重酒石酸去甲肾上腺素注射液超说明书用药调查分析  

Investigation and Analysis of Off⁃label Drug Use of Norepinephrine Bitar⁃trate Injection

作　　者：刘海珍 黄宇虹 许惠溢 刘洁 肖凤 蔡瑞娜 LIU Hai-zhen;HUANG Yu-hong;XU Hui-yi;LIU Jie;XIAO Feng;CAI Rui-na(Department of Pharmacy,Xiamen Haicang Hospital,Xiamen 361026,China;Xiamen Haicang Xinyang Hospital,Xiamen 361026,China)

机构地区：[1]厦门市海沧医院药学部,福建厦门361026 [2]厦门海沧新阳医院,福建厦门361026

出　　处：《海峡药学》2023年第12期75-78,共4页Strait Pharmaceutical Journal

摘　　要：目的回顾性调查医院住院患者使用重酒石酸去甲肾上腺素注射液的超说明书情况,为临床合理用药提供参考。方法抽取医院2021年1月~12月使用重酒石酸去甲肾上腺素注射液的住院患者医嘱563例,参照药品说明书内容,对用药合理性进行分析。结果在分析的563例医嘱中,272例存在不同程度的超说明书用药情况,超说明书用药发生率为48.31%,主要表现为超适应症(48.31%)、超给药途径(48.31%)和溶媒选择不当(46.53%)。对超说明书用药进行循证评价,消化道出血时口服、急性消化道出血内镜下注射治疗、消化道出血内镜下局部喷洒、纤维支气管镜检查时经气管镜直接注入出血部位,均为重酒石酸去甲肾上腺素注射液的合理用药;牙龈出血时漱口外用为不合理用药。结论重酒石酸去甲肾上腺素注射液的超说明书用药情况在该院广泛存在,应该加强监测与管控,规范超说明书用药行为,促进临床合理用药。OBJECTIVE To investigate the status of off⁃label use drug of norepinephrine bitartrate injection in our hospital,and provide reference for clinical rational drug use.METHODS A total of 563 medical advice of hos⁃pitalized patients who used norepinephrine bitartrate injection was selected in our hospital from January 2021 to De⁃cember 2021.According to the drug instructions,the rationality of off⁃label drug use was analyzed according to the drug instructions.RESULTS Among of 563 medical advices,272 of which off⁃label.The rate of off⁃label drug use was 48.31%,including 48.31%were over indication,48.31%were way of administration and improper of solvent(46.53%).After evidence⁃based evaluation instruction of off⁃label use,several utilizations of norepinephrine bitar⁃trate were assessed as rational,including oral for gastrointestinal bleeding,endoscopic injection for acute gastrointesti⁃nal bleeding,endoscope⁃guided norepinephrine spaying in the treatment of gastrointestinal bleeding and infusing nor⁃epinephrine acid via fiberoptic bronchoscope.However,norepinephrine for gum Bleeding were considered as irration⁃al.CONCLUSION The off⁃label drug use of norepinephrine bitartrate injection is widespread in our hospital.It is recommended to strengthen the monitoring and standardizing for off⁃label drug use,promote rational use of drugs.

关 键 词：重酒石酸去甲肾上腺素注射液 超说明书用药 合理用药 

分 类 号：R969.4[医药卫生—药理学]