左甲状腺素钠片临床使用情况调研

Investigation on the clinical use of levothyroxine sodium tablets

目的:调查左甲状腺素钠片(L-T4)在临床应用过程中是否存在不合理使用的情况,并分析原因,通过药师干预提高L-T4应用的合理性。方法:通过床旁问诊、审核医嘱、访谈护士的形式,对2019年6月1日–11月30日入住某院内分泌科室的患者进行调查分析。结果:本次调研共收集80例服用L-T4的患者,发现L-T4在临床使用过程中存在以下不合理的情况:在用药时间上,入院前患者早餐前30 min内、早餐前30 min以上、早餐后服用的人数分别占到21%、69%、7%;入院后患者早餐前30 min内、早餐前30 min以上、早餐后服用的分别占到14%、75%、10%;在医嘱下达方面,下达时间在8:00的占到63%;在合并用药上,含钙制剂服用人数较多,与L-T4间隔时间在2h以内占到63%;在饮食结构上,有93%的患者在服用L-T4时,与牛奶、豆浆等食物间隔在2 h以内。结论:药师在临床工作中应积极发挥用药监督、指导的作用,及时发现临床不合理用药情况并给予干预,以促进临床合理用药。

Objective:To investigate the clinical application of levothyroxine sodium tablets(L-T4),and improve the rational use of L-T4 by pharmacist intervention.Methods:Data of the patients admitted to the endocrine department and using L-T4 in a hospital from June 1,2019 to November 30,2019 were collected and analyzed through bedside consultation,medical order audits,and interview with nurses.Results:A total of 80 patients using L-T4 were enrolled in this study and the following unreasonable application of L-T4 were found for medication time,the proportion of patients taking L-T4 within 30 minutes before breakfast,more than 30 minutes before breakfast,and after breakfast were 21%,69%,and 7%respectively before admission while those proportion after admission were 14%,75%,and 10%respectively.63%of the patients were ordered L-T4 at 8:00 am.63%of the patients took calcium containing preparations within 2 hours after taking L-T4.93%of patients took L-T4 within 2 hours after eating milk,soybean milk,etc.Conclusion:Pharmacists should play an active role in supervision and guidance of drug use in clinic,find out the unreasonable drug use and give advices in time,so as to promote the rational drug use.