文成镇中心卫生院培训课件范文.doc

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1、文成镇中心卫生院2012年版国家基本药物应用指南及处方集培训课件（二）抗生素合理应用主讲人：李加武主治医师医疗机构是药品流通的终端环节，是人们看病用药的主要场所。药物治疗是整个医疗活动最重要的部分，药品安全贯穿药品使用的始终。喹诺酮类光线促进了药物的自动氧化Ø光线促使药物差向异构化变质Ø光线加速药物的聚合变质Ø光线可促成药物水解变质?化脓性咽炎、扁桃体炎的抗菌物选择β-内酰胺类抗菌药物n青霉素类n头孢菌素类n头霉素类n单酰胺类n氧头孢烯类nβ-内酰胺酶抑制剂n碳青霉烯类β-内酰胺类抗菌药物的共同特性n结构上均具有β-内酰胺环n杀菌剂n多数品种半衰期1h左右，需每日多次给药n临床应用指征广

2、，可用于各类细菌性感染n多数品种不良反应少，必要时可大剂量给药n相同特性品种间存在交叉耐药β-内酰胺类抗菌药物的不同特性n分为多个亚类，各亚类内品种间抗菌谱也不完全相同，如第三代头孢菌素间的抗菌谱不同；n各品种的代谢、排泄途径不同，在脏器功能不全等特殊人群需作不同的剂量调整；n各品种间不良反应不同。特点:n杀菌作用强、毒性低n新品种抗菌谱广、价廉n青霉素G大剂量CSF浓度高n过敏反应率高青霉素类不耐酶青霉素青霉素G不耐酶青霉素n青霉素V耐酶青霉素常用品种：苯唑西林、氯唑西林、氟氯西林、萘夫西林抗菌作用：想到这里，他立即带上两个测工，肩扛手拎着仪器，硬是徒步走到了现场。sectionoft

3、heDepartmentofprojectmanagement;Projectdocumentsandinformation:ProjectEngineeringDepartment;Materialsandequipment:materialsupplyprojects;Securitycontrols:theprojectDepartmentofsafetyandsecurity;Constructionmachinery:ProjectEngineeringDepartment;Financial:ProjectManagementDepartmentoffinance;Secur

4、ityandfireservices:projectsecurity.3.3.5managementrepresentativeandprojectmanagerinthisitemspecifiesthattheChiefEngineeristhemanagementrepresentative,responsiblefortheoperationofqualitymanagementsystemandsupervision,regardlessofhowhisotherresponsibilities,shouldhaveaclearmandateto:ensurethatthequ

5、alitymanagementsystemisimplementedandmaintained;Therunningofthequalitymanagementsystemtotheprojectmanager,includingneededimprovements;Alwaysbeawarethatthecustomer'sneedsandrequirements.3.43.4.1projectmanagementreviewshouldbeanannualreviewofitsqualitymanagementsystemtoensureitscontinuingsuitabilit

6、y,adequacyandeffectiveness.3.4.2Administrationreviewbytheprojectmanagerresponsiblefororganizationandimplementation,projectqualitycontrolDepartmentisresponsibleforspecifictasks.3.4.3themanagementreviewshouldcompareandevaluatethefollowinginput:internalandexternalqualityauditsandcorrectiveeffect;Cus

7、tomerfeedbackontheconstruction,installation,commissioning,serviceinformation(complaintsandsatisfaction);Qualityrecords,qualitycompliancewithtrendreports,analysisofresults;Combinedwiththequalitypolicyandtheachievementof