211例抗精神病药物不良反应回顾性调查

Retrospective investigation of 211 cases of adverse drug reaction caused by antipsychotic drug

目的调查某院抗精神病药物引起不良反应的特点,为合理安全用药提供参考。方法收集2017年12月~2018年12月期间某院使用抗精神病药物后出现不良反应的患者临床资料,对患者性别、年龄、诊断、发生不良反应的药品及临床表现、给药途径、联合用药情况等进行统计分析。结果发生不良反应共211例,不良反应发生率为2.2%。男性104例(49.3%),女性107例(50.7%),年龄10~79岁,平均(37.18±16.05)岁;21~29岁年龄段占比最高,为28%,其次为30~39岁。不良反应发生的平均时间为(8.7±10.8)d,48.8%不良反应发生时间为用药后1~5d。不良反应主要累及神经系统,其次为消化系统、心血管系统和泌尿系统。190例(90.0%)为口服给药引起,注射给药21例(10.0%)。发生不良反应例数最多的前5位药品是利培酮、奥氮平、氯氮平、阿立哌唑和氟哌啶醇,利培酮、阿立哌唑、氟哌啶醇主要引起锥体外系反应,奥氮平、氯氮平主要引起肝功能异常。结论某院抗精神病药物引起不良反应情况较多见,临床药师应重视抗精神病药引起的不良反应,加强患者的药学监护,协助医师科学合理使用抗精神病药物。

Objective To investigate the characteristics of adverse drug reaction caused by antipsychotic drug in our hospital and provide reference for reasonable and safe medication.Methods Collect the clinical data of patients who had adverse drug reactions after using antipsychotic drugs in our hospital from December 2017 to December 2018.The patient's gender,age,diagnosis,adverse drug reactions,clinical manifestations,route of administration,combined medication were analyzed statistically.Results A total of 211 adverse drug reactions occurred,and the incidence of adverse drug reactions was 2.2%.There are 104 males(49.3%)and 107 females(50.7%).The age distribution ranged from 10 to 79 years old and averaged(37.18±16.05)years old.The age group of 21~29 years(28%)accounted for the largest proportion,followed by 30~39 years old.The average time to occurrence of adverse drug reactions was(8.7±10.8)days,and 48.8%of adverse drug reactions occurred 1 to 5 days after medication.Adverse reactions mainly involve the nervous system,followed by the digestive system,cardiovascular system and urinary system.190 cases(90%)were caused by oral administration,and 21 cases(10%)were administered by injection.Top 5 antipsychotic drug that caused the adverse drug reaction were risperidone,olanzapine,clozapine,aripiprazole and haloperidol.Risperidone,aripiprazole,and haloperidol mainly cause extrapyramidal reactions,olanzapine and clozapine mainly cause abnormal liver function.Conclusion The adverse reactions caused by antipsychotic drugs in our hospital are common.Clinical pharmacists should pay attention to the adverse reactions,strengthen the patient's pharmaceutical care,and assist doctors in scientific and rational use of antipsychotic drugs.