某院门诊患者胺碘酮与他汀类药物潜在代谢性相互作用处方分析  

Analysis of the outpatient prescriptions of potential metabolic interactions between amiodarone and statins

作　　者：曹迪[1] 王兆斌[1] 程军[1] CAO Di;WANG Zhao-bin;CHENG Jun(Department of Pharmacy,the Third People′s Hospital of Bengbu,Bengbu 233000,China)

机构地区：[1]蚌埠市第三人民医院药学部,安徽蚌埠233000

出　　处：《实用药物与临床》2021年第8期738-741,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的分析门诊患者胺碘酮与他汀类药物合用处方中潜在的代谢性药物相互作用(pDDIs),提高药物联合使用的合理性、安全性。方法应用医院合理用药软件调取2017年1月至2020年5月门诊所有胺碘酮与他汀类联合用药处方,基于Micromedex药物相互作用数据库,对胺碘酮联合他汀类处方中的pDDIs进行鉴别及严重性分级,搜集相关数据库收载的胺碘酮与他汀类药物相互作用致不良反应个案报道进行系统性分析。结果共收集到胺碘酮与他汀类合用处方243张,发生pDDIs处方174张(占71.6%),其中辛伐他汀16张,阿托伐他汀158张,严重性分级分别为“Major(B)”、“Moderate(C)”。检索出胺碘酮与他汀类药物相互作用致不良反应个案报道14例,其中横纹肌溶解10例、肝功能损害4例。结论我院胺碘酮与他汀类药物存在pDDIs,虽无超限定日剂量使用,但存在联用第二种CYP3A4抑制剂情况,需要加强监测和干预,以提高药物治疗的安全性。Objective To analyze the potential metabolic drug interactions(pDDIs)occurring in outpatient prescriptions for combination use of amiodarone and statins,and improve the rationality and safety of drug combination.Methods All the outpatient prescriptions of amiodarone and statins from January 2017 to May 2020 were retrieved from the rational drug use software of the hospital.Based on the Micromedex drug interaction database,pDDIs in prescriptions for combination use of amiodarone and statins were identified and the severity was graded.Case reports of adverse reactions caused by the interaction of amiodarone and statins from related databases were collected and analyzed systematically.Results Totally 243 prescriptions for combination use of amiodarone and statins were collected.There were 174 prescriptions concerning pDDIs(71.6%),including 16 prescriptions of simvastatin and 158 prescriptions of atorvastatin,while the severity grade was“Major(B)”and“Moderate(C)”respectively.Fourteen cases of adverse reactions caused by the interaction of amiodarone and statins were retrieved,including 10 cases of rhabdomyolysis and 4 cases of liver damage.Conclusion There are pDDIs in combination use of amiodarone and statins in this hospital.Although there is no over-limit daily dose,the combination use of the second CYP3A4 inhibitor requires enhanced monitoring and intervention,so as to improve the safety of drug treatment.

关 键 词：胺碘酮 他汀类药物 药物相互作用 

分 类 号：R969.2[医药卫生—药理学]