门急诊中药注射剂的合理用药分析
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摘要
目的报告中药注射剂在门急诊的使用情况,分析其用药合理性及潜在危害。方法查阅我院2013-05-10门急诊病人中药注射剂用药情况,分析其用药的合理性及有潜害的药物配伍情况。参考标准为药物说明书的适应症、用量用法、禁忌及注意事项,《中药注射剂临床使用指导原则》及现有的安全合理用药知识。将中药注射剂与抗菌药物合用判为潜在危害。结果中药注射剂处方占门诊处方的0.67%,占儿科处方的10.3%,占急诊处方的7.9%。从较高水准的合理用药分析,门诊处方中药注射剂合理用药比为66.67%;急诊处方中药注射剂合理用药比为14.0%;儿科处方中药注射剂合理用药比为4.5%。结论中药注射剂不合理使用情况在急诊及儿科病人中较严重,需加强监管以避免药物损害(DII)事件的发生。
Objective To investigate the prescription of traditional Chinese medicine injections in outpatient and emergency departments in order to analyze its rational use and potential hazards.Methods All prescriptions of out-patients on May 10th 2013treated with traditional Chinese medicine injection in our hospital were reviewed.Rational use of traditional Chinese medicine injection and potential hazardous drug compatibility were analyzed with reference to standards including indications,dosage and administration of traditional Chinese medicine injection in package inserts;Clinical Guidelines for Traditional Chinese Medicine Injection and the present knowledge of safe and rational drug use.Results The proportion of traditional Chinese medicine injection prescriptions were 0.67%in outpatient service, 10.3%in pediatric service,and 7.9%in emergency service.Rates of rational use of traditional Chinese medicine injection were 66.7%in routine service,4.5%in pediatric service,14.0%in emergency service. Conclusion The situation of irrational use of traditional Chinese medicine injection was serious in emergency and pediatric services,which must be regulated strictly in order to reduce traditional Chinese medicine injection induced injury.
Objective To investigate the prescription of traditional Chinese medicine injections in outpatient and emergency departments in order to analyze its rational use and potential hazards.Methods All prescriptions of out-patients on May 10th 2013treated with traditional Chinese medicine injection in our hospital were reviewed.Rational use of traditional Chinese medicine injection and potential hazardous drug compatibility were analyzed with reference to standards including indications,dosage and administration of traditional Chinese medicine injection in package inserts;Clinical Guidelines for Traditional Chinese Medicine Injection and the present knowledge of safe and rational drug use.Results The proportion of traditional Chinese medicine injection prescriptions were 0.67%in outpatient service, 10.3%in pediatric service,and 7.9%in emergency service.Rates of rational use of traditional Chinese medicine injection were 66.7%in routine service,4.5%in pediatric service,14.0%in emergency service. Conclusion The situation of irrational use of traditional Chinese medicine injection was serious in emergency and pediatric services,which must be regulated strictly in order to reduce traditional Chinese medicine injection induced injury.
引文
[1]卞兆祥,商洪才,吴泰相,等.中药注射剂不良反应/不良事件的反思[J].中国循证医学杂志,2010,10(2):116-121.
[2]田月洁,李泮海,李彩利.中药注射剂在临床应用中的配伍禁忌概况[J].中国药物警戒,2010,7(2):105-108.
[3]刘洋,朱蓓,郭桂明.178例中药不良反应/事件分析[J].中国药物警戒,2010,7(1):48-51.
[4]关开,姜楠,田原.论中药“毒性”与不良反应的关系[J].亚太传统医药,2010,6(2):96-97.
[5]De Berardis G,Lucisano G,D'Ettorre Antonio,et al.association of aspirin use with major bleeding in patients with and without diabetes[J].JAMA,2012,307(21):2286-2294.
[6]方忠宏,曾宏辉,张军.2例帕珠沙星致药源性损害的用药分析[J].临床药物治疗杂志,2010,8(6):58-59.
[7]杨青,李胡冰.头孢硫脒联合美洛西林静脉滴注诱发EB[J].中国医学论坛报,2012,37(1274):A06-08.
