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目的:明确住院治疗的心脏病患者中潜在的药物-药物相互作用(drug-drug interaction,DDI),并对DDI相关危险因素进行评估。方法:选择2013年5月至2013年12月入院治疗的至少服用2种药物且入院不少于24小时的心脏病患者为研究对象,应用“标准药物相互作用数据库Micromedex-2(Thomson Reuters)×2.0”对这些患者可能发生的药物相互作用进行分析。结果:共入选150例患者,其中32例患者被确认出现了至少一种药物组合的DDI,发生率为21.3%;明确了48个有潜在危险因素的药物相互作用。阿托伐他汀/阿奇霉素(10.4%)、依那普利/二甲双胍(10.4%)、依那普利/氯化钾(10.4%)、阿托伐他汀/克拉霉素(8.3%)、呋塞米/庆大霉素(6.3%)是最常见的存在相互作用的药物组合,阿托伐他汀、依那普利、地高辛、呋塞米、氯吡格雷、华法林等药物经常参与药物相互作用。大多数药物的相互作用比较温和,但“用药种类增多、住院时间延长、存在合并症”等危险因素与潜在药物-药物相互作用(potential drug-drug interaction,p DDI)密切相关。结论:住院治疗的心脏病患者潜在DDI发生率较高,用药种类增多、住院时间延长、存在合并症均为其发生的危险因素。对那些存在明确危险因素的住院治疗的心脏病患者密切监测是十分必要的,医务人员要尽早发现和预防这些潜在的药物相互作用对人体健康造成的伤害。
OBJECTIVE: To determine the potential drug-drug interaction (DDI) in hospitalized patients with cardiac disease and to assess the risk factors associated with DDI. METHODS: Cardiac patients admitted to hospital from May 2013 to December 2013 with at least 2 medications and admitted to hospital for not less than 24 hours were enrolled in this study. The “Standard Drug Interaction Database Micromedex-2 (Thomson Reuters) × 2.0 ”The possible drug interactions in these patients were analyzed. RESULTS: A total of 150 patients were enrolled. Of 32 patients, DDI was identified with at least one combination of drugs at a rate of 21.3%. Forty-eight drug interactions with potentially dangerous factors were identified. Atorvastatin / Azithromycin (10.4%), Enalapril / Metformin (10.4%), Enalapril / Potassium Chloride (10.4%), Atorvastatin / Clarithromycin Gemcitabine (6.3%) is the most common drug combination with interactions, and atorvastatin, enalapril, digoxin, furosemide, clopidogrel, warfarin and other drugs are often involved medicine interactions. Most drug interactions are milder, but risk factors such as increased drug use, prolonged hospital stay, and comorbidities are associated with potential drug-drug interactions (pDDI). Conclusions: The incidence of potential DDI in hospitalized patients with heart disease is higher, the types of drugs used, the length of hospital stay, and the presence of comorbidities are all risk factors. It is imperative to monitor closely those hospitalized patients with heart disease who have definite risk factors, and medical staff should early detect and prevent the potential harm to human health caused by these potential drug interactions.