山东省某综合医院门诊麻精药品使用风险分析

Risk Analysis of Anesthesia and Psychotropic Drugs in Outpatient Department of a General Hospital in Shandong Province

目的:了解某综合医院门诊麻醉药品、精神药品使用现状及存在的问题。方法:提取该综合医院门诊2019年10月1日—2020年9月30日使用麻醉药品、精神药品处方信息,分析麻精药品使用总量、单处方剂量和用药天数等信息,依据《处方管理办法》分析可能存在的用药风险。结果:用药频度较高的药物分别是氨酚双氢可待因片(DDDs为83192)、阿普唑仑片(DDDs为41882)和盐酸曲马多缓释片(DDDs为10223),其中盐酸羟考酮缓释片、芬太尼贴剂、盐酸哌甲酯缓释片、阿普唑仑片、氯硝西泮片和盐酸曲马多缓释片等药品的部分处方超过规定用药量。有503人同一天开具2次及以上同一种麻醉药品、精神药品(片剂),开具的药品主要是第二类精神药品。麻精药品处方可在该综合医院简易门诊开具,部分精神药品有超过20%的处方由简易门诊开具。结论:该综合医院存在麻醉药品、精神药品滥用和流弊风险,需要制定切实可行的措施加强药物滥用监管。

Objective: To understand the status and problems of narcotic and psychotropic drugs in the outpatient department of a general hospital. Methods: Outpatient prescriptions containing narcotic drugs and psychotropic drugsof a general hospital from October 1, 2019 to September 30, 2020 were extracted. DDDs, the single prescription dosage and days were analyzed. The possible medication risks analysis was performed in accordance with the prescription management regulations. Results: Drugs with high DDDs were paracetamol and dihydrocodeine tartrate tablets(DDDs: 83 192), alprazolam tablets(DDDs: 41 882) and tramadol hydrochloride sustained-release tablets(DDDs: 10 223). The prescriptions of oxycodone hydrochloride sustained-release tablets, fentanyl patch, methylphenidate hydrochloride sustained-release tablets, alprazolam tablets, clonazepam tablets and tramadol hydrochloride sustained-release tablets exceeded the specified dosage. 503 people prescribed the same drug(tablet) twice or more on the same day, which were mainly the second category of psychotropic drugs.Anesthesia and psychotropic drugs could be prescribed in simple clinic, and more than 20% of the prescriptions for some psychotropic drugs were prescribed. Conclusion: This general hospital has risks of anesthesia and psychotropic drug abuse, and it is necessary to formulate practical measures to strengthen drug abuse supervision.