirúrgica en distintas subáreas, como la farmacia quirúrgica oncológica.Este artículo presenta el modo de trabajo de los farmacéuticos quirúrgicosen China, que proporciona servicios de atención farmacéutica en el periodoperioperatorio de los pacientes incorporando los distintos aspectos del tratamiento antitumoral, control de infecciones, anestesia, anticoagulación, controlde la presión arterial y la glucosa en sangre, nutrición y tratamiento del dolor,con el objetivo de mejorar la calidad de vida de los pacientes. (AU)

Surgery plays an irreplaceable role in the prevention, diagnosis, staging, reconstruction, and rehabilitation in the overall management of cancer. Nevertheless, it is difficult for surgeons and nurses to take into accountthe details of medication management, considering the impact of surgeryon the patient’s physical function and the complexity of anti-tumor treatmentwith comorbidity. The pharmaceutical care services previously provided bypharmacists in oncology focus more on the internal medicine system, notwidely the surgical field. At present, the pharmaceutical working mode inoncology surgery has not well been formed around China, and the wholeprocess medication management needs to be improved. In 2015, theGuangDong Pharmaceutical Association came up with the concept of surgical pharmacist in China and subsequently created its position. In 2021,the GuangDong Pharmaceutical Association established a new disciplinetermed “surgical pharmacy”, which is the knowledge system of surgicalpharmacists, and also tried to differentiate surgical pharmacy into diverseareas, such as oncology surgical pharmacy. This article introduced a working mode of surgical pharmacists in China that providing pharmaceutical care services in perioperative period around anti-tumor, anti-infection,anesthesia, anticoagulation, blood pressure, blood glucose, nutrition, andpain management, to improve quality of life for patients. (AU)

Clinical pharmacist participation in selecting and dosing targeted drugs for a patient with ALK-positive non-small cell lung cancer: a case report.

Ceritinib and alectinib are recommended as the second-line therapies in the 2019 Chinese Society of Clinical Oncology (CSCO) guidelines for patients with anaplastic lymphoma kinase (ALK) positive non-small-cell lung cancer (NSCLC) in whom the first-line therapy has failed, but no optimal second-line treatment has been identified. Before 2018, the approved dose of ceritinib in the United States and many other countries was 750 mg/d fasted. In China, the approved dose was 450 mg/d fed although the dose of 750 mg/d fasted is still used in clinical practices. In our current case, a clinical pharmacist was involved in the selection and dose adjustment of a targeted drug for an ALK-positive NSCLC patient. The selection of second-line targeted drugs is based mainly on the results of clinical trials and real-world data of ceritinib and aletinib, along with the comprehensive analysis of health insurance policy, pharmacoeconomics, and drug accessibility. Alectinib may be more efficacious than ceritinib is in second-line settings. However, in our current case, the patient finally chose ceritinib after considering the drug prices and the health insurance policy. The clinical pharmacist optimized the dosage of ceritinib from 750 mg/d fasted to 450 mg/d fed, which not only improved the patient's medication compliance but also ensured the safety and efficacy of the drug; in addition, it lowered the financial burden of both the health insurance system and the patient, offering a good example for rational drug use and health insurance cost reduction. In conclusion, in choosing second-line targeted therapy for ALK-rearranged NSCLC, a variety of factors should be considered, including clinical efficacy, adverse effects, health insurance policy, drug price, and drug accessibility, and the dosage of ceritinib should be optimized to 450 mg/d fed in real-world settings.

[Effect of changji'an capsule on mRNA expressions of NPY and ACTH contents in brain-gut axis of IBS-D model rats].

OBJECTIVE: To explore the effect of Changji'an Capsule (CA) on mRNA expressions of neuropeptide Y (NPY) in the hypothalamus and colon and serum levels of adreno-cortico-tropic hormone (ACTH) in rats of diarrhea predominant irritable bowel syndrome (IBS-D) model rats. METHODS: Totally 48 SD rats were randomly divided into six groups, i.e., the normal control group, the model group, the Pinaverium Bromide group (PB, 0.018 g/kg), the high dose CA group (2.812 g/kg), the medium dose CA group (1.406 g/kg), and the low dose CA group (0.703 g/kg), 8 in each group. The IBS-D rat model was established by using separation of breast milk + stimulation of acetic acid + constraint of four limbs. Normal saline was given to rats in the normal control group and the model group. All medication lasted for 14 successive days by gastrogavage. The serum content of ACTH was detected by enzyme linked immunosorbent assay (ELISA). The expressions of NPY mRNA in the colon and the hypothalamus were detected using real-time fluorescence quantitative PCR. RESULTS: Compared with the normal control group, the serum ACTH content significantly increased (P < 0.01), the NPY mRNA expression in the colon and the hypothalamus obviously decreased (P < 0.01) in the model control group. Compared with the model group, the serum ACTH obviously decreased in the high dose CA group, the medium dose CA group, and the PB group (P < 0.01, P < 0.05). The NPY mRNA expression in the colon and the hypothalamus were obviously up-regulated in the high dose CA group, the medium dose CA group, the low dose CA group, and the PB group (P < 0.05). CONCLUSIONS: CA could modulate the abnormity of brain-gut axis of IBS-D rats possibly by up-regulating NPY mRNA expressions in the hypothalamus and the colon and down-regulating the ACTH content in the hypothalamic-pituitary-adrenal axis.