我院静脉滴注用PPIs的使用概况及医嘱审核注意事项分析

Analysis of the use of PPIs for intravenous infusion in our hospital and the precautions for medical order review

目的通过检索质子泵抑制剂(PPIs)药品说明书、相关诊疗指南及规范,汇总我院静脉用PPIs类药品的使用情况,分析我院PPIs类药品使用的规范性及合理性。方法通过医院信息系统(HIS)检索我院2021年静脉用PPIs使用情况,包括使用的品规数、支数及金额数等;回顾性分析我院2021年静脉用药调配中心(PIVAS)静脉用药医嘱干预情况,汇总PPIs类药品的常见不适宜用药处方。结果我院静脉用PPIs类药品使用广泛,其中兰索拉唑类使用量最大,雷贝拉唑类使用金额占比最高;临床存在的不合理使用情况主要表现为无适应证用药、溶媒选取有误、用法用量不适宜、配伍禁忌等。结论各级医疗机构应加强PPIs类药品的使用管控,PIVAS药师应依据药品说明书、诊疗指南及规范等认真、严肃地审核用药医嘱,确保临床患者用药安全、有效、经济、适宜。

Objective To summarize the use of intravenous proton pump inhibitors(PPIs)in our hospital by searching the drug instructions,relevant diagnosis and treatment guidelines,and specifications of PPIs drugs,and analyze the standardization and rationality of the use of PPIs drugs in our hospital.Methods The use of PPIs for intravenous use in our hospital in 2021 was retrieved through the hospital information system(HIS),including the number of specifications,the number of branches and the amount of money used.The intervention of intravenous medication orders in pharmacy intravenous admixture services(PIVAS)of our hospital in 2021 was retrospectively analyzed,and the common inappropriate medication prescriptions of PPIs were summarized.Results PPIs drugs for intravenous use in our hospital were widely used,among which lansoprazole was the most used,and rabeprazole accounted for the highest proportion of consumption amount;the irrational clinical use were mainly manifested as no indications of medication,incorrect solvent selection,inappropriate usage and dosage,incompatibility and so on.Conclusion Medical institutions at all levels should strengthen the control of the use of PPIs drugs.PIVAS pharmacists should carefully and seriously review medication orders based on drug instructions,diagnosis and treatment guidelines,and standards to ensure the safety,effectiveness,economy and suitability of clinical patients'medication.