神经内科超说明书用药循证医学甄鉴
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摘要
为了解某院神经内科超说明书用药情况和用药合理性,选取该院神经内科病区2016年6月~2016年12月共2988条长期医嘱,进行超说明书用药循证依据分析。结果发现神经内科超说明书用药均有循证医学证据支持,但证据质量存在差异。建议在实际应用中应充分评估超说明用药的有效性和安全性,尽量规避风险。
To investigate the rationality of off-label drug use in the department of neurology in a hospital, totally 2988 inpatient medication orders selected from June 2016 to December 2016 were analyzed. The rationality of the off-label drug use was evaluated according to evidence-based medical proofs. It was found that all the off-label uses of medications in neurology inpatients had evidence-based supports. But the varying quality of those evidences should not be neglected. In practice, the rationality and effectiveness of off-label use should be fully evaluated to avoid or minimize risks.
To investigate the rationality of off-label drug use in the department of neurology in a hospital, totally 2988 inpatient medication orders selected from June 2016 to December 2016 were analyzed. The rationality of the off-label drug use was evaluated according to evidence-based medical proofs. It was found that all the off-label uses of medications in neurology inpatients had evidence-based supports. But the varying quality of those evidences should not be neglected. In practice, the rationality and effectiveness of off-label use should be fully evaluated to avoid or minimize risks.
引文
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[9]中华医学会疼痛学分会头面痛学组,中国医师协会神经内科医师分会,疼痛和感觉障碍专委会.中国偏头痛防治指南[J].中国疼痛医学杂志,2016,22(10):721-7.
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[11]Choi KH,Park MS,Kim HS,et al.Alpha-lipoic acid treatment is neurorestorative and promotes functional recovery after stroke in rats[J].Mol Brain,2015,8:9.
[12]Shibuya M,Hirai S,Seto M.Effects of fasudil in acute ischemic stroke:results of a prospective placebocontrolled double-blind trial[J].J Neurol Sci,2005,238(1-2):31-9.
[13]王强,张玉萍,詹媛.丹参多酚酸盐注射液治疗急性脑梗死的临床疗效观察[J].临床合理用药,2016,9(14):29-30.
[2]中国药理学会治疗药物监测研究专业委员会药品风险管理学组.超说明书用药专家共识[J].药物不良反应杂志,2015,17(2):101-3.
[3]中国免疫学会神经免疫学分会.中国视神经脊髓炎谱系病诊断与治疗指南[J].中国神经免疫学和神经病学杂志,2016,23(3):155-66.
[4]Sellner J,Boggild M,Clanet M,et al.EFNS guidelines on diagnosis and management of neuromyelitis optica[J].Eur J Neurol,2010,17(8):1019-32.
[5]中华医学会神经病学分会神经免疫学组,中国免疫学会神经免疫学分会.中国重症肌无力诊断和治疗指南[J].中华神经科杂志,2015,48(11):934-40.
[6]Sussman J,Farrugia ME,Maddison P,et al.Myasthenia gravis:Association of British Neurologists’Management Guidelines[J].Pract Neurol,2015,15(3):199-206.
[7]Nosadini M,Mohammad SS,Ramanathan S,et al.Immune therapy in autoimmune encephalitis:a systematic review[J].Expert Rev Neurother,2015,15(12):1391-419.
[8]Centre for Clinical Practice at NICE(UK).Neuropathic Pain:The Pharmacological Management of Neuropathic Pain in Adults in Non-specialist Settings[DB/OL].London:National Institute for Health and Care Excellence,2013.https://www.guidance.nice.org.uk/cg173
[9]中华医学会疼痛学分会头面痛学组,中国医师协会神经内科医师分会,疼痛和感觉障碍专委会.中国偏头痛防治指南[J].中国疼痛医学杂志,2016,22(10):721-7.
[10]Soliven B,Rezania K,Gundogdu B,et al.Terbutaline in myasthenia gravis:A pilot study[J].J Neurol Sci,2009,277(1-2):150-4.
[11]Choi KH,Park MS,Kim HS,et al.Alpha-lipoic acid treatment is neurorestorative and promotes functional recovery after stroke in rats[J].Mol Brain,2015,8:9.
[12]Shibuya M,Hirai S,Seto M.Effects of fasudil in acute ischemic stroke:results of a prospective placebocontrolled double-blind trial[J].J Neurol Sci,2005,238(1-2):31-9.
[13]王强,张玉萍,詹媛.丹参多酚酸盐注射液治疗急性脑梗死的临床疗效观察[J].临床合理用药,2016,9(14):29-30.