3380例心内科住院患者注射用质子泵抑制剂应用合理性分析
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摘要
目的:了解南通大学附属医院(以下简称"我院")心内科住院患者注射用质子泵抑制剂使用的合理性,为促进临床合理用药提供参考。方法:从医院信息系统中筛选出2016年7月至2018年6月我院心内科3 380例使用注射用质子泵抑制剂的住院患者病历,对注射用质子泵抑制剂的用法与用量、溶剂选择及疗程等进行统计分析,评估用药合理性。结果:3 380例患者中,使用注射用泮托拉唑钠(80 mg)的患者有3 165例(占93.64%),使用注射用艾司奥美拉唑钠(40 mg)患者有215例(占6.36%);不合理用药812例(占24.02%),主要为用药疗程不合理(430例,占12.72%),其次为用药指征不明确(277例,占8.20%)、用法与用量不合理(63例,占1.86%)和存在药物相互作用(42例,占1.24%)。结论:我院心内科住院患者注射用质子泵抑制剂的使用仍存在一些问题,需进一步提高用药合理性。
OBJECTIVE: To investigate the application rationality of proton pump inhibitors in inpatients in department of cardiology from Affiliated Hospital of Nantong University(hereinafter referred to as "our hospital"), so as to provide reference for the rational drug application in clinic. METHODS: From the hospital information system, the medical records of 3 380 inpatients with application of proton pump inhibitors for injection in department of cardiology of our hospital from Jul. 2016 to Jun. 2018 were selected. The usage, dosage, solvent selection and treatment course of proton pump inhibitors for injection were statistically analyzed to evaluate the rationality of drug application. RESULTS: Of the 3 380 patients, 3 165 cases(93.64%) were treated with pantoprazole sodium for injection(80 mg), and 215 cases(6.36%) received esomeprazole sodium for injection(40 mg). Totally 812 cases(24.02%) were irrational drug application, mainly performed as irrational drug treatment course(430 cases, 12.72%), followed by unclear indications(277 cases, 8.20%), improper usage and dosage(63 cases, 1.86%) and drug interactions(42 cases, 1.24%). CONCLUSIONS: There are still some problems in the application of proton pump inhibitors for injection in department of cardiology of our hospital, which need to be further improved.
OBJECTIVE: To investigate the application rationality of proton pump inhibitors in inpatients in department of cardiology from Affiliated Hospital of Nantong University(hereinafter referred to as "our hospital"), so as to provide reference for the rational drug application in clinic. METHODS: From the hospital information system, the medical records of 3 380 inpatients with application of proton pump inhibitors for injection in department of cardiology of our hospital from Jul. 2016 to Jun. 2018 were selected. The usage, dosage, solvent selection and treatment course of proton pump inhibitors for injection were statistically analyzed to evaluate the rationality of drug application. RESULTS: Of the 3 380 patients, 3 165 cases(93.64%) were treated with pantoprazole sodium for injection(80 mg), and 215 cases(6.36%) received esomeprazole sodium for injection(40 mg). Totally 812 cases(24.02%) were irrational drug application, mainly performed as irrational drug treatment course(430 cases, 12.72%), followed by unclear indications(277 cases, 8.20%), improper usage and dosage(63 cases, 1.86%) and drug interactions(42 cases, 1.24%). CONCLUSIONS: There are still some problems in the application of proton pump inhibitors for injection in department of cardiology of our hospital, which need to be further improved.
引文
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[4] 白荷荷,聂晓静,王金萍,等.住院患者预防使用质子泵抑制剂的合理性评价[J].临床药物治疗杂志,2017,15(7):30-34.
[5] 抗血小板药物消化道损伤的预防和治疗中国专家共识组.抗血小板药物消化道损伤的预防和治疗中国专家共识(2012更新版)[J].中华内科杂志,2013,52(3):264-270.
[6] 柏蓉,张晓兰,鲍丽琴,等.制定注射用质子泵抑制剂药物利用评价标准评析预防应激性溃疡用药的合理性[J].药学与临床研究,2016,24(6):472-474.
[7] 王燕.某三甲医院住院患者质子泵抑制剂合理使用情况分析[J].中国药事,2016,30(8):827-831.
