交叉过敏的临床药学干预

Clinical pharmacological intervention on cross allergy

目的提高医务人员对于临床药物交叉过敏的防范意识，降低用药差错的发生率。方法对用药咨询、用药失误以及近似错误的在线报告系统的以往记录进行统计分析，对药品说明书中禁忌症项关于交叉过敏症状的描述进行数据挖掘以及信息分析，并对医院实行临床药学干预的效果进行评估。结果药物的化学结构相似是造成交叉过敏的主要因素。临床上易发生交叉过敏的药物除了27类药理作用相似的同类药品外，还有7类涉及多种药理作用类别的药物。有部分药物的禁忌症与交叉过敏有关的描述缺乏科学性，没有临床指导意义，部分药物进口产品和国内的产品之间也存在一定的差异。但是在药师对临床药学进行持续的干预之后，整个临床方面对药物交叉过敏的意识有大幅度的提升。结论药师对临床药学的干预对于交叉过敏的问题有非常重要的意义。

Objective To strengthen the clinical awareness of cross allergy and to reduce the incidence rate of incorrect uses of medicines. Methods The previous records of medication counseling, incorrect uses of medicines, and approximation errors in the online reporting system were analyzed. Data mining was performed. Prescribing information on cross allergy in ＂contraindieations＂ was derived from a software. Clinical pharmacological interventions were conducted and the effects were evaluated. Results Similarity in chemical structures was the main cause of cross allergy. Besides 27 kinds of medications within pharmacologically similar class involving cross allergy, there were seven sorts with complete different pharmacological effects. Prescribing information on some medications had unscientific descriptions on cross allergy associated contraindications, lacking clinical value in guiding safe use of medication.There were difference in descriptions on cross allergy in some drugs within pharmacologically similar class, and some domesic and imported products. After pharmacological interventions, awareness was greatly increased; the occurrence rate of incorrect uses of medicines and approximation errors decreased. Conclusions Comprehensive pharmacological interventions is of very important significance in cross allergy.