2020~2021年某院760例药品不良反应报告分析

Analysis of 760 ADR reports in a hospital from 2020 to 2021

目的探究某院药品不良反应(ADR)发生状况和特点,为临床合理用药提供参考。方法选取2020年~2021年某院上报的760例药品不良反应报告,对药品不良反应的严重程度、用药途径、用药原因及药品不良反应的类型进行统计分析。结果在760例ADR中,男性356例,占46.8%;女性404例,占53.2%;60~69岁年龄段患者的比例最高,占21.6%,其次是50~59岁年龄段的患者,占20.3%。静脉滴注发生率最高有598例,占78.7%;其次是口服给药有82例,占10.8%。ADR排名前5位的药物依次为抗肿瘤类药物(123例,占16.2%)、抗感染类药物(104例,占13.7%)、心血管系统类药物(90例,占11.8%)、消化系统类药物(84例,占11.1%)、呼吸系统类药物(75例,占9.9%)。其中,抗肿瘤药物中,发生ADR前5位的药品分别为奥沙利铂注射液(32例,占26.0%)、顺铂注射液(25例,占20.3%)、多西他赛注射液(20例,占16.3%)、注射奈达铂(20例,占16.3%)、卡铂注射液(18例,占14.6%);抗感染药物中,发生ADR前5的药品分别为乳酸左氧氟沙星氯化钠注射液(10例,占9.6%)、注射用头孢曲松钠(9例,占8.6%)、甲磺酸左氧氟沙星注射液(7例,占6.7%)、注射用头孢他啶(6例,占5.8%)、注射用头孢哌酮钠舒巴坦钠(5例,占4.8%)。新的ADR报告243例,其中排名前3位的为米索前列醇片(9例,占3.7%),果糖二磷酸钠注射液(8例,占3.3%),氨甲环酸注射液、盐酸倍他司汀注射液、注射用头孢他啶和注射用尼麦角林(均为7例,占2.9%);新的ADR中严重的有4例,分别为注射用哌拉西林钠他唑巴坦钠、注射用头孢孟多酯钠、吸入用乙酰半胱氨酸溶液、二乙酰氨乙酸乙二胺注射液。结论在临床用药中,应重点监测抗肿瘤类药物和抗感染类药物的使用,同时应注意中老年患者的用药安全,消化道系统反应是常见的ADR发生信号。在临床中应不断的提高安全用药的意识,减少ADR的发生。

Objective To explore the occurrence and characteristics of adverse drug reactions(ADR)in our hospital,and provide reference for clinical rational drug use.Methods 760 cases of ADR reported by our hospital from 2020 to 2021 were selected for statistical analysis of the severity of ADR,route of administration,reason of administration and types of ADR.Results Among 760 ADR cases,356 cases were male,accounting for 46.8%;404 cases were female,accounting for 53.2%;Patients aged 60 to 69 years accounted for 21.6%,followed by patients aged 50 to 59 years,accounting for 20.3%.The highest incidence of intravenous drip was 598 cases(78.7%).The second was oral administration(82 cases,10.8%).The top 5 ADR drugs were anti-tumor drugs(123 cases,16.2%),anti-infective drugs(104 cases,13.7%),cardiovascular drugs(90 cases,11.8%),digestive drugs(84 cases,11.1%)and respiratory drugs(75 cases,9.9%).Among the anticancer drugs,the top five drugs with ADR were oxaliplatin injection(32 cases,26.0%),cisplatin injection(25 cases,20.3%),docetaxel injection and nedaplatin injection(20 cases,16.3%),carboplatin injection(18 cases,14.6%),iodoxanol injection and flurbiprofen ester injection(3 cases,2.4%);Among the anti-infective drugs,the top 5 drugs for ADR were levofloxacin lactate sodium chloride injection(10 cases,9.6%),ceftriaxone sodium for injection(9 cases,8.6%),levofloxacin mesylate injection(7 cases,6.7%),ceftazidime for injection(6 cases,5.8%).4.8%),cefoperazone sodium and sulbactam sodium for injection(5 cases,5.1%).243 new ADR cases were reported,among which the top 3 were misoprostol tablets(9 cases,3.7%),fructose sodium diphosphate injection(8 cases,3.3%),tranexamic acid injection,betastine hydrochloride injection,ceftazidime for injection and niergoserin for injection(7 cases,2.9%).Four new ADR cases were serious,including piperacillin sodium and tazobactam sodium for injection,cefmendol sodium for injection,acetylcysteine solution for inhalation,ethylenediamine diacetoacetic acid injection.Conclusion In clinical medication,the use of anti-tumor drugs and anti-infective drugs should be monitored.Meanwhile,due to the attention to the safety of medication in middle-aged and elderly patients,common ADR signals in the digestive system are reflected.In clinical practice,doctors should constantly improve the awareness of safe drug use and reduce the occurrence of ADR.