临床药师参与抗肿瘤辅助用药医嘱审核及干预效果分析  

Participation of Clinical Pharmacists in Medical Order Check and Effect Analysis of Anti-tumor Adjuvant Medication

作　　者：贾立华[1] 赵振满[1] 贾娜娜[1] 曲恒燕[1] 刘泽源[1] 

机构地区：[1]解放军第307医院药学部,北京100071

出　　处：《中国药房》2013年第39期3739-3742,共4页China Pharmacy

摘　　要：目的:促进抗肿瘤辅助用药的规范性、安全性和经济性。方法:回顾性分析某院2011年12月至2012年11月开展抗肿瘤辅助用药医嘱专项点评中发现的主要问题,通过临床药师查房宣教的形式对部分典型问题加以干预,评价该类药在临床应用中的潜在风险和经干预后的效果。结果与结论:该院抗肿瘤辅助用药中应用范围最广的是中药注射剂和免疫增强剂,其中审核医嘱问题出现较多的分别为小牛脾提取物注射液、马来酸桂哌齐特注射液、大株红景天注射液和香菇多糖注射液,问题医嘱比例分别为100.00%、98.81%、93.33%和74.25%。存在的主要问题是给药途径不适宜、适应证不明确、给药剂量偏大、出现配伍禁忌等,其中香菇多糖注射液超剂量和给药频次的问题通过临床药师持续干预得到有效改善。肿瘤治疗中辅助用药目前尚缺少客观和系统的评价依据,临床药师应协助医师查找循证证据,客观评价用药合理性,逐步规范辅助用药行为,以规避用药风险。OBJECTIVE： To promote the standardization, security and economy of anti-tumor adjuvant medication. METH- ODS： Main problems of special evaluation of anti-tumor adjuvant medication in a hospital from Dec. 2011 to Nov. 2012 were ana- lyzed respectively. Clinical pharmacists intervened in the typical problems through the ward inspection. The potential risk of anti-tu- mor agents and the effects of intervention were evaluated. RESULTS＆CONCLUSIONS ： Among anti-tumor agents, TCM injections and immune enhancer are widely applied in the hospital. Drugs which have many problems in medical order checking were Calf spleen extract injection, Cinepazide maleate injection, Sofren injection and Lentinan injection. The proportions of problem prescrip- tions are 100.00 %, 98.81%, 93.33 % and 74.25 % respectively. Main problems include unsuitable route of administration, unclear indication, high drug dose and incompatible drug use, etc. During the application of Lentinan injection, super dose and frequency of delivery problems have been improved effectively by continuous intervention of clinical pharmacists. Objective and system evalua- tion of anti-tumor adjuvant medication is still lacked, but clinical pharmacists should assist the doctor to find evidence of evi- dence-based medicine, evaluate the rationality of drug use objectively and standardize medication behavior so as to avoid the risk of drug use.

关 键 词：抗肿瘤辅助用药 审核 评价 干预 

分 类 号：R969.3[医药卫生—药理学] R952[医药卫生—药学]