伊伐布雷定临床应用合理性和安全性分析  

Rationality and safety evaluation on the clinical application of ivabradine

作　　者：罗柳金[1] 尤俊文 张其爱 曾彩芳[1] LUO Liu-jin;YOU Jun-wen;ZHANG Qi-ai;ZENG Cai-fang(Department of Pharmacy,Second Affiliated Hospital,Guangzhou Medical University,Guangdong Guangzhou 510000,China;School of Pharmaceutical Sciences,Guangzhou Medical University,Guangdong Guangzhou 510000,China)

机构地区：[1]广州医科大学附属第二医院药学部,广东广州510000 [2]广州医科大学药学院,广东广州510000

出　　处：《中国医院药学杂志》2021年第21期2217-2221,共5页Chinese Journal of Hospital Pharmacy

基　　金：广州医科大学2020年度校级大学生实验室开放项目(编号:0506309)。

摘　　要：目的:调查住院患者接受伊伐布雷定治疗的情况,了解该药的应用现状和不良反应并分析其危险因素,为规范其临床合理应用提供依据。方法:汇总国内外伊伐布雷定相关指南、文献和专家共识,形成伊伐布雷定临床应用的合理性评价标准,回顾性调查广州医科大学附属第二医院2020年上半年住院患者中使用伊伐布雷定的病例,按照已制订的评价标准进行合理性和安全性分析,并提出合理化用药建议。结果:2020年上半年共有173例患者应用了伊伐布雷定,其中有效病例169例,不合理使用病例共81例,不合理使用率达47.93%,以用法用量不适宜和特殊人群用药不合理为主要原因;不良反应共5例,发生率为2.96%,以心房颤动、窦性心动过缓和房室传导阻滞等不良反应为主;临床使用期间应多关注患者的血压和心电监护指标,关注伊伐布雷定的用法用量、特殊人群用药和不良反应等方面。结论:伊伐布雷定减慢心率的作用在临床应用越来越普遍,针对其不合理应用情况和不良反应事件,临床药师应密切留意伊伐布雷定临床指南和专家共识等最新信息,制定合理性评价标准和用药建议,做到实时点评和加强医患沟通,促进伊伐布雷定的合理使用。OBJECTIVE To explore the treatment of ivabradine in hospitalized patients to understand the status quo and its adverse reactions and analyze its risk factors to provide rationales for regulating its rational clinical application.METHODS The relevant guidelines,literatures and expert consensus of ivabradine at home and abroad were summarized for formulating the standard of clinical application of ivabradine.Also the applications of ivabradine in 173 hospitalized patients at Second Affiliated Hospital of Guangzhou Medical University in the first half of 2020 were retrospectively reviewed.Established evaluation criteria were utilized for analyzing its rationality and safety and proposing reasonable medication advices.RESULTS Among them,169 patients were actually analyzed.A total of 81 cases and 47.93%of application were irrational.The major reasons were improper usage/dosage and special groups.Furthermore,the incidence of adverse reactions was 2.96%(n=5),including atrial fibrillation,sinus bradycardia and atrioventricular block.More attention should be paid to monitoring the parameters of blood pressure and electrocardiography(ECG),usage/dosage of ivabradine,dosing of special groups and adverse reactions.CONCLUSION The effect of ivabradine on slowing heart rate is becoming more and more common in clinical applications.Because of unreasonable dosing and adverse events,clinical pharmacists should pay close attention to the latest information such as the clinical guidelines and expert consensus of ivabradine,formulating rationality evaluation standards and medication recommendations,conducting real-time evaluations and strengthening physician-patient communications to promote the rational use of ivabradine.

关 键 词：伊伐布雷定 评价标准 不良反应 

分 类 号：R972.32[医药卫生—药品]