免疫抑制剂不合理用药典型案例解析

Analysis of typical cases of irrational use of immunosuppressants

目的:通过对门诊处方和住院医嘱审核中发现的免疫抑制剂不合理使用典型案例进行解析,提高医院合理用药水平。方法:通过查阅药品说明书、相关的指南及文献,对门诊处方及住院医嘱审核中发现的免疫抑制剂不合理使用典型案例进行详细的解析。结果:免疫抑制剂门诊处方和住院医嘱审核中发现的主要问题是钙调磷酸酶抑制剂与他汀类药物、大环内酯类抗菌药物、质子泵抑制剂、利福平、五酯胶囊以及唑类抗真菌药物等之间的药物相互作用问题。结论:免疫抑制剂中的钙调磷酸酶抑制剂与多种药物之间存在有临床意义的相互作用,是免疫抑制剂不合理处方的常见问题,应该作为药师审核处方(医嘱)时的关注重点。

Objective:To analyze the typical cases of irrational use of immunosuppressants in the review of outpatient prescriptions and inpatient medical orders,so as to improve rational use of drugs in the hospital.Methods:By referring to drug instructions,relevant guidelines and literature,typical cases found in outpatient prescriptions and inpatient medical orders concerning irrational use of immunosuppressants were analyzed in detail.Results:The main problems identified in the review of outpatient prescriptions and inpatient medical orders of immunosuppressant drugs were the interactions between calcineurin inhibitors and statins,macrolide antibacterials,proton pump inhibitors,rifampin,Wuzhi capsules and azole antifungal agents.Conclusion:The clinical interactions between calcineurin inhibitors and a variety of drugs are common problems in irrational prescription of immunosuppressants and should be the focus of pharmacists when they review prescriptions and medical orders.