门诊处方中氯吡格雷联合用药的调查分析

Investigation and analysis of Clopidogrel combined drug use in outpatient prescriptions

目的了解徐州医科大学附属第三医院(以下简称我院)门诊处方中氯吡格雷的使用情况,为临床安全、合理用药提供参考。方法收集2018年7月1日~12月31日我院门诊的509张含有氯吡格雷的处方进行整理和统计,从肝脏细胞色素P450代谢酶的角度分析与氯吡格雷可能存在潜在相互作用的药物。结果与氯吡格雷联合用药的处方共485张,含有潜在相互作用的他汀类处方有256张(52.8%);含有潜在相互作用的二氢吡啶类钙离子通道阻滞剂药物处方有201张(41.4%);含有潜在相互作用的阿司匹林处方有189张(39.0%);含有潜在相互作用的质子泵抑制剂处方有48张(9.9%);含有潜在相互作用的复方丹参滴丸处方有18张(3.7%);含有潜在相互作用的胺碘酮片处方有2张(0.9%)。结论我院氯吡格雷的老年患者多药合用现象普遍,存在潜在的药物代谢相互作用,应引起重视。

Objective To investigate the use of Clopidogrel in outpatient prescriptions of the Third Affiliated Hospital of Xuzhou Medical University(hereinafter referred to as our hospital),so as to provide reference for clinical safety,rational drug use.Methods A total of 509 prescriptions containing Clopidogrel were collected from the outpatient clinic of our hospital from July 1 to December 31,2018.The potential interaction of clopidogrel was analyzed from the perspective of liver cytochrome P450 metabolic enzymes.Results There were 485 prescriptions for combination with Clopidogrel,256 prescriptions(52.8%)for statins with potential interaction,201 prescriptions(41.4%)for dihydropyridine calcium channel blockers,189 prescriptions(39.0%)for Aspirin with potential interaction,48 prescriptions(9.9%)for proton pump inhibitors with potential interaction.There were 18 prescriptions(3.7%)for Compound Danshen Dropping Pills with potential interaction and 2 prescriptions(0.4%)for Amiodarone Tablets with potential interaction.Conclusion The phenomenon of multi-drug combination in elderly patients of our hospital with clopidogrel is common,and potential drug metabolic interaction exists,which should be paid attention to.