2646条曲妥珠单抗住院医嘱用药合理性及不良反应分析

Analysis of Rationality and Adverse Drug Reactions of 2 646 Inpatient Prescriptions of Trastuzumab

目的:了解辽宁省肿瘤医院(以下简称"我院")曲妥珠单抗住院医嘱的用药合理性及药品不良反应发生情况,为临床合理用药提供参考.方法:通过我院PASS系统,选取2018年使用曲妥珠单抗的全部住院医嘱,进行回顾性分析;对医嘱中患者的性别、年龄和诊断进行汇总分析;评价曲妥珠单抗住院医嘱的用药合理性;对病例报道的不良反应进行分类汇总.结果:共收集2646条曲妥珠单抗住院医嘱,涉及495例患者,其中,女性患者483例(占97.58%),远多于男性患者(12例,占2.42%);>40~60岁患者居多(324例,占65.45%).2646条曲妥珠单抗住院医嘱中,乳腺癌患者医嘱居多(2525条,占95.43%),其次为胃癌患者(58条,占2.19%);不合理医嘱385条,医嘱不合理率为14.55%,主要为用法与用量不合理(309条,占不合理医嘱数的80.26%);曲妥珠单抗致不良反应440例次,均为常见不良反应,未发现严重不良反应.结论:我院部分曲妥珠单抗住院医嘱存在不合理情况,需基于处方点评制度进一步加强处方前置审核,提高药物合理应用水平;虽未发现曲妥珠单抗所致严重不良反应,但仍需加强不良反应的监测、上报制度,保障安全用药.

OBJECTIVE:To investigate the rationality and adverse drug reactions of inpatient prescriptions of trastuzumab in Liaoning Cancer Hospital(hereinafter referred to as“our hospital”),so as to provide reference for the rational drug application in clinic.METHODS:All the inpatient prescriptions of trastuzumab in 2018 were retrospectively analyzed by the PASS system.The gender,age and diagnosis of patients in prescriptions were summarized and analyzed.The rationality of the inpatient prescriptions of trastuzumab was evaluated by prescription review,and the adverse drug reactions reported in cases were classified and summarized.RESULTS:A total of 2646 inpatient prescriptions of trastuzumab were collected,including 495 patients,and there were 483 female patients(97.58%),far more than male patients(12 cases,2.42%).The majority of patients aged>40 to 60 years(324 cases,65.45%).Of the 2646 inpatient prescriptions of trastuzumab,breast cancer took the lead(2525 prescriptions,95.43%),followed by gastric cancer(58 prescriptions,2.19%).There were 385 irrational prescriptions,and the irrational rate was 14.55%,mainly due to irrational usage and dosage(309 prescriptions,accounting for 80.26%of irrational prescriptions).A total of 440 adverse drug reactions were caused by trastuzumab,all of which were common adverse drug reactions,and no severe adverse drug reactions were found.CONCLUSIONS:There are irrational circumstances in inpatient prescriptions of trastuzumab in our hospital.It is necessary to further strengthen the prescription review based on the prescription review system,so as to improve the rational application of drugs.Although no severe adverse drug reactions caused by trastuzumab were found,the monitoring and reporting system of adverse drug reactions should be strengthened to ensure the safe application of drugs.