达格列净临床应用合理性和安全性分析  

Rationality and safety evaluation on clinical application of dapagliflozin

作　　者：罗柳金[1] 谢宗泰 曾彩芳[1] LUO Liu-jin;XIE Zong-tai;ZENG Cai-fang(Department of Pharmacy,Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510000,China;School of Pharmaceutical Sciences,Guangzhou Medical University,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：《现代药物与临床》2022年第9期2109-2113,共5页Drugs & Clinic

摘　　要：目的调查住院患者接受达格列净治疗的情况,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。方法检索PubMed、中国知网、万方和维普数据库,汇总国内外达格列净相关指南、文献和专家共识,形成达格列净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2021年3月1日—2022年2月28日住院患者使用达格列净的情况,按照已制定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。结果共有201例患者应用了达格列净,其中有效病例198例,不合理用药病例共27例,不合理使用率为13.64%,以用药时机不适宜、禁忌证用药和特殊人群用药不合理为主要原因。不良反应共6例,发生率为3.03%,以泌尿系感染、糖尿病酮症和糖尿病酮症酸中毒等不良反应为主。结论达格列净降低血糖和改善心力衰竭预后的作用越来越受到临床医生重视,临床用药期间应多关注患者的血β-羟基丁酸和肝肾功能指标,关注达格列净的用药时机、特殊人群用药和不良反应等方面。针对其不合理应用情况和不良反应,临床药师应结合达格列净新修订的说明书、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,进一步促进钠–葡萄糖共转运蛋白2抑制剂(SGLT2i)的合理使用。Objective To explore the treatment of dapagliflozin in hospitalized patients to understand the status quo and its adverse reactions and analyze its risk factors,so as to provide a basis for regulating its rational clinical application.Methods PubMed,CNKI,Wanfang,and VIP databases were searched,and the relevant guidelines,literatures and expert consensus of dapagliflozin at home and abroad were summarized to form the rationality evaluation standard of dapagliflozin in clinical application.The use of dapagliflozin in inpatients in the Second Affiliated Hospital of Guangzhou Medical University from March 1,2021 to February 28,2022 was retrospectively investigated.The rationality and safety of dapagliflozin were analyzed according to the established evaluation criteria,and rational medication suggestions were put forward.Results A total of 201 patients were treated with dapagliflozin,including 198 effective cases,There were 27 cases of irrational drug use,and the rate of irrational drug use was 13.64%.The main reasons were inappropriate medication timing,contraindications,and irrational drug use in special population.There were 6 cases of adverse reactions,the incidence of which was 3.03%.The main adverse reactions were urinary tract infection,diabetic ketosis,and diabetic ketoacidosis.Conclusion The role of dapagliflozin in reducing blood glucose and improving the prognosis of heart failure has attracted more and more attention from clinicians.During clinical medication,more attention should be paid to the bloodβhydroxybutyric acid and liver and kidney function indexes of patients,the timing of dapagliflozin administration,special population medication,and adverse reactions.In view of the irrational use and adverse reactions of dapagliflozin,clinical pharmacists should formulate rationality evaluation criteria and medication recommendations based on the latest information such as the newly revised instructions,clinical guidelines and expert consensus,so as to make real-time comments and further promote the rational

关 键 词：达格列净 钠–葡萄糖共转运蛋白2抑制剂 评价标准 不良反应 糖尿病 心力衰竭 

分 类 号：R977[医药卫生—药品]