静脉用药集中调配中心的细胞毒性药物管理分析  

Analysis on the management of cytotoxic drugs in the pharmacy intravenous admixture services

作　　者：平慧[1] 许艳[1] PING Hui;XU Yan(Department of Pharmacy,Changshu Second People's Hospital,Changshu 215500,China)

机构地区：[1]江苏省常熟市第二人民医院药学部,215500

出　　处：《中国现代药物应用》2022年第12期164-167,共4页Chinese Journal of Modern Drug Application

摘　　要：目的分析本院静脉用药集中调配中心(PIVAS)细胞毒性药物管理情况,并总结拟定相对应的管理措施。方法PIVAS细胞毒性药物用药医嘱5732份,通过查阅医院信息系统收集药师审核相关信息,查阅“用药错误记录本”收集其他工作环节执行信息,记录处方错误与调配错误情况。结果在5732份细胞毒性药物用药医嘱中共发生用药错误18份(0.31%),均为处方开具错误,分别为溶媒使用量不适、药物使用浓度不当、处方不完整,但均有审方药师审核出,并未发生伤害,属于A级错误。在18份用药错误医嘱中,溶媒使用量不适12份(66.67%),药物使用浓度不当5份(22.77%),处方不完整1份(5.56%)。用药错误排名前5位药物依次为注射用环磷酰胺10份(55.56%)、注射用紫杉醇(白蛋白结合型)3份(16.67%)、注射用吉西他滨2份(11.11%)、依托泊苷注射液2份(11.11%)、注射用培美曲塞1份(5.56%),以溶媒使用量不适和药物使用浓度不当为主。结论PIVAS细胞毒性药物管理差错时有发生,均为A级错误以给药剂量和浓度不当为主,其药物主要发生在注射用环磷酰胺、注射用紫杉醇(白蛋白结合型)、注射用吉西他滨、依托泊苷注射液、注射用培美曲塞中,因此,加强细胞毒性药物管理,积极提高医护人员防护,确保临床用药安全及有效尤为重要。Objective To analyze the management of cytotoxic drugs in the pharmacy intravenous admixture services(PIVAS),and summarize and formulate the corresponding management measures.Methods There were 5732 medical orders for cytotoxic drugs in PIVAS.Collected pharmacist review related information by consulting the hospital information system,and checked the"medication error record book"to collect other work link execution information,and recorded prescription errors and allocation errors.Results A total of 18 medication errors(0.31%)occurred in 5732 medical prescriptions for cytotoxic drugs,all of which were prescription errors,namely,inappropriate dosage of solvents,inappropriate concentration of medication,and incomplete prescriptions,but all of them were reviewed out by the reviewing pharmacist and no harm occurred,which were A-level errors.Of the 18 medical orders of medication error,12 orders(66.67%)were for inappropriate dosage of solvents,5 orders(22.77%)were for inappropriate concentrations of medication,and 1 order(5.56%)was for incomplete prescriptions.The top 5 medication errors were 10 orders(55.56%)for cyclophosphamide for injection,3 orders(16.67%)for paclitaxel(albumin-bound type)for injection,2 orders(11.11%)for gemcitabine for injection,2 orders(11.11%)for etoposide for injection,and 1 order(5.56%)for pemetrexed for injection,mainly due to inappropriate dosage of solvent and inappropriate concentration of drugs.Conclusion Management errors of cytotoxic drugs in PIVAS occur from time to time,all of which are A-level errors,mainly due to improper dosage and concentration,mainly occur in cyclophosphamide for injection,paclitaxel for injection(albuminbound type),and gemcitabine for injection,etoposide for injection,and pemetrexed for injection.Therefore,it is particularly important to strengthen the management of cytotoxic drugs,actively improve the protection of medical staff,and ensure the safety and effectiveness of clinical medications.

关 键 词：静脉用药集中调配中心 细胞毒性药物 不合理用药 安全管理 

分 类 号：R95[医药卫生—药学]