CN114913957A - Dosage adjustment system for reasonable application of antibacterial drugs and use method thereof - Google Patents
Dosage adjustment system for reasonable application of antibacterial drugs and use method thereof Download PDFInfo
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- CN114913957A CN114913957A CN202210514335.XA CN202210514335A CN114913957A CN 114913957 A CN114913957 A CN 114913957A CN 202210514335 A CN202210514335 A CN 202210514335A CN 114913957 A CN114913957 A CN 114913957A
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- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
- G16H20/10—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients
Abstract
The invention discloses a dose adjusting system for reasonable application of antibacterial drugs and a using method thereof, wherein the system comprises an information input unit, a dose adjusting unit and a dose adjusting unit, wherein the information input unit is used for inputting medicine information and acquiring individualized information of a patient aiming at a specified drug; and the task allocation unit comprises a qualitative database, an allocation system and a display system, and the computer acquires corresponding information according to the task allocation of the task allocation unit and further displays corresponding index parameters and operation results on the appearance of the calculator. The system can avoid risks caused by random medication, can predict according to specific dosage and usage of the medicine, and improves medication safety.
Description
The technical field is as follows:
the invention relates to the technical field of medicament dosage, in particular to a dosage adjusting system for reasonable application of an antibacterial medicament and a using method thereof.
Background art:
since the discovery of penicillin by a bacteriologist of fleming in 1928, antibacterial drugs are widely applied to clinic and make great contribution to the healthy life of human beings. However, overuse and misuse of antibiotics inevitably leads to the development of antibiotic resistance. The incidence of continuously high levels of multidrug resistant bacteria (MDR) constitutes a burden on global public health. WHO reports that 70 million people die from drug resistant infections every year worldwide, and that 1000 million people would be expected to die from "superbacteria" by 2050 if no action is taken, resulting in an economic loss of $ 100 trillion. There is a fear that since the 70's of the 20 th century, development of new antibiotics has been reduced with such crisis, and the gap between clinical demand for new antibiotics and discovery and development of new drugs has been increasing. Although we can never forego searching for new antibiotic drugs, we must also firmly focus on protecting our existing drugs. This can be achieved to a certain extent by scientific and rational fine use of existing drugs.
The dosage of the antibacterial drug is too large, and adverse reaction is easily caused by accumulation; the low dosage stimulation easily causes the bacteria to generate drug resistance. Therefore, under the condition of selecting the medicine, the proper dosage is beneficial to safely exerting the curative effect of the medicine. In the prior art, doctors in hospitals have busy work and uneven levels, adverse reactions are caused by excessively large dosage of antibacterial drugs, and poor anti-infection treatment effects are caused by excessively small dosage. In reality, the blood concentration monitoring (TDM) of the rational medicine precise technology is influenced by various factors and is not spread out in a large range.
In view of this, a system is provided which is accurate and can evaluate the liver and kidney functions and adjust the dosage according to the liver and kidney functions, so as to remind the clinical attention of the dosage to become a technical problem to be solved urgently.
The invention content is as follows:
the invention aims to solve the technical problem of providing a dosage adjustment system for reasonable application of antibacterial drugs, which can avoid risks caused by random medication, can predict according to specific dosage and usage of the drugs and improves medication safety.
The technical solution of the present invention is to provide a dose adjustment system for rational application of antibacterial drugs, the system comprising:
an information input unit for drug information input, acquisition of individualized information by the patient for a given drug;
the task allocation unit comprises a qualitative database, an allocation system and a display system, and the computer acquires corresponding information according to the task allocation of the task allocation unit and further displays corresponding index parameters and operation results on the appearance of the calculator (the function without task allocation is not displayed);
the database unit is used for storing the qualitative database distributed by the task distribution unit and a preset dose adjustment database based on the liver and kidney function abnormality;
the liver and kidney function evaluation unit is used for calculating ideal body weight, creatinine clearance rate and Child-Pugh grading score;
the comparison processing unit is used for comparing the result evaluated by the liver and kidney function evaluation unit with a dose adjustment database based on patients with liver and kidney dysfunction;
and a result output unit for outputting the dose of medication.
Preferably, the input mode of the medicine information is order identification or entry.
Preferably, the qualitative database comprises four qualitative databases, wherein the four qualitative databases are not required to be adjusted for liver and kidney functions, only need to be adjusted for liver functions and only need to be adjusted for liver and kidney dysfunction.
