Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwaƙwalwa na Magunguna ) da Kula da Kaya

Riba:

Ability don kimanta ingancin shaidar da iyakancewar fitarwa lokacin da aka fara gwajin magunguna-magungunan, abinci-abinci da mu'amalar cututtukan ƙwayoyi tare da hankali na wucin gadi.
Ikon ketare-tabbatar fitar da bayanan sirri na wucin gadi tare da lissafi mai zaman kansa da SmPC a cikin kashi, raka'a da lissafin mitar aikace-aikace
Ikon fahimtar cewa babban alhakin hulɗa da yanke shawara na sashi yana kan ƙwararren likitan harhada magunguna kuma dole ne a kimanta mahimmancin asibiti a cikin mahallin haƙuri.

A tsakiyar kantin magunguna akwai tambayoyi guda biyu: "Shin waɗannan magungunan lafiya tare?" kuma "Shin wannan kashi daidai ne ga majinyacin?" Ana yin waɗannan tambayoyin sau ɗari a kowace rana, kuma kowannensu yana taɓa lafiyar majiyyaci kai tsaye. Hankalin wucin gadi na iya hanzarta bincikar waɗannan tambayoyin; Yana sanya yuwuwar hulɗar a gaban ku a cikin jeri, yana tunatar da ku dabaru na sashi, kuma yana nuna wani batu da kuka manta. Amma bambanci tsakanin "ma'amala mai yiwuwa" da "ma'amala mai ma'ana ta asibiti ga wannan majinyaci" shine ainihin sana'ar ku, kuma kuna yin wannan bambanci, ba AI ba. A cikin wannan rukunin za ku koyi yadda ake yin hankali na wucin gadi ya zama amintaccen kayan aikin tantancewa don mu'amala da sarrafa kashi.

Iri uku na hulɗar magunguna

Mu'amala ita ce lokacin da wani abu ya canza tasirin wani abu. Akwai manyan iri guda uku:

Mu'amalar miyagun ƙwayoyi: Magunguna biyu suna ƙaruwa ko rage tasirin juna. Misali: Yin amfani da warfarin lokaci guda (mai bakin jini) da wasu maganin rigakafi na iya ƙara haɗarin zubar jini.
Mu'amalar sinadirai-magunguna: Abinci yana canza sha ko haɓakar ƙwayar cuta. Misali: ruwan 'ya'yan innabi na iya ƙara yawan matakan jini na wasu magunguna.
Mu'amalar miyagun ƙwayoyi-cuta: Magani na iya dagula cutar da majiyyaci ke ciki. Misali: wasu magungunan kashe zafi na iya zama cutarwa a cikin gazawar zuciya ko cutar koda.

AI na iya dubawa don duk nau'ikan guda uku, amma aikin mai harhada magunguna ne don kimanta mahimmancin asibiti na kowane faɗakarwa (ko a zahiri yana buƙatar sa baki) a cikin mahallin majiyyaci.

Tsanaki: Hatta bayanan mu'amala suna bambanta tsakanin hulɗar "ka'idar" da "ma'ana ta asibiti". AI na iya lissafin duka biyu tare da mahimmanci daidai. Auna kowane faɗakarwa akan tushen yanzu don guje wa faɗuwa cikin gajiyawar faɗakarwa (faɗakarwa da yawa da rasa na ainihi).

Inda basirar wucin gadi ke taimakawa wajen sarrafa kashi

Kula da kashi ya ƙunshi matakai guda uku: sanin daidai adadin, daidaita shi ga mai haƙuri, da yin lissafin daidai. Hankali na wucin gadi:

Tunatarwa: "Shin wannan maganin yana buƙatar daidaita sashi a cikin gazawar koda?" Yana ba da amsoshi ga irin waɗannan tambayoyin kamar tantancewar farko.
Ƙididdigar ƙididdiga: da sauri yana fitar da ƙididdiga na yau da kullum kamar lissafin mg/kg, juyawa mL, mitar aikace-aikace.
Yana samar da jerin abubuwan dubawa: Ya lissafa abubuwan da zaku nema kafin tabbatar da kashi.

