某院5-HT3受体拮抗剂防治CINV的合理性评价

Rationality evaluation of 5-HT3 receptor antagonists used for the prevention and treatment of CINV in our hospital

目的:对我院5-HT3受体拮抗剂用于防治化疗引起的恶心呕吐的使用情况进行合理性评价,进一步提高临床化疗止吐药的合理使用。方法:从我院用药决策系统随机抽取2016年6-11月住院静脉化疗患者中使用5-HT3受体拮抗剂止吐的电子病历200例。从适应症、药品遴选、用法用量、综合止吐方案、药物相互作用、用药时机、给药途径等多方面进行处方点评。结果:不合理用药病历111例,占55.5%。药品遴选不合理13例,占6.5%,以肺癌和乳腺癌为著;用法用量不合理75份,占37.5%;联合用药不合理19例,占9.5%。9例存在2种以上不合理用药情况,占4.5%。14例高致吐风险级别综合止吐方案单用5-HT3受体拮抗剂不合理,占7.0%。结论:我院止吐药5-HT3受体拮抗剂的应用存在较多不合理使用情况,有必要规范临床合理使用5-HT3受体拮抗剂,促进临床合理用药。

OBJECTIVE To improve the level of rational use of 5-HT3 receptor antagonists in chemotherapy induced nausea and vomiting by evaluating the clinical use of 5-HT3 receptor antagonists in our hospital.METHODS Medical records of 200 patients treated with 5-HT3 receptor antagonists from June 2016 to November 2016 were randomly selected.Evaluation contents included indications,drug selection,usage and dosage,drug interactions,drug interactions,timing of medication and route of administration,etc.RESULTS There were 111 cases of irrational drug use accounting for 55.5%;13 cases of unreasonable drug selection accounting for 6.5%,mostly against lung and breast cancers;75 cases of unreasonable usage accounting for37.5%;19 cases of unreasonable combined antiemetic regimen accounting for 9.5%;9 cases with irrational use of more than2 drugs accounting for 4.5%;14 cases of high risk level of emesia only treated with 5-HT3 receptor antagonist,accounting for7.0%.CONCLUSION Many application of 5-HT3 receptor antagonists is unreasonable in our hospital,and it is necessary to standardize the clinical rational use of 5-HT3 receptor antagonist to promote clinical rational drug use.