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目的:了解某院泌尿外科门诊超说明书用药情况,为临床合理用药提供科学依据,促进临床合理安全用药。方法:收集某院自2014年1月1日-2016年1月1日泌尿外科门诊处方,遴选出全部不符合药品说明书所规定的用药适应证,剂量以及频率的处方,进行相关统计分析。对照国内外相关指南、文献报道分析超说明书用药的合理性。结果:在所抽取的21 485张泌尿外科门诊处方中,有524张处方(2.4%)涉及超说明书用药,共涉及药品9种,均属于超适应证用药范畴,未出现超剂量、超用药频次以及超疗程用药的情况。超适应证用药共7项,均有相关证据支持,其中2项符合国外内指南用法;5项有相关的文献报道支持。在所有超说明书用药的处方中,α1-受体阻滞剂(坦索罗辛缓释胶囊、多沙唑嗪缓释片)所占比例最大(55.9%),所涉及的用药适应证是输尿管下段结石。结论:该院的泌尿外科门诊常见超说明书用药均有相关证据支持,使用基本合理,但证据质量存在差异。在临床实际工作中,临床药师应与处方医师充分协作,权衡超说明书用药的利弊,提高临床合理用药水平以及处方的合理性。
OBJECTIVE: To understand the usage of super instructions in the urology clinic of a hospital to provide a scientific basis for rational clinical use and to promote the rational and safe use of clinical medicine. Methods: Urine clinic prescriptions collected in a hospital from January 1, 2014 to January 1, 2016 were collected and all the prescriptions that did not meet the indications, dosage and frequency of medication prescribed by the drug specification were selected for statistical analysis. Control guidelines at home and abroad, reported in the literature analysis of super rationale for the use of drugs. Results: Of the 21 485 urological outpatient prescriptions out of which 524 prescriptions (2.4%) involved the use of hyper-description drugs, involving a total of 9 kinds of drugs, all belong to the category of indications for the use of drugs, there was no overdose, overdose frequency As well as super-medication medication situation. There were altogether 7 overdose indications, all of which were supported by relevant evidences, of which 2 were in compliance with the guidelines used in foreign countries and 5 were supported by relevant literature reports. Among all the prescriptions for over-specification, α1-blockers (tamsulosin sustained-release capsules and doxazosin sustained-release tablets) accounted for the largest proportion (55.9%), and the indications involved were ureteral Lower stones. CONCLUSIONS: The most commonly used instructions in urology clinics in this hospital are supported by relevant evidences, but the quality of evidence is different. In clinical practice, clinical pharmacists should cooperate fully with the prescribing physicians to weigh the advantages and disadvantages of using the instructions, to improve the rational use of clinical medicine and the rationality of prescription.