精神专科医院齐拉西酮速效针剂的超说明书用药调查  

A survey of the off-label use of the intramuscular ziprasidone in a psychiatric hospital

作　　者：杨欣湖 郑伟[2] 张帆[2] 周燕玲[2] 王怀坤 段炼[2] 蓝晓嫦[2] 黄雄[2] 范妮[2] 宁玉萍[2,3] YANG Xin-hu;ZHENG Wei;ZHANG Fan;ZHOU Yan-ling;WANG Huai-kun;DUAN Lian;LAN Xiao-chang;HUANG Xiong;FAN Ni;NING Yu-ping(The Affiliated Brain Hospital of Guangzhou Medical University,Guangzhou 510370,China)

机构地区：[1]广州医科大学,510370 [2]广州医科大学附属脑科医院,广东省精神疾病转化医学工程技术研究中心 [3]南方医科大学第一临床医学院

出　　处：《临床精神医学杂志》2021年第5期361-364,共4页Journal of Clinical Psychiatry

基　　金：广东省科技计划项目(2019B030316001);广州市医学重点学科(2021-2023)。

摘　　要：目的:了解齐拉西酮速效针剂的超说明书用药情况,分析其处方特征,为制订齐拉西酮速效针剂使用规范以及相关专家共识提供参考依据。方法:通过电子病历系统收集2019年广州医科大学附属脑科医院(广州市惠爱医院)使用过齐拉西酮速效针剂的患者相关信息,以药品说明书为依据判断超说明书用药情况,进行统计分析。结果:共收集426例患者,其中有370例(86.85%)为超说明书用药,最主要的超说明用药类型为超适应证(90.00%)。使用齐拉西酮速效针剂的患者中,年龄≤17岁有47例(11.00%),≥65岁有3例(0.70%);用药日剂量>40 mg有3例(0.70%);用药疗程>3 d有35例(8.22%);诊断分布为心境/情感障碍[包括双相障碍(53.76%)、躁狂发作(16.67%)],其次为精神分裂症(14.79%)及使用精神活性物质所致的精神和行为障碍(7.75%)等。结论:我院齐拉西酮速效针剂超说明书用药现象较为普遍,主要集中在超适应证方面,在临床治疗中存在一定的合理性和必要性,同时也需要进行规范。Objective:To investigate the status of the off-label use of intramuscular ziprasidone,so as to provide the basis for establishing the off-label use norm and expert consensus.Method:The information of patients who took intramuscular ziprasidone was collected from Electronic Medical Record System in 2019 in the Affiliated Brain Hospital of Guangzhou Medical University(Guangzhou Huiai Hospital).The off-label drug use was judged based on the drug instructions.Data was analyzed by the prospectus.Results:A total of 426 patients were collected,in which 370 patients(86.85%)were in the situation of off-label use.The main categories of off-label use were beyond indications(90.00%).There were 47 patients who were less than 17 years old,accounting for 11.00%,only 3 patients whose age were over 65 years old,accounting for 0.70%.As for daily dose,3 patients(0.7%)used drugs over 40 mg per day,35 patients(8.22%)who was prescribed over 3 days.The diagnoses were mood disorder[including bipolar disorder(53.76%),manic episode(16.67%)],schizophrenia(14.79%)and psychoactive substance-induced disorders(7.75%).Conclusion:Off-label use is common in patients prescribed intramuscular ziprasidone in the psychiatric hospital and the primary category of off-label use is about indications.To a certain extent,it's reasonable and imperative in the clinical therapeutics.Meanwhile,it should be normalized.

关 键 词：齐拉西酮速效针剂 超说明用药 合理用药 

分 类 号：R749[医药卫生—神经病学与精神病学]