综合性医院门诊抗高血压药的药物利用研究

Drug Utilization of Antihypertensives for Outpatients in a General Hospital

关键词:  抗高血压药  药物利用  合理用药  相互作用  药动学  用药教育

Key words:  antihypertensives  drug utilization  rational drug use  drug interaction  pharmacokinetics  patient education

摘要:

目的了解抗高血压药的临床应用模式，并促进其合理用药。方法利用医院信息系统药房管理子系统，对2008年11月14日-11月18日某综合性医院门诊患者含抗高血压药的处方进行回顾性分析。合理性标准为药品说明书、国内外循证医学研究结果、药物代谢酶学和2007年欧洲高血压治疗指南。结果该院的抗高血压药治疗应用总体较为合理，较好地符合治疗指南。极少量处方在用法用量和合并用药方面的合理性值得商榷。结论临床医生和药师应遵循药物治疗指南，注意鉴别潜在的相互作用，做好患者用药教育和抗高血药药物治疗达标管理。应用药动学原理，可以有效指导临床合理选药。对于多重用药患者可以加强药物治疗监测，必要时换用替代药品等。

Abstract:

OBJECTIVE To know the clinical use pattern of antihypertensives and enhance the rationality of drug use. METHODS Using a pharmacy administration software, retrospective survey of recipes containing antihypertensives was conducted during Novernber 14 - Novernber 18, 2008. The standard for rational prescriptions include content of package insert, results of evidence-based medicine, science of drug metabolism and 2007 European Guide for hypertension. RESULTS The clinical use of antihypertensives was generally rational in a better accordance with standard therapeutic guidline. Only a small number of prescriptions were worth discussing in repect of dosage and coadministration. CONCLUSION Doctors and pharmacists should follow the relevant standard therapeutic guidline, identify the potential drug-drug interactions, enhance patient education and help patients achieve blood pressure goals. The pharmacokinetic principles can be applicated to guide the prescribing antihypertensives. For patients receiving multiple medications, pharmacotherapy monitoring should be strenthened and if necessary use the alternatives.