多种微量元素注射液相关药品不良反应及联合用药中配伍禁忌分析与预防策略  

Analysis and Prevention Strategies of Adverse Drug Reactions Related to Multi-Trace Elements Injection and Incompatibility in Drug Combination

作　　者：庞国勋[1] 闫彬 靳会欣[1] PANG Guoxun;YAN Bin;Jin Huixin(Dept.of Pharmacy,Hebei General Hospital,Hebei Shijiazhuang 050000,China)

机构地区：[1]河北省人民医院药学部,河北石家庄050000

出　　处：《中国医院用药评价与分析》2021年第7期881-885,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：2019年度河北省医学科学研究课题(No.20190201)。

摘　　要：目的:了解多种微量元素注射液相关药品不良反应(adverse drug reaction,ADR)及联合用药中的配伍禁忌,探讨预防策略,以期为该药的临床应用及药品说明书修订提供参考。方法:检索中国知网、万方数据库以及维普数据库,检索时间段为2007—2020年,纳入多种微量元素注射液相关ADR及联合用药中配伍禁忌的文献报道,进行整理分析。结果:共检索到相关文献53篇,其中多种微量元素注射液致ADR文献8篇(1篇为多病例报告,7篇为个案报告),联合用药中配伍禁忌相关文献45篇。所有ADR均为静脉滴注给药,除1例使用果糖注射液作为溶剂且多种微量元素注射液浓度较高之外,其余患者均按照药品说明书中规定的正常用法与用量用药,滴注速度亦符合要求;多病例报告中,多种微量元素注射液致ADR发生在输注开始后15 min左右,9例个案报告中,6例(占66.67%)ADR发生于给药后1~6 h;ADR的临床表现包括血管局部疼痛明显,血管呈条索状内陷、闭塞且周围皮肤痛感明显,输注部位红肿、疼痛、硬结,静脉炎,输液反应和皮肤坏死等;所有ADR预后基本良好,未出现严重的ADR及死亡病例。多种微量元素注射液(Ⅱ)与多种药物存在配伍禁忌。结论:多种微量元素注射液的ADR发生率不高,以静脉炎为主;ADR、配伍禁忌的发生与溶剂选择、输注速度、输注顺序和用药监护等诸多因素有关,临床应用时,应严格遵照药品说明书的用法、用量及注意事项,尽量单独、缓慢滴注,并加强用药监护,确保用药安全。目前,多种微量元素注射液致ADR以及配伍禁忌的报道多来自于临床一线护理人员,其物质基础和作用机制尚需药学专业人员进一步研究。OBJECTIVE:To investigate the adverse drug reaction(ADR)related to multi-trace element injection and and incompatibility in drug combination,and to discuss the prevention strategies,so as to provide reference for the clinical application of the drug and the revision of drug instructions.METHODS:CNKI,Wanfang database and VIP database were retrieved,the retrieval time was from 2007 to 2020.Literature with ADR related to multi-trace element injection and incompatibility in drug combination were extracted and analyzed.RESULTS:A total of 53 relevant literature were retrieved,including 8 literature with ADR induced by multi-trace element injection(1 for multiple case report,7 for case report),and 45 literature with incompatibility of drug combination.All ADR were administered by intravenous drip.Except for one case with fructose injection as the solvent and the high concentration of multi-trace element injection,the rest of the patients were administered in accordance with the normal usage and dosage specified in the drug instructions,and the drip rate also met the requirements.In multiple case reports,ADR induced by multi-trace element injection occurred about 15 min after the start of the infusion.In 9 case reports,6 cases(66.67%)of ADR occurred 1 to 6 h after administration.The clinical manifestations of ADR included localized pain in the blood vessels,streak-like invagination,occlusion and pain in the surrounding skin,redness,swelling,pain and stiffness at the infusion site,phlebitis,infusion reaction and skin necrosis.The prognosis of all ADR was basically good,and no severe ADR or death cases were found.There were contraindications in the compatibility of multi-trace element injection(Ⅱ)and a variety of drugs.CONCLUSIONS:The incidence of ADR for multi-trace element injection is not high,mainly for phlebitis.The occurrence of ADR and contraindications is related to many factors such as solvent selection,infusion speed,infusion sequence and medication monitoring.In clinical application,the usage,dosage and precaut

关 键 词：多种微量元素注射液 药品不良反应 配伍禁忌 预防策略 

分 类 号：R97[医药卫生—药品]