Preferably, according to the task allocation of the task allocation unit, the computer acquires corresponding information, and then displays corresponding index parameters and operation results, wherein the corresponding index parameters and the operation results refer to the medicine information input by the information input unit, the task allocation unit allocates comparison tasks, determines whether the medicine needs to be adjusted in dosage according to the allocated comparison tasks, and qualitatively allocates a corresponding qualitative database when the medicine needs to be adjusted in dosage.
Preferably, the modules for calculating the ideal body weight, the creatinine clearance rate and the Child-Pugh grading score are a single calculating module or three independent calculating modules which are independent from each other.
Preferably, the dose adjustment database based on liver and kidney dysfunction is a database preset according to a medicine instruction book, a domestic external medicine guide and medical expert consensus.
Furthermore, the invention also provides a using method of the reasonable application dose adjusting system of the antibacterial drug, which comprises the following steps,
step 1, performing qualitative distribution based on input medicine information;
step 2, carrying out qualitative distribution, and entering the next step if the dosage of the medicine needs to be adjusted; if the dosage of the medicine does not need to be adjusted, the dosage of the medicine is directly output according to the medicine information;
step 3, acquiring individualized information of a patient for a specified drug based on the distributed qualitative database;
step 4, evaluating and calculating the liver and kidney functions of the relevant patients based on the acquired individualized information;
and 5, matching the generated evaluation calculation result with a preset dose adjustment database based on the liver and kidney dysfunction and outputting the medication dose.
Compared with the prior art, the invention has the following advantages after adopting the scheme:
the evaluation and recommendation of the drug dosage are automatically calculated based on the index values of the liver and kidney functions of the patient, a quantitative treatment standard is given, the diagnosis and treatment efficiency is improved, and the burden of doctors is reduced; in addition, the usage amount recommended by a medicine specification and a clinical guideline and common clinical conditions are considered, the individualized recommendation result is comprehensively evaluated and output for clinical reference, and clinical selection and selection can be performed according to actual conditions, so that the flexibility is good; the system can adjust and update the database in real time according to the situation, and has good operability; according to the original intention of individual and refined medication, a reasonable medication thought is penetrated, the user is reminded to pay attention to the medication dosage, and the drug resistance harm and adverse reaction brought by the dosage problem are avoided.
Description of the drawings:
FIG. 1 is a schematic diagram of the system of the present invention;
FIG. 2 is a flow chart of the system of the present invention;
fig. 3 is a schematic diagram of a display interface according to an embodiment of the present invention.
The specific implementation mode is as follows:
the invention will be further described with respect to specific embodiments in conjunction with the following drawings:
as shown in figures 1-3, a dosage adjustment system for rational application of an antimicrobial drug comprises
The information input unit is used for medicine information input and acquisition of individualized information of a patient aiming at a specified medicine, wherein the input mode of the medicine information is medical advice identification or entry;
the task allocation unit comprises a qualitative database, an allocation system and a display system, wherein according to task allocation of the task allocation unit, the computer acquires corresponding information and further displays corresponding index parameters and operation results on the appearance of the calculator (the function without task allocation is not displayed), wherein the qualitative database comprises four qualitative databases, namely, a qualitative database and a quantitative database, wherein, the qualitative databases are not required to be adjusted, and are only required to be adjusted according to renal functions, liver functions and abnormal liver and kidney functions;
the database unit is used for storing a qualitative database distributed by the task distribution unit and a preset dose adjustment database based on liver and kidney dysfunction, and the preset dose adjustment database based on liver and kidney dysfunction is preset according to a medicine specification, a domestic and foreign medication guide and medical expert consensus;
the liver and kidney function evaluation unit is used for calculating ideal body weight, creatinine clearance rate and Child-Pugh grading score;
the comparison processing unit is used for comparing the result evaluated by the liver and kidney function evaluation unit with a dose adjustment database based on patients with liver and kidney dysfunction;
and a result output unit for outputting the dose of medication.
Preferably, the modules for calculating the ideal body weight, creatinine clearance and Child-Pugh grading score are a single calculation module or three independent calculation modules which are independent from each other.
