摘要
目的通过对真实世界的胺碘酮的药品药物相互作用与不良反应进行分析与评价,为临床合理用药提供参考。方法使用由杭州逸曜信息技术有限公司研发的逸曜合理用药管理系统,收集滕州市中心人民医院2020年1月1日至2024年6月30日住院科室中使用胺碘酮的病例,筛选使用胺碘酮及其联合用药时间>3 d的案例进行数据统计,调查医嘱中胺碘酮联合用药情况及其可能的不良反应。结果共收集到3692例使用胺碘酮的病例,筛选出与胺碘酮具有药物相互作用的病例共3027例,占81.99%,与胺碘酮有关的药物相互作用数为9877种,其中X级740种,D级3012种,C级6125种,以C级占比最多,为62.01%;美托洛尔、华法林和呋塞米分别是引起胺碘酮C级、D级、X级药物相互作用最为常见的药物(10.40%、6.53%、1.08%),其不良结果主要有:增加严重心动过缓、低血压和心脏停搏风险;增加华法林的血药浓度和抗凝活性;增加QT间期延长风险,特别是尖端扭转型室速。结论胺碘酮与多种常用药物存在相互作用,多药合用是致胺碘酮药物相互作用的危险因素。重视与胺碘酮有关的药物相互作用风险,在处方前置审核系统中完善其药物相互作用的监测和预警,以避免潜在药源性损害的产生,提高医疗质量。
Objective To provide a reference for rational clinical drug use by analyzing and evaluating the drug interactions and adverse durg reactions of amiodarone in the real world.Methods Using the yiyao rational drug use management system developed by Hangzhou Yiyao Information Technology Co.Ltd.,cases of amiodarone use in inpatient departments of Tengzhou Central People's Hospital from January 1,2020 to June 30,2024 were collected.Cases of amiodarone use and its combination therapy for more than 3 days were screened for data statistics,and the situation of amiodarone combination therapy and its possible toxic side effects in medical orders were investigated.Results A total of 3692 cases using amiodarone were collected,and 3027 cases with drug interactions with amiodarone were screened,accounting for 81.99%.The number of drug interactions related to amiodarone was 9877,including 740 in grade X,3012 in grade D,and 6125 in grade C,with grade C accounting for the highest proportion at 62.01%;metoprolol,warfarin,and furosemide were the most common drugs that cause C-class,D-class,and X-class drug interactions with amiodarone(10.40%,6.53%,1.08%),respectively.Their adverse outcomes mainly included:increased risk of severe bradycardia,hypotension,and cardiac arrest;increased blood concentration and anticoagulant activity of warfarin;increased risk of QT interval prolongation,especially torsades de pointes ventricular tachycardia.Conclusion Amiodarone interacts with multiple commonly used drugs,and the combination of multiple drugs is a risk factor for drug interactions with amiodarone.Pay attention to the drug interaction risks related to amiodarone,and improve the monitoring and warning of drug interactions in the prescription pre-approval system to avoid potential drug-induced damage and improve medical quality.
作者
葛欣
程慎令
刘平
朱妍莹
GE Xin;CHENG Shen-ling;LIU Ping;ZHU Yan-ying(Department of Pharmacy,Tengzhou Central People's Hospital,Tengzhou,Shandong 277599,China)
出处
《医药论坛杂志》
2026年第1期70-73,78,共5页
Journal of Medical Forum
基金
山东省药学会资助项目(Kjyw2024-23)。
