多种西药联合使用的不良反应与临床合理用药对策

Adverse reactions of combination use of various western medicine and countermeasures for clinical rational drug use

目的分析多种西药联合应用的临床不良反应,并对其应对措施进行研究探讨。方法选取2016年3月至2017年3月我院药剂科1 876张西药处方,对多种西药联合使用的处方数量进行统计,分析各处方引起的药物不良反应及合理用药对策。结果在1 876张西药处方中,其中多种西药联合使用的处方为1 532张(81.66%),发生不良反应的处方为285张(18.60%),其主要发生原因为不良配伍(3.78%)、重复给药(3.62%)、用法不当(3.84%)、剂量不当(3.94%)。在285张不良反应处方中,其中过敏反应的处方共90张(31.58%),显著高于其他不良反应,差异有统计学意义(P<0.05)。结论临床医生为提高治疗效果,常采用多种西药联合使用来促进患者康复,但常因忽略用药的适应证及合理用药等导致患者出现一系列药物不良反应,因此临床医生应掌握科学合理的用药方式,加强用药监督与指导,避免药物不良反应,保证临床合理用药。

Objective To analyze the clinical adverse reactions of combination use of various western drugs, and to investigate the countermeasures for the clinical rational use of these drugs. Methods A total of 1 876 pieces of western medicine prescriptions which collected from March 2016 to March 2017 in the pharmacy department of our hospital were selected as the research objects. The number of combination usage for the western medicine were summarized. Meanwhile,the adverse reactions caused by these medicine and the countermeasures for clinical rational drug use were investigated.Results Among the 1 876 pieces of western medicine prescriptions, 1 532 pieces(81.66%) of them were combination medication, and adverse reactions occurred in 285 pieces(18.60%) of them. The main reason for these adverse reactions were poor compatibility(3.78%), repeated drug use(3.62%), improper usage(3.84%) and improper dosage(3.94%). Among the285 pieces of medicine prescriptions with adverse reactions, 90 pieces(31.58%) of them were allergic reaction, and in which the occurrence rate of allergic reaction was significantly higher than the other adverse reactions(P<0.05). Conclusion The clinical doctors always adopt the combination use of western medicine to promote the rehabilitation of patients. A series of adverse drug reactions were caused by the neglect of the indications and the rational use of drugs. So scientifically rational use of western medicine should be mastered for clinical doctors. Moreover, supervision and guidance of drug use should be carried out to avoid the adverse reactions, and insure the clinical rational drug use.