The implementation of the above system is further explained below:
firstly, the system acquires medicine information and individualized information of a patient aiming at a specified medicine, the system carries out qualitative distribution according to four qualitative databases, namely, the liver and kidney functions do not need to be adjusted, the kidney functions only need to be adjusted, the liver functions only need to be adjusted, and the liver and kidney function abnormity all need to be adjusted, when the task distribution database is matched with the liver and kidney functions which do not need to be adjusted, the functions are not activated and are not displayed, and the result, namely, normal dose and dose do not need to be adjusted according to the liver and kidney functions, is directly output. When one of the functional areas is matched to be 'adjustment-free' and the other is matched to be 'adjustment-needed', the next step is carried out, for example, the tasks are distributed to be 'adjustment only according to the renal function' and 'adjustment only according to the hepatic function'. When the two functional areas are matched, namely the liver and kidney dysfunction needs to be adjusted, the next step is carried out, two functional results are displayed, and the results are finally output: ' the patients have abnormal liver and kidney functions, and individual administration and blood concentration monitoring are recommended when necessary.
In the next step, based on the assigned qualitative database, the individualized information of the patient for the specified drug is obtained, including name, hospital number, sex, age, height, weight, renal function index: endogenous creatinine clearance, creatinine, liver function indices: alanine Aminotransferase (ALT), aspartate Aminotransferase (AST), alkaline phosphatase (ALP), r-glutamyl transpeptidase (r-GT), the ratio of ALT/AST, total bilirubin (Tbil), indirect bilirubin (Ibil), serum albumin, prothrombin time, ascites conditions, hepatic encephalopathy conditions.
And evaluating and calculating the liver and kidney functions of related patients through a liver and kidney function evaluation unit based on the acquired individualized information, setting normal reference values for indexes, recommending normal doses for the indexes normally, and marking red and thick abnormal indexes. If the renal function has endogenous creatinine clearance data, the data is preferentially adopted and matched with a database, and a result can be directly obtained; otherwise, the creatinine clearance calculation module is executed. Estimated creatinine clearance (CrCl) was calculated for non-obese and obese patients using different methods.
The specific calculation formula is as follows:
1. ideal body weight:
calculate ideal body weight in kg (IBW):
■ the male: 50kg +2.3 kg/inch (height over 60 inches)
■ female: 45kg +2.3 kg/inch (height over 60 inches)
Obesity is defined as 20% above ideal body weight or Body Mass Index (BMI) > 30
2. Estimation of creatinine clearance
Non-obese patient-
■ calculate ideal body weight in kg (as before)
■ the following formula was used to calculate the estimated creatinine clearance (CrCl)
Obesity patient E-
■ weight more than ideal weight more than 20% or BMI more than 30
■ the estimated CrCl is calculated using the following formula
And matching the creatinine clearance value obtained by calculation with a preset database, and outputting a recommended dose. When the calculated creatinine clearance value is more than or equal to 130mL/min/1.73m 2 Then, the patient is output with suspected renal hyperfunction, and individual administration and concurrent blood concentration monitoring are recommended. "
Among them, liver function damage includes acute liver function damage and chronic liver function damage, and the currently used liver function test cannot fully reflect the metabolic clearance capability of the liver to the drug, and therefore cannot be used as a basis for adjusting the administration scheme. The method for adjusting the dosage of the medicine mainly comprises the following steps:
scoring according to CTP (Child-Pugh grading, see Table 1);
② according to the biochemical index of the patient;
and thirdly, according to the pharmacokinetic parameters.
When the liver function index shows abnormal, the method can remind the patients of not adjusting dosage, avoiding using the patients during the liver diseases and reducing the cautious varieties during the liver diseases and output corresponding results; and evaluating the degree of hypohepatia according to different abnormal liver function indexes. For example, ALT (1000U/L) and AST are remarkably increased, and the AST/ALT ratio is increased, which usually indicates that liver cells are seriously damaged and necrotized. And (4) grading the degree of severity according to an improved Child-Pugh grading standard, and completing data matching of medicine dosage adjustment during severe liver diseases.
The Child-Pugh rating scale is as follows:
wherein, A level: 5-6 min; b stage: 7-9 minutes; c level: 10-15 minutes.
When the final result is output, the critical infection patient with urgent disease is prompted when meeting the conflict of whether the dosage adjustment is needed: "Normal dose ceiling can be used as appropriate".
