临床药师干预妊娠期超说明书用药实践

Practice of Clinical Pharmacists'Intervention of Off-label Use in Pregnant and Parturient Women

目的对妊娠期妇女超说明书用药典型问题进行分析和干预,为临床合理用药提供参考。方法依据牛津循证医学中心GRADE分级系统、Micromedex的Thomson分级系统,制定超说明书用药评价标准,并以该标准评价临床超说明书用药问题。结果盐酸利托君片、注射用间苯三酚禁止超说明书用药,硫酸特布他林注射液在特殊情况可超说明书用药。结论对妊娠期妇女超说明书用药应谨慎,超说明书用药通常是经过广泛临床观察,且有文献和循证医学证据支持。

Objective To analyze and intervene the questions of“off-label use”in pregnant and parturient women for references of rational drug use in the clinic.Methods Formulating the evaluation standard of“off-label use”in our hospital according to the GRADE classification system(developed by the Oxford Center for Evidence-based Medicine),and Micromedex's Thomson classification system.And this standard is used to evaluate the problem of“off-label use”in actual work.Results The off label use of ritodrine hydrochloride tablets and phloroglucinol for injection should be prohibited in pregnant and parturient women,and tetrabutaline sulfate injection can be used in special situation.Conclusion For pregnant and parturient women,“off-label use”should be careful.It should only be used under the support of authoritative clinical data evidence.