Amma a cikin dukkan matakai guda uku, magana ta ƙarshe tana cikin SmPC (Taƙaitaccen Bayanin Samfur; rubutun bayanan da aka amince da shi a hukumance) da asusun mai zaman kansa. AI na iya yin kuskuren tunawa da kashi, rikitar da raka'a (mg tare da mcg), ko ba da kashi don wata alama ta daban.

uku mini lokuta

Case 1 - Warfarin da maganin rigakafi. Likitan ya rubuta sabon maganin rigakafi ga majiyyaci mai shekaru 72 ta hanyar amfani da warfarin. Leken asiri na wucin gadi ya yi gargadin "ƙarin haɗarin zub da jini, ana ba da shawarar sa ido sosai kan INR" a cikin gwajin farko. Likitan harhada magunguna ya tabbatar da wannan gargaɗin tare da bayanan hulɗa na yanzu da SmPC, ya sanar da likita kuma ya tunatar da mai haƙuri game da ranar sarrafa INR (gwajin jini). AI ya zama cibiyar tsaro a nan; An yanke shawarar tare da haɗin gwiwar likitan magunguna-likita.

Case 2 - Matsakaicin adadin yara. An wajabta syrup ga yaro mai shekaru 4, yana auna kilo 16. Kashi 15 mg / kg / rana a cikin allurai 2 kowace rana. An ƙididdige AI "16 × 15 = 240 mg / day, 120 MG kowace kashi." Likitan harhada magunguna da kansa ya tabbatar da lissafin, ya sami maida hankali na syrup (misali 250 MG / 5 ml) daga SmPC kuma ya ƙididdige shi azaman 2.4 ml kowace kashi. AI ba zai iya ba mL ba saboda bai san maida hankali ba; Mai harhada magunguna ya kammala wannan matakin da kansa.

Case 3 - Aikin koda. Majiyyaci tare da ƙididdige adadin creatinine na 25 ml/min an wajabta maganin da aka saba bayarwa a cikakken kashi. Leken asiri na wucin gadi ya ce, "Wannan magani na iya buƙatar daidaita sashi a cikin gazawar koda, tabbatarwa daga SmPC." Likitan harhada magunguna ya gani a cikin SmPC cewa yakamata a rage kashi idan izinin ya kasance ƙasa da 30 ml / min kuma ya tuntuɓi likita. Bayanan wucin gadi sun buga ƙofar dama, amma SPC ta ba da ainihin ƙimar.

Ma'amala ta mataki zuwa mataki da sarrafa kashi

Saita mahallin da ba a san sunansa ba. Shirya shekarun majiyyaci, nauyi, matsayin koda/hanta, da cikakken jerin magunguna (ba tare da ganewa ba).
Nemi kafin dubawa. Tambayi AI don lissafin hulɗar hulɗa da haɗarin sashi.
Tace don mahimmancin asibiti. Yi la'akari da kowane faɗakarwa akan bayanan bayanai / SmPC na yanzu; Shin yana da ma'ana ko ma'ana?
Yi lissafin da kansa. Magance lissafin kashi kuma tare da nazarin naúrar.
Tuntuɓi likita idan ya cancanta. Idan kuna shakka, tuntube mu; Yi rikodin yanke shawara da dalili.

Rauni mai ƙarfi / Ƙarfi mai ƙarfi

Rauni: "Shin waɗannan magungunan suna hulɗa?"

Ƙarfafa: "Jeri yiwuwar hulɗar miyagun ƙwayoyi-magunguna da cututtuka-cututtuka a matsayin pre-screening ga mai haƙuri ta yin amfani da jerin magunguna masu zuwa. Mara lafiya: 68 shekaru, rashin ciwon zuciya, creatinine clearance ~ 35 mL / min. Drugs: [jerin]. Ga kowane hulɗar, rubuta inji, yiwuwar sakamako na asibiti, da kuma lura da 'SmPC / lissafin bayanan asibiti da ake bukata kawai'.

A cikin hanzari mai ƙarfi, mahallin haƙuri, jerin magunguna, da iyaka sun bayyana; Fitowar ba yanke shawara ba ce, amma jeri ne don tabbatarwa.

Samfura huɗu masu kwafi

Aiki: Pre-screening (BA YANKEWA) .Mara lafiya (wanda ba a san shi ba): shekaru [...], nauyi [...], koda / hanta [...], tantancewa [...]. Lissafin magunguna: [...].Fitowa: | Magani biyu | Makanikai | Sakamakon da zai yiwu | fifiko (babba/matsakaici/ƙananan) | Tushen tabbatarwa |Lura: Ƙara "tabbatarwar SPC/database da ake buƙata" ga kowane layi.

