含奈玛特韦片/利托那韦片联用医嘱的潜在药物相互作用分析

Analysis of potential drug interactions in the combined medication of inpatient′s orders containing nirmatrelvir tablets/ritonavir tablets

目的 分析住院医嘱中奈玛特韦片/利托那韦片合并用药情况,为临床合理用药提供参考。方法 抽取我院2022年12月1日至2023年2月28日使用奈玛特韦片/利托那韦片的住院患者医嘱信息,参考Medscape和用药助手数据库中药物相互作用的信息,鉴别出存在药物相互作用的医嘱,并进行严重性分级,对因药物相互作用而导致的不良反应事件进行分析。结果 使用奈玛特韦片/利托那韦片的住院患者共计452例,其中有117例患者联合用药存在潜在相互作用,占比25.88%,药物相互作用严重性分级为禁忌、严重、中度分别占27例、70例、20例。因药物相互作用导致不良反应事件有8例,主要表现为呕吐、肾损伤、嗜睡、心率减慢、胃肠道不适、心律不齐、低血压及其相关症状(恶心、头晕)。结论 奈玛特韦片/利托那韦片多药联用普遍,部分患者联合用药存在药物相互作用及药物不良反应,临床治疗中应高度重视;临床药师应加强信息系统对潜在药物相互作用医嘱的拦截设置,积极参与临床用药指导,尽量避免潜在的药物不良相互作用,确保患者用药安全。

Objective To analyze the combined medication of nirmatrelvir tablets/ritonavir tablets in inpatients′order and provide references for rational clinical use.Methods Information on all patients′order using nirmatrelvir tablets/ritonavir tablets from December 1st,2022 to February 28th,2023 in our hospital was extracted;by referring to the information on drug interactions in Medscape and Medication Assistant databases,the medical orders with drug-drug interactions were identified and the severity was graded.The adverse events caused by drug interactions were analyzed.Results A total of 452 inpatients were treated of neimatvir tablets/ritonavir tablets,and 117 patients had potential interaction with neimatvir tablets/ritonavir tablets,accounting for 25.88%.The severity of drug interactions was classified as contraindication in 27 cases,severe in 70 cases,and moderate in 20 cases.There were 8 cases of adverse events caused by drug interactions,mainly manifested as vomiting,kidney injury,drowsiness,slow heart rate,gastrointestinal discomfort,arrhythmia,hypotension and related symptoms(nausea,dizziness).Conclusion Multiple combined use of nirmatrelvir tablets/ritonavir tablets is common.Drug interactions and adverse drug reactions occur in some patients with combined use of nirmatrelvir tablets/ritonavir tablets,which should be paid more attention to in clinical treatment.Clinical pharmacists should strengthen the information system to intercept potential drug interaction orders and actively participate in clinical medication intervention in order to avoid potential adverse drug interactions and ensure patients′medication safety.