某院糖尿病患者住院用药相互作用分析

Analysis of Drug-Drug Interactions in Prescriptions for Hospitalized Diabetic Patients

目的 调查并确定某院内分泌科糖尿病住院患者2012年3月-2013年2月药疗医嘱中潜在药物间相互作用（DDIs）及涉及的药物类别,为医师及临床用药管理提供依据。方法 收集某院1年中内分泌科糖尿病住院患者的药疗医嘱,结合医院药物信息支持系统及临床药师手工筛查检测处方药物潜在药物相互作用。结果 1年内在某三甲医院内分泌科住院的糖尿病患者共450人。入院前1个月内或住院期间检查的糖化血红蛋白平均值为（9.4±2.4）%,平均病程为（11.0±8.1）年。住院患者中使用最多的治疗方案为胰岛素治疗,其次为胰岛素与α糖苷酶抑制剂联合使用方案。发生DDIs较多的药物为阿司匹林及β受体阻滞剂。结论 由于内分泌科住院患者中存在多种常用药物之间的DDIs,会给患者带来潜在的医疗风险,有必要研发结合本院实际情况快速自动预警系统用以防止发生DDIs。临床医师必须对潜在的DDIs有所了解,同时临床药师需要及时审查医嘱,保证药物治疗的质量与安全。

OBJECTIVE To evaluate the types and prevalence of potential drug-drug interactions （DDIs） in the prescriptions for diabetic patients hospitalized in the department of endocrinology from March 2012 to February 2013, classify the DDIs as per pharmacotherapeutic class of medications and investigate the relationship between medication classes and frequency of potential DDIs, in order to provide basis for management of medication therapy. METHODS The prescriptions were checked for drug interactions by clinical pharmacists with the support of hospital drug information system. RESULTS Prescriptions for total of 450 diabetic patients were collected. The average HbA1C before hospitalization was （9. 4 ± 2. 4）%. The average duration of diabetes was （11.0 ± 8. 1 ）years. The most common regimen was insulin therapy, followed by combination therapy of insulin and alpha glucosidase inhibitors. The most common DDIs occured between aspirin and β-blockers. CONCLUSION The patients are at risk of potential DDIs. An appropriate surveillance system for monitoring such interactions should be implemented. Physicians should be more aware of potentially harmful DDIs. Pharmacists can contribute to the detection and prevention of drug-related injuries, especially of clinically meaningful DDIs that pose potential risks to patient safety.