Research On Clinical Pharmacist’s Pharmacy Service In The Treatment Of Urinary Prostate Disease

Objective:The aim of this article was to discuss the role of clinical pharmacists in promoting the rational use of clinical medicine and clinical pharmacy services,we explored the clinical pharmacist’s pharmacological service model and work focus in urology and prostate medicine,and established the urology department of urology and prostate according to the characteristics of urinary prostate disease diagnosis and treatment exclusive pharmaceutical services,which was based on the entry point for the rational use of drugs,by observing the clinical pharmacist pharmacy service in the treatment of urinary and prostate diseases,the rational use evaluation and intervention of antibacterial drugs and auxiliary drugs in the perioperative period,as well as the clinical pharmacist’s pharmacological monitoring practice in clinical patients.Methods:In this study the rationality of the use of perioperative antimicrobial drugs and auxiliary hepatoprotective drugs of 260 patients hospitalized in the urinary and prostate surgery ward was first analyzed retrospectively,and the treatment evaluation criteria of perioperative preventive antibacterial drugs and perioperative auxiliary liver protection drugs were formulated,which Initially assess the rationality of the use of the two drugs.At the same time,the rationality of the use of that two kind of drugs were preliminary evaluated.The clinical pharmacist then intervened in the urinary tract through retrospective interventions,staged special interventions,and administrative assessments supported by pharmacy,in order to interfere with the management of perioperative antibacterial drugs and auxiliary liver protection drugs in urinary and prostate surgery.After the pharmaceutical intervention,the rationality of the use of the two drugs in the perioperative period of 399 patients hospitalized in the urinary and prostate surgery ward after the intervention of pharmaceutical services was retrospectively analyzed.Then we compared and analyzed the basic information of that two groups of patients before and after the intervention,including the perioperative preventive antimicrobial drugs and hepatoprotective drugs about the drug use indications,drug selection and other reasonable use.Then we further investigated the use of imipenem cilastatin in 112 patients in urinary and prostate surgery.We used the drug utilization assessment method to establish the "Urology Surgery Imipenem Cilastatin Use Evaluation Criteria for Drug Utilization",formulated corresponding intervention measures and intervened for half a year.We retrospectively analyzed the use of imipenem cilastatin in 24 patients after interventional urinary and prostate surgery,and statistically analyzed the basic information and the evaluation of imipenem cilastatin drug utilization of that two groups of patients.Finally,we combined the clinical pharmacist’s participation in 1 case of severe adverse reactions caused by the use of olanzapine during the perioperative period that caused aspartate aminotransferase elevation,and launched personalized pharmacy service practice suitable for the actual situation of the hospital.Results:(1)There was no significant difference between the two groups of patients in the general data and the proportion of the two types of surgery,which could be compared(P>0.05).Both cases were grade A healed after surgery,and there were no cases of secondary hospital infection,and no related adverse reactions were found.(2)Before and after the intervention,the indications for the use of antibacterial drugs during the perioperative period and the rationality of the administration route indicators were both maintained at a high level.The types of drugs that conform to the preventive use of antibacterial drugs during the perioperative period of urological surgery increased from 33.8%before intervention to 87.5%after intervention.Among them,the second-generation cephalosporin used in the pre-intervention group accounted for 0%,and the proportion used after intervention rose to 35.1%;the fluoroquinolone antibacterial drugs rose from 21.5%before intervention to 26.1%;Aminoglycoside antibacterial drugs rose from 2.7%before the intervention to 21.5%.The reasonable proportion of the types of antimicrobial drugs used for preventive use during the perioperative period before intervention was low,at 33.8%;however,after the intervention by clinical pharmacists,the reasonable ratio of this index was significantly increased to 87.5%.In addition,the reasonable rate of selection of antibacterial drugs before intervention was 14.6%,and the reasonable rate after intervention increased to 85.0%.(3)Before pharmacological intervention,the urinary and prostate surgery department’s drug indication compliance rate for imipenem cilastatin was 57%,liver function monitoring compliance rate was 58%,administration frequency compliance rate was 57%,and bacterial culture compliance rate was 90%.After pharmacological intervention,the compliance rate of imipenem cilastatin was 75%,72 h later the liver function monitoring compliance rate was 100%,administration frequency compliance rate was 96%,and bacterial culture compliance rate was 100%.(4)In the index of contraindications for the use of adjuvant hepatoprotective drugs during the perioperative period,both before and after the intervention were kept at a high level.In the prognosis group,when the number of normal liver function cases reached 94.2%and 83.1%of the patients used hepatoprotective drugs during the perioperative adjuvant treatment.In the post-intervention group,after the clinical pharmacist conducted education,the proportion of cases with normal liver function reached 93.0%,and the proportion of adjuvant liver protection drugs used in adjuvant therapy decreased to 16.5%.In the pre-urinary and prostate surgery intervention group,the liver-protecting drugs used during the perioperative period were mainly magnesium isoglycyrrhizinate injections,and the number of cases reached 175,accounting for 67.3%.After the pharmacological intervention by the clinical pharmacist,the number of reduced glutathione used in the post-intervention group was 0,and the number of cases of magnesium isoglycyrrhizinate injection also dropped significantly to 66,accounting for 16.5%.At the same time,the reasonable number and reasonable proportion of liver protection drugs used in adjuvant therapy before intervention in the perioperative period was 22.3%.However,after the intervention of clinical pharmacists reasonable ratio of that index reached 90.5%.(5)The clinical pharmacist assisted in the discovery of a rare serious adverse reaction caused by olanzapine-induced alanine aminotransferase elevation.The clinician adopted the clinical pharmacist’s advice,and as a result,the serious adverse reactions of the patients with elevated aspartate aminotransferase were corrected,and a better clinical treatment effect was obtained.Conclusions:Clinical pharmacists participate in the medication,of patients with urinary and prostate surgery,could rationality of perioperative antibacterial drugs,perioperative auxiliary drugs,and postoperative complications of prostate diseases.,reduce the incidence of adverse events or adverse reactions,optimize the drug treatment plans,and ensure the safety and effectiveness of medication for patients with prostate diseases.The drug utilization evaluation was applied to the clinical use management of imipenem cilastatin in urology,which promoted the rational use of imipenem cilastatin in hospital urology and prostate surgery,and provided a reference for the establishment of a specialty pharmaceutical service model.