The invention automatically calculates, evaluates and recommends the drug dosage based on the index values of the liver and kidney functions of the patient, gives quantitative treatment standards, improves the diagnosis and treatment efficiency and lightens the burden of doctors; in addition, the usage amount recommended by a medicine specification and a clinical guideline and common clinical conditions are considered, the individualized recommendation result is comprehensively evaluated and output for clinical reference, and clinical selection and selection can be performed according to actual conditions, so that the flexibility is good; the system can adjust and update the database in real time according to the situation, and has good operability; according to the original intention of individual and refined medication, a reasonable medication thought is penetrated, the user is reminded to pay attention to the medication dosage, and the drug resistance harm and adverse reaction brought by the dosage problem are avoided.
The foregoing is illustrative of the preferred embodiments of the present invention only and is not to be construed as limiting the claims. All the equivalent structures or equivalent process changes made by the description of the invention are included in the scope of the patent protection of the invention.
Claims (7)
1. A dose adjustment system for rational application of antibacterial agents, characterized by: the system comprises
An information input unit for drug information input, acquisition of individualized information by the patient for a given drug;
the task allocation unit comprises a qualitative database, an allocation system and a display system, and the computer acquires corresponding information according to the task allocation of the task allocation unit and further displays corresponding index parameters and operation results;
the database unit is used for storing the qualitative database distributed by the task distribution unit and a preset dose adjustment database based on the liver and kidney function abnormality;
the liver and kidney function evaluation unit is used for calculating ideal body weight, creatinine clearance rate and Child-Pugh grading score;
the comparison processing unit is used for comparing the result evaluated by the liver and kidney function evaluation unit with a dose adjustment database based on patients with liver and kidney dysfunction;
and a result output unit for outputting the dose of medication.
2. A dose titration system for rational use of an antibacterial agent according to claim 1, wherein: the input mode of the medicine information is medical advice identification or entry.
3. A dose titration system for rational use of an antibacterial agent according to claim 1, wherein: according to the task allocation of the task allocation unit, the computer acquires corresponding information, and then displays corresponding index parameters and operation results, wherein the corresponding index parameters and the operation results refer to medicine information input by the information input unit, the task allocation unit allocates comparison tasks, determines whether the medicine needs to be subjected to dose adjustment according to the allocated comparison tasks, and qualitatively allocates a corresponding qualitative database when the medicine dose needs to be adjusted.
4. A dose titration system for rational use of an antibacterial agent according to claim 3, wherein: the qualitative database comprises four qualitative databases which are not required to be adjusted for the functions of the liver and the kidney, only required to be adjusted for the functions of the liver and the kidney and all required to be adjusted for the abnormality of the functions of the liver and the kidney.
5. A dose titration system for rational use of an antibacterial agent according to claim 1, wherein: the module for calculating ideal body weight, creatinine clearance and Child-Pugh grading score is a single calculating module or three independent calculating modules which are independent.
6. A dose titration system for the rational utilization of an antimicrobial according to claim 1, wherein: the dose adjustment database based on the liver and kidney dysfunction is a preset database according to a medicine instruction book, a medication guide and medical expert consensus.
7. Method of use of a dose-modifying system for rational use of an antibacterial drug according to any one of claims 1 to 6, characterized in that: comprises the following steps of (a) carrying out,
step 1, performing qualitative distribution based on input medicine information;
step 2, carrying out qualitative distribution, and entering the next step if the dosage of the medicine needs to be adjusted; if the dosage of the medicine does not need to be adjusted, the dosage of the medicine is directly output according to the medicine information;
step 3, acquiring individualized information of the patient for the specified medicine based on the distributed qualitative database;
step 4, evaluating and calculating the liver and kidney functions of the relevant patients based on the acquired individualized information;
and 5, matching the generated evaluation calculation result with a preset dose adjustment database based on the liver and kidney dysfunction and outputting the medication dose.
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN116779186A (en) * | 2023-08-23 | 2023-09-19 | 寿光市人民医院 | Adenosine cyclophosphate drug data information processing system for arrhythmia patients |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN116779186A (en) * | 2023-08-23 | 2023-09-19 | 寿光市人民医院 | Adenosine cyclophosphate drug data information processing system for arrhythmia patients |
| CN116779186B (en) * | 2023-08-23 | 2023-12-12 | 寿光市人民医院 | Adenosine cyclophosphate drug data information processing system for arrhythmia patients |
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