[8] 李春红.我院病区质子泵抑制剂使用合理性分析[J].海峡药学,2016,28(6):223-225.
[9] Yu LY,Sun LN,Zhang XH,et al.A review of the novel application and potential adverse effects of proton pump inhibitors[J].Adv Ther,2017,34(5):1070-1086.
[10] Ito T,Jensen RT.Association of long-term proton pump inhibitor therapy with bone fractures and effects on absorption of calcium,vitamin B12,iron,and magnesium[J].Curr Gastroenterol Rep,2010,12(6):448-457.
[11] Craig DG,Thimappa R,Anand V,et al.Inappropriate utilization of intravenous proton pump inhibitors in hospital practice—a prospe-ctive study of the extent of the problem and predictive factors[J].QJM,2010,103(5):327-335.
[12] Freedberg DE,Kim LS,Yang YX.The risks and benefits of long-term use of proton pump inhibitors:Expert review and best practice advice from the American Gastroenterological Association[J].Gastroenterology,2017,152(4):706-715.
[13] 高云玲,刘家宜,陈素卿.我院质子泵抑制剂用药分析及合理使用探讨[J].中国药物滥用防治杂志,2014,20(4):195-197,212.
[14] 冯美蓉,姜葵,吕宗舜,等.氯吡格雷联用质子泵抑制剂对心血管事件影响的Meta分析[J].临床荟萃,2012,27(2):108-113.
[15] 秦秀兰,温悦,孟德胜.某综合性三甲医院门急诊患者质子泵抑制剂应用分析[J].中国医院用药评价与分析,2011,11(7):595-598.
[2] 王国建,陈建.质子泵抑制剂过度使用常见不良事件的循证评价[J].中国医院药学杂志,2013,33(11):919-922.
[3] Bourne C,Charpiat B,Charhon N,et al.Emergent adverse effects of proton pump inhibitors[J].Presse Med,2013,42(2):e53-e62.
[4] 白荷荷,聂晓静,王金萍,等.住院患者预防使用质子泵抑制剂的合理性评价[J].临床药物治疗杂志,2017,15(7):30-34.
[5] 抗血小板药物消化道损伤的预防和治疗中国专家共识组.抗血小板药物消化道损伤的预防和治疗中国专家共识(2012更新版)[J].中华内科杂志,2013,52(3):264-270.
[6] 柏蓉,张晓兰,鲍丽琴,等.制定注射用质子泵抑制剂药物利用评价标准评析预防应激性溃疡用药的合理性[J].药学与临床研究,2016,24(6):472-474.
[7] 王燕.某三甲医院住院患者质子泵抑制剂合理使用情况分析[J].中国药事,2016,30(8):827-831.
[8] 李春红.我院病区质子泵抑制剂使用合理性分析[J].海峡药学,2016,28(6):223-225.
[9] Yu LY,Sun LN,Zhang XH,et al.A review of the novel application and potential adverse effects of proton pump inhibitors[J].Adv Ther,2017,34(5):1070-1086.
[10] Ito T,Jensen RT.Association of long-term proton pump inhibitor therapy with bone fractures and effects on absorption of calcium,vitamin B12,iron,and magnesium[J].Curr Gastroenterol Rep,2010,12(6):448-457.
[11] Craig DG,Thimappa R,Anand V,et al.Inappropriate utilization of intravenous proton pump inhibitors in hospital practice—a prospe-ctive study of the extent of the problem and predictive factors[J].QJM,2010,103(5):327-335.
[12] Freedberg DE,Kim LS,Yang YX.The risks and benefits of long-term use of proton pump inhibitors:Expert review and best practice advice from the American Gastroenterological Association[J].Gastroenterology,2017,152(4):706-715.
[13] 高云玲,刘家宜,陈素卿.我院质子泵抑制剂用药分析及合理使用探讨[J].中国药物滥用防治杂志,2014,20(4):195-197,212.
[14] 冯美蓉,姜葵,吕宗舜,等.氯吡格雷联用质子泵抑制剂对心血管事件影响的Meta分析[J].临床荟萃,2012,27(2):108-113.
[15] 秦秀兰,温悦,孟德胜.某综合性三甲医院门急诊患者质子泵抑制剂应用分析[J].中国医院用药评价与分析,2011,11(7):595-598.