基于115例药品不良反应报告探讨药学会诊促进合理用药的作用  

Role of Pharmaceutical Consultation in Promoting Rational Drug Use Based on 115 Adverse Drug Reaction Reports

作　　者：李荣 金艳平 李颖慧 杨莉[2] LI Rong;JIN Yan-ping;LI Ying-hui;YANG Li(Department of Pharmacy,Beijing Miyun District Hospital,Beijing 101500,China;Department of Pharmacy,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]北京市密云区医院药剂科,北京101500 [2]首都医科大学附属北京天坛医院药学部,北京100070

出　　处：《中国合理用药探索》2024年第6期98-107,共10页Chinese Journal of Rational Drug Use

摘　　要：目的:临床药师通过对会诊患者的药学监护,评价药品不良反应(ADR发生情况,探索药学会诊促进合理用药实践。方法:收集2016~2022年临床药师上报国家药品不良反应监测中心的115例ADR报告,对ADR的类型、发生ADR患者的性别及年龄、涉及药物种类、给药途径、ADR的发生时间、恢复时间、ADR累及器官/系统及临床表现、药学会诊建议、ADR关联性评价及转归情况等进行回顾性分析。结果:115例ADR报告中,男性(50.43%)和女性(49.57%)患者ADR发生比例相当;60岁以上老年患者发生ADR较多(53.04%),且发生严重ADR比例较高;上报的ADR涉及14类药物共43个品种;抗感染药物致ADR的发生率最高(86.12%);一般ADR最多(85.22%);严重ADR有17例,其中14例由抗感染药物引起;静脉滴注为发生ADR的主要途径(82.61%);ADR发生时间大多为用药后24h~1周;恢复时间多数在ADR发生后24h~1周;ADR主要累及器官/系统为皮肤及皮肤附件疾病(25.74%);药学会诊建议以停用可疑药物为主(85.22%);ADR的结果均为好转或痊愈。结论:临床药师开展药学会诊,实施药学监护,有助于加强ADR的识别与监测,促进临床合理用药,保障患者用药安全。Objective:To evaluate the occurrence of adverse drug reactions(ADRs)and to explore the practice of promoting rational drug use by pharmaceutical consultation through clinical pharmacists'pharmaceutical care for patients.Methods:A total of 115 ADRs reported by clinical pharmacists to China National Center for ADR Monitoring from 2016 to 2022 were collected and retrospectively analyzed for their types,gender and age of patients,types of drugs involved,route of administration,onset time,recovery time,organs/systems involved and clinical manifestations,pharmaceutical consultation suggestions,association evaluation and outcome.Results:Among the reported ADRs,the incidence in male patients(50.43%)was comparable to that in female patients(49.57%),but was high in the elderly patients over 60 years old(53.04%);There were a total of 43 drugs from 14 categories involved;ADRs were most frequently caused by antiinfective drugs(86.12%);the incidence of moderate ADRs was the highest(85.22%);there were 17 serious ADRs,14 of which were attributed to anti-infective drugs;in terms of route of administration,intravenous drip accounted for the predominant ADRs(82.61%);ADRs mostly occurred within 24 hours to 1 week postdose.The recovery time was mostly 24 hours to 1 week after the occurrence;The main organ/system involved by ADRs was skin and its appendages(25.74%);the main recommendation of pharmaceutical consultation is to stop the suspected drugs(85.22%);the outcome of ADRs was either recovering or recovered.Conclusion:Clinical pharmacists should carry out pharmaceutical consultation,perform pharmaceutical care,and strengthen the identification and monitoring of ADRs to promote clinical rational drug use and ensure medication safety among patients.

关 键 词：临床药师 药品不良反应 药学会诊 合理用药 安全用药 

分 类 号：R972.6[医药卫生—药品]