老年患者慢性病综合治疗中药物相互作用的分析及对策

Analysis and countermeasures of drug interactions in the treatment of chronic diseases in elderly patients

目的:分析老年患者慢性病治疗中可能发生的药物相互作用,以减少药品不良反应(ADRs)和并发症,指导临床合理用药。方法:采用回顾性研究方法,查阅和整理甘肃省酒泉市人民医院2017年1月至2017年5月以心脑血管系统疾病、糖尿病和慢性呼吸系统疾病等慢性病患者的病例资料共180份,对治疗过程中的用药情况进行统计,并针对可能发生的药物相互作用进行分析。结果:慢性病综合治疗过程中,联合用药比例最高的是6~10种药物,占40%;联合用药品种最少的是2种药物,最多的是16种药物;存在药物相互作用的有116例,比例高达64.4%,其中以两药间相互作用比例最高,占40.0%。病程中有记录并上报ADRs的有8例,经典的或常用的药物发生药物相互作用情况较多见。结论:慢性病治疗中多种药物联用出现药物相互作用的现象较为普遍。药师应掌握常用药物相互作用发生的机制及规律,协助医师优化治疗方案,尽量减少用药种类,避免或减少由于药物相互作用引起的ADRs,保证临床安全用药。

Objective:To analyze possible drug interactions in the treatment of chronic diseases in elderly patients,so as to reduce adverse drug reactions(ADRs)and complications,and also to guide rational use of drugs in clinic.Methods:Case information of 180 patients with cardio-cerebral vascular diseases,diabetes and chronic respiratory diseases were screened from Jiuquan People’s Hospital of Gansu Province from January 2017 to May 2017 in a retrospective study.The drug utilization was summarized and potential drug interactions were analyzed.Results:In the comprehensive treatment of chronic diseases,the highest percentage of drug combination involved 6-10 drugs,accounting for 40%,the least used combination drugs were related with 2 drugs,and the most frequently used combination drugs were as many as 16 drugs.There were 116 cases of drug interactions,with a percentage as high as 64.4%,of which the highest percentage of drug interactions involved 2 drugs,accounting for 40.0%.8 cases of ADRs were recorded and reported in the course of disease.Drug interactions that occurred between classical or commonly-used drugs were quite frequent.Conclusion:In the treatment of chronic diseases,drug interactions are commonly seen.Pharmacists should clearly know the mechanism and regularity of common drug interactions,assist physicians to optimize treatment profiles and minimize the kinds of drugs used,so as to avoid or reduce adverse reactions between drugs and ensure safe clinical medication.