呼吸内科87例药品不良反应报告分析

Analysis of 87 cases of adverse drug reactions in respiratory medicine

目的分析呼吸内科药品不良反应(ADR)发生的规律与特点,为临床安全用药提供参考。方法选取2019年1月至2021年5月咸阳市第一人民医院呼吸内科上报至国家药品不良反应监测中心的87例报告,采用回顾性研究方法、应用Excel软件对87例报告中发生ADR的性别、年龄、给药途径、药物种类、药品分布及转归情况、累及器官或系统及其主要临床表现、上报人员职业分布情况进行统计分析。结果87例报告中,发生ADR的男性占比(57.47%)略高于女性占比(42.53%);41~60岁和61~80岁这两个年龄段最易发生ADR,占发生ADR总例数的86.21%。静脉滴注是发生ADR的主要给药途径(占比75.86%),其次为口服给药(占比14.94%)。发生ADR的前3位药物种类依次为抗菌药物(占比43.68%)、抗肿瘤药物(占比21.84%)、平喘药物(占比17.24%);发生ADR排名前3位药品依次为莫西沙星(占比14.94%)、注射用顺铂(占比9.20%)、左氧氟沙星(占比5.75%)。一般ADR为主要发生类型(占比91.95%)。ADR累及器官或系统最常见的为消化系统(占比32.18%),主要临床表现为恶心、呕吐、反酸、腹泻、腹痛、便秘,其次为神经系统(占比20.69%),主要临床表现为头痛、头昏、胡言乱语、烦躁不安、谵妄、失眠。上报人员职业主要为药师(占比83.91%)。结论呼吸内科ADR的发生以中老年患者居多,主要由抗菌药物和抗肿瘤药物引发,给药途径主要为静脉滴注,主要累及系统为消化系统和神经系统。应将抗菌药物及抗肿瘤药列为重点监测药物,以减少ADR发生率,保障患者安全用药。

Objective To analyze the regularity and characteristics of adverse drug reaction(ADR)in respiratory medicine,and to provide reference for clinical safe medication.Methods Eighty-seven cases reported to the National ADR Center for Monitoring,China by the respiratory medicine of the First People's Hospital of Xianyang from January 2019 to May 2021 were selected.The gender,age,route of administration,drug type,drug distribution and outcome,involved organs or systems and their main clinical manifestations,as well as the occupational distribution of reporting personnel of 87 ADR reports were statistically analyzed by using the retrospective research method and Excel software.Results Among 87 cases reports,the proportion of males with ADR(57.47%)was slightly higher than that of the proportion of females(42.53%);41-60 years old and 61-80 years old were the two age groups most prone to ADR,accounting for 86.21%of the total cases of ADR.Intravenous infusion was the main route of administration for ADR(accounting for 75.86%),followed by oral administration(accounting for 14.94%).The top 3 drugs of ADR were antibacterial drugs(accounting for 43.68%),anti-tumor drugs(accounting for 21.84%)and antiasthmatic drugs(accounting for 17.24%);the top 3 drugs for ADR were moxifloxacin(accounting for 14.94%),cisplatin for injection(accounting for 9.20%)and levofloxacin(accounting for 5.75%).General ADR was the main type(accounting for 91.95%).The most common organ or system involved in ADR was the digestive system(accounting for 32.18%),and the main clinical manifestations were nausea,vomiting,acid regurgitation,diarrhea,abdominal pain and constipation,followed by the nervous system(accounting for 20.69%),and the main clinical manifestations were headache,dizziness,nonsense,restlessness,delirium and insomnia.The reported personnel occupation mainly was pharmacist(accounting for 83.91%).Conclusion ADR in respiratory medicine mostly occured in middle-aged and elderly patients,mainly caused by antibacterial drugs and anti-tumor drugs;the main route of administration is intravenous infusion,and the ADR is mainly involving the digestive system and nervous system.Antibacterial drugs and anti-tumor drugs should be listed as key monitoring drugs to reduce the incidence of ADR and ensure the safe medication of patients.