克拉霉素潜在不良药物相互作用分析及精细化前置审方规则建立  

Analysis of clarithromycin potential adverse drug interactions and establishment of refined prescription pre-review rules

作　　者：汪龙[1] 张莉 朱玲娜[1] 张冠军[1] 程军[1] WANG Long;ZHANG Li;ZHU Lingna;ZHANG Guanjun;CHENG Jun(Dept.of Pharmacy,the Third People’s Hospital of Bengbu,Anhui Bengbu 233099,China;Dept.of Pharmacy,the Second Affiliated Hospital of Bengbu Medical University,Anhui Bengbu 233004,China)

机构地区：[1]蚌埠市第三人民医院药学部,安徽蚌埠233099 [2]蚌埠医科大学第二附属医院药学部,安徽蚌埠233004

出　　处：《中国药房》2025年第8期986-990,共5页China Pharmacy

基　　金：蚌埠市科技创新指导类项目(No.2024ZD0050)。

摘　　要：目的分析克拉霉素的潜在不良药物相互作用(pADIs),建立精细化前置审方规则。方法利用医院信息系统收集2024年1月1日至6月30日蚌埠市第三人民医院门诊开具的克拉霉素联合用药处方,依据Lexicomp和Micromedex数据库对与克拉霉素有pADIs的药物进行风险鉴别和分级,再根据鉴别和风险等级结果建立克拉霉素pADIs的精细化前置审方规则。结果共纳入克拉霉素联合用药处方3046张,其中812张处方存在pADIs,共发生946例次pADIs;分级为“禁忌”“严重”和“中度”的分别有6、415和525例次;“禁忌”等级的联用药物为坦索罗辛、卢帕他定、多潘立酮和替格瑞洛,“严重”等级的主要为茶碱类、地塞米松和氨氯地平等。建立了26项精细化审方规则,包括“警示信息→处方拦截”4项、“警示信息→处方双签确认”11项和“注意信息→处方通过”11项。结论该院克拉霉素与其联用药物存在“禁忌”“严重”风险;成功建立了用于克拉霉素联合用药处方的精细化前置审方规则。OBJECTIVE To analyze the potential adverse drug interactions(pADIs)of clarithromycin,and establish refined prescription pre-review rules.METHODS Outpatient prescriptions of clarithromycin in combination with other drugs were collected from January 1,2024 to June 30,2024 through hospital information system of the Third People’s Hospital of Bengbu.pADIs were identified and their risk severities were graded according to Lexicomp and Micromedex databases.Then,refined prescription pre-review rules for clarithromycin pADIs-related drugs were established according to the identification and risk level results.RESULTS Among 3046 clarithromycin combined drug prescriptions,946 cases of pADIs occurred in 812 prescriptions.There were 6,415 and 525 cases classified as“contraindicated”,“major”and“moderate”,respectively.The combination drugs with“contraindicated”levels were tamsulosin,rupatadine,domperidone and ticagrelor,while those with“major”levels were mainly theophylline,dexamethasone and amlodipine.Accordingly,26 refined rules were established,including 4 items of“warning information→prescription interception”,11 items of“warning information→prescription double signature”and 11 items of“attention information→prescription approval”.CONCLUSIONS There are“contraindicated”and“major”risks associated with clarithromycin and its combination drugs in the hospital,and refined prescription pre-review rules for clarithromycin combined drug prescription have been established successfully.

关 键 词：克拉霉素 潜在不良药物相互作用 处方前置审核 

分 类 号：R969.2[医药卫生—药理学]