[8]Gruchalla,R S,Pirmohamed M.antibiotic allergy[J].N Engl J Med,2006,354(6):601-609.
[9]Patel RA,Gallagher JC.drug fever[J].Pharmacotherapy,2010,30(1):57-69.
[10]国家药品不良反应信息通报.警惕清开灵注射剂的严重不良反应[J].中国医学论坛报,2009,36(1196):A12-12.
[11]王秀艳.治疗心脑血管疾病常用中药注射液的不良反应[J].中国医药导报,2010,7(8):124-125.
[12]周素娥.静脉注射中药针剂的不良反应及护理[J].中国社区医师,2012,13(1):179-180.
[13]黄振伟.临床常用中药注射液引起的不良反应及预防[J].中国药事,2010,24(2):200-202.
[14]安英子,崔明花.探讨中药注射剂的特点、不良反应原因及其预防[J].中国实用医药,2010,5(4):176-177.
[15]一48岁壮年男性,因感冒就诊用药死亡[EB/OL].[2013-07-10].http://www.sda.gov.cn/WS01/CL0078/38014_1.html.
[16]陈道阳.中药注射剂48例不良反应分析[J].临床医药实践,2010,19(1):109-110.
[17]何陵湘,何莹.5种常用中药注射液不良反应文献分析[J].中国医院用药评价与分析,2010,10(1):65-67.
[18]李廷谦.中药注射剂不良反应及临床合理用药[J].中国循证医学杂志,2010,10(2):111-115.
[2]田月洁,李泮海,李彩利.中药注射剂在临床应用中的配伍禁忌概况[J].中国药物警戒,2010,7(2):105-108.
[3]刘洋,朱蓓,郭桂明.178例中药不良反应/事件分析[J].中国药物警戒,2010,7(1):48-51.
[4]关开,姜楠,田原.论中药“毒性”与不良反应的关系[J].亚太传统医药,2010,6(2):96-97.
[5]De Berardis G,Lucisano G,D'Ettorre Antonio,et al.association of aspirin use with major bleeding in patients with and without diabetes[J].JAMA,2012,307(21):2286-2294.
[6]方忠宏,曾宏辉,张军.2例帕珠沙星致药源性损害的用药分析[J].临床药物治疗杂志,2010,8(6):58-59.
[7]杨青,李胡冰.头孢硫脒联合美洛西林静脉滴注诱发EB[J].中国医学论坛报,2012,37(1274):A06-08.
[8]Gruchalla,R S,Pirmohamed M.antibiotic allergy[J].N Engl J Med,2006,354(6):601-609.
[9]Patel RA,Gallagher JC.drug fever[J].Pharmacotherapy,2010,30(1):57-69.
[10]国家药品不良反应信息通报.警惕清开灵注射剂的严重不良反应[J].中国医学论坛报,2009,36(1196):A12-12.
[11]王秀艳.治疗心脑血管疾病常用中药注射液的不良反应[J].中国医药导报,2010,7(8):124-125.
[12]周素娥.静脉注射中药针剂的不良反应及护理[J].中国社区医师,2012,13(1):179-180.
[13]黄振伟.临床常用中药注射液引起的不良反应及预防[J].中国药事,2010,24(2):200-202.
[14]安英子,崔明花.探讨中药注射剂的特点、不良反应原因及其预防[J].中国实用医药,2010,5(4):176-177.
[15]一48岁壮年男性,因感冒就诊用药死亡[EB/OL].[2013-07-10].http://www.sda.gov.cn/WS01/CL0078/38014_1.html.
[16]陈道阳.中药注射剂48例不良反应分析[J].临床医药实践,2010,19(1):109-110.
[17]何陵湘,何莹.5种常用中药注射液不良反应文献分析[J].中国医院用药评价与分析,2010,10(1):65-67.
[18]李廷谦.中药注射剂不良反应及临床合理用药[J].中国循证医学杂志,2010,10(2):111-115.