Aiki: Samar da lissafin lissafin sashi. Drug: [...], nuni: [...], shekarun haƙuri / nauyi / aiki: [...] 2) Shin daidaitawar koda / hanta ya zama dole?3) Matsakaicin haɗarin wuce gona da iri? 4) Mitar aikace-aikace/lokaci? Rubuta "tabbatar daga SmPC" don kowane abu. Kar a ba da takamaiman lamba, cire abin da za a bincika.

Aiki: nuna lissafin mg / kg kashi MATAKI TA MATSAYI kuma rubuta nazarin naúrar.Input: nauyi [...] kg, kashi [...] mg / kg / rana, yawan adadin [...]/ rana, samfurin samfurin [...] Nuna naúrar a kowane mataki. Gargaɗi: Dole ne mai harhada magunguna ya tabbatar da kansa da kansa.

Teburin kula da sashi bisa ga nau'in magani

Matsayi

Matsayin basirar wucin gadi

Tabbaci na wajibi

Daidaitaccen adadin manya

Tunatarwa/jerin dubawa

Matsakaicin adadin SPC

Ciwon koda/hanta

Alamar cewa ana buƙatar gyara

Madaidaicin ƙimar + ƙididdige ƙididdigewa daga SmPC

Likitan yara (mg/kg)

daftarin asusun

Asusu mai zaman kansa + maida hankali

kunkuntar magungunan warkewa (misali warfarin, digoxin)

Haɓaka faɗakarwa

SmPC + siga na saka idanu + likita

Kuskuren gama gari

Dauki kowane gargaɗi daidai da mahimmanci. Ya kamata a rabu da mahimmancin ma'amala da mahimmanci na asibiti.
Cire mayar da hankali daga hankali na wucin gadi. Ana ɗaukar tattarawar samfur koyaushe daga alamar SmPC/label.
Tsallake rudani. Ya kamata a bayyana raka'a kamar mg/mcg, mg/mL, % a cikin lissafin.
Annashuwa a kan kunkuntar magungunan warkewa. A cikin waɗannan kwayoyi, ƙananan kuskure shine babban haɗari; ana buƙatar bibiya.
Jinkirta shawarwari tare da likita. Bai kamata a jinkirta sadarwa ba game da ma'amala mai ma'ana/ batun kashi.

A takaice

Hankali na wucin gadi shine kayan aikin dubawa mai ƙarfi da kayan aikin tunatarwa a cikin hulɗa da sarrafa kashi; Yana bayyana yiwuwar haɗari kuma yana hanzarta ayyukan yau da kullun. Amma aikin mai harhada magunguna ne ya bambanta tsakanin "mai yiwuwa" da "ma'ana ga wannan majiyyaci", don samun taro da ainihin rabo daga SmPC, don tabbatar da lissafin da kansa, da tuntuɓar likita lokacin da ake shakka. Hukuncin da alhakin ya rage ga ƙwararren likitan harhada magunguna.

Aikin aikace-aikace

Ƙirƙirar bayanin martaba mara lafiya (shekaru, nauyi, aikin koda, magunguna 4-5). Tambayi AI don tuntuɓar mu'amala ta farko da jerin abubuwan bincike. Kwatanta kowane faɗakarwa a cikin fitarwa tare da tushen hulɗar yanzu da SmPC; Nuna wanne gargaɗin yake da mahimmanci a asibiti kuma wanne ne ka'idar. Yi lissafin kashi da kansa kuma kwatanta shi tare da sakamakon AI kuma lura da bambanci.

jerin abubuwan dubawa

[ ] Na ba mai haƙuri mahallin ba tare da sunansa ba kuma gaba ɗaya.
[ ] Na tace gwajin hulɗar farko don mahimmancin asibiti.
[ ] Na tabbatar da kowane gargaɗi tare da bayanan bayanai/SmPC na yanzu.
[] Na tabbatar da lissafin kashi ta hanyar bincike mai zaman kansa da naúrar.
[ ] Na sami rabo / daidaitaccen rabo daga SPC.
[ ] Na yi ƙarin taka tsantsan a cikin ƙwayoyi tare da kunkuntar jigon jiyya.
[ ] Lokacin da nake shakka, na tuntuɓi likita kuma na rubuta shawarar.