住院病儿使用利奈唑胺致5-羟色胺毒性相关的用药禁忌情况调查

Investigation of drug⁃drug interactions related to serotonin toxicity with the use of linezolid in hospitalized children

目的调查使用利奈唑胺治疗的住院病儿存在的5-羟色胺毒性相关的用药禁忌情况。方法通过查阅中英文数据库和药品说明书,整理与利奈唑胺存在5-羟色胺毒性相关的用药禁忌的药品,回顾性收集浙江大学医学院附属儿童医院2018年1月1日至12月31日使用利奈唑胺的住院病儿的住院信息和用药信息,对用药禁忌情况进行统计分析。结果住院药房共24种药品与利奈唑胺存在5-羟色胺毒性相关的用药禁忌。全院有1 510例次使用利奈唑胺,用药禁忌发生率为24.6%。利奈唑胺在血液科的使用率和用药禁忌发生率最高,分别为42.5%和32.9%;重症监护室(ICU)次之,分别为21.0%和25.6%;其中合用例次较多的禁忌药品有氨溴特罗口服溶液、愈酚甲麻那敏糖浆、枸橼酸芬太尼注射液。结论利奈唑胺在住院病儿临床应用广泛,与氨溴特罗口服溶液、愈酚甲麻那敏糖浆、枸橼酸芬太尼注射液等多种存在5-羟色胺毒性相关的禁忌药物合用的发生率较高,这需要引起医务工作者,特别是血液科和ICU医生的足够重视。

Objective To investigate the contraindications related to serotonin toxicity in hospitalized children treated with linezol⁃id.Methods By consulting domestic and foreign databases as well as drug instructions,the drugs with contraindications related to serotonin toxicity with linezolid were sorted out.In⁃patient information and medication information of hospitalized children who used linezolid from Jan.1 to Dec.31 in 2018 in Children’s Hospital,Zhejiang University School of Medicine which were collected retro⁃spectively,and the number of contraindications were statistically analyzed.Results A total of 24 drugs had contraindications relat⁃ed to serotonin toxicity with linezolid in the in⁃patient pharmacy.There were 1510 cases using linezolid in the whole hospital,and the incidence of contraindication was 24.6%.The utilization rate and contraindication rate of linezolid in hematology department were the highest,which was 42.5%and 32.9%,respectively.The utilization rate and contraindication rate of linezolid in Intensive Care Unit(ICU)department came second,which was 21.0%and 25.6%,respectively.Among these drugs,the cases of contraindica⁃tion ranked ahead were Ambroxol Hydrochloride And Clenbuterol Hydrochloride Oral Solution,Guaifenesin,Methylephedrine And Chlorphenamine Syrup,and Fentanyl Citrate Injection,successively.Conclusion Linezolid is widely used in clinical practice in hospitalized children,and the incidence of combining with multiple contraindicated drugs related to serotonin toxicity,e.g.,Ambrox⁃ol Hydrochloride And Clenbuterol Hydrochloride Oral Solution,Guaifenesin,Methylephedrine And Chlorphenamine Syrup,and Fen⁃tanyl Citrate Injection,etc,is high,which needs attention by medical workers,especially doctors in hematology department and ICU department.