我院2013年上半年糖皮质激素类药物临床使用分析

Analysis of the Application of Glucocorticoid Drugs in Our Hospital in the First Half of 2013

目的:分析医院糖皮质激素类药物的使用情况,为临床合理用药提供参考。方法:利用临床药学管理软件随机抽取2013年1-6月我院使用糖皮质激素类药物的门诊处方600份、出院病历180份,以药品说明书及专业用药指南为依据,对用药数量、品种、分布、用途及合理性进行分析点评。结果:门诊糖皮质激素类药物主要用于抗炎、抗过敏等。共点评出不合理处方11份,占1.83%,存在的主要问题是处方诊断与用药不符。病区主要以退热降低体温为主要用途,占26.67%,多分布于儿科感染发热患者,其次为外科麻醉辅助用药。在用药品种方面,以地塞米松及甲泼尼龙琥珀酸钠用量最大。甲泼尼龙琥珀酸钠主要用于慢性阻塞性肺疾病等呼吸系统疾病及类风湿关节炎的抗炎治疗。结论:我院糖皮质激素类药物的使用基本合理,但应严格控制并避免将糖皮质激素类药物常规用于退热、降低体温的滥用趋势;另外分级管理及安全性监测仍需加强。

OBJECTIVE：To analyze the application of glucocorticoid drugs in the hospital, and to provide reference for rational drug use in the clinic. METHODS ： 600 outpatient prescriptions and 180 medical records of glucocorticoid drugs in our hospital were selected randomly by clinical pharmacy management software during Jan.-Jun. 2013. Based on the drug instructions and professional medication guide, the drug amount, variety, distribution, utilization and rationality were analyzed. RESULTS： Outpatient glucocorticoid drugs mainly used for anti-inflammatory, anti-allergic, etc. 11 irrational prescriptions were reviewed, accounting for 1.83%. The main problems were prescription diagnosis and medication discrepancies. The antipyretic hypothermia as the main purpose, accounting for 26.67 %, mainly distributed in the pediatric infectious fever patients, followed by surgical adjuvant anesthesia. In the variety of drug, the dosage of dexamethasone and methylprednisolone sodium succinate was in the forefront. Methylprednisolone sodium succinate was mainly used for respiratory diseases as chronic obstructive pulmonary disease and rheumatoid arthritis. CONCLUSIONS： The utilization of glucocorticoid drugs is rational in the hospital on the whole, but it should be strictly controlled and avoided to abuse conventional glucocorticoid drugs to lower the body temperature in the clinic. On the other hand, classification management and security monitoring need to be strengthened.