>60岁住院患者口服固体制剂分剂量用药情况调查分析与应对措施

Investigation and Countermeasures on the Application of Oral Solid Preparation in Inpatients Over 60 Years Old

目的:了解>60岁住院患者口服固体制剂分剂量用药情况,为临床合理用药提供参考。方法:调取2018年6月至2019年5月吉林大学第一医院>60岁住院患者口服固体制剂分剂量用药医嘱18795条,去除重复医嘱后保留10583条,依次统计按药理作用分类的药品品种、具体药品分剂量情况、不同剂型药品分剂量情况及分剂量后的给药方式。结果:10583条用药医嘱共涉及7类药物131种药品,主要为心血管疾病系统用药(40种,占30.53%),其次为中枢神经系统用药(33种,占25.19%);分剂量医嘱数排序居首位的药品为琥珀酸美托洛尔缓释片,共5158条医嘱(占48.74%),主要拆分为1/2片(4699条,占琥珀酸美托洛尔缓释片医嘱数的91.10%);缓控释制剂和肠溶制剂分剂量医嘱数共5199条(占49.13%),其中采用鼻饲给药的医嘱138条(占缓控释制剂和肠溶制剂医嘱数的2.65%),胃管注入2条(占缓控释制剂和肠溶制剂医嘱数的0.04%)。结论:临床上口服固体制剂分剂量问题不可避免,市场上的药品规格满足不了特殊人群用药需求,药师应对固体制剂分剂量的准确性和安全性进行药学监护,以促进临床合理用药。

OBJECTIVE:To investigate and application of oral solid preparation in inpatients over 60 years old,so as to provide references for clinical rational medication.METHODS:Totally 18795 medical orders on medication of oral solid preparation in inpatients over 60 years old in the First Hospital of Jilin University from Jun.2018 to May 2019 were retrieved,10583 items were retained after removing repeated medical orders,categories of drugs classified by pharmacological effects,specific drug divided dose status,drug divided dose status of different dosage forms and administration route after divided dose were sequentially analyzed.RESULTS:Totally 7 kinds of 131 categories of drug were involved in the 10583 medical orders,mainly were medication on cardiovascular disease(40 categories,30.53%),followed by medication on central nervous system(33 categories,25.19%);the first drug ranked by numbers of divided dose medical orders was Metoprolol succinate sustained-release tablets,including 5158 medical orders(48.74%),mainly were split into 1/2 pieces(4699 medical orders,accounted for 91.10%of medical orders of Metoprolol succinate sustained-release tablets);the number of divided dose medical orders of sustained and controlled release preparations and enteric-coated preparations was 5199(49.13%),of which 138 were nasogastric dosing(accounted for 2.65%of medical orders of sustained and controlled release preparations and enteric-coated preparations),and 2 were stomach tube infusing(accounted for 0.04%of medical orders of sustained and controlled release preparations and enteric-coated preparations).CONCLUSIONS:The problem of divided dose of oral solid preparation is inevitable in clinical,the drug specifications on the market cannot meet the medication needs of special populations,pharmacists should conduct pharmaceutical monitoring on the accuracy and safety of divided dose of solid preparation to promote clinical rational medication.