基于评价数据库探索易致重度不良反应药品的儿童用药安全性

Exploration on the Safety of Drugs for Children Prone to Severe Adverse Reactions Based on the Evaluation Database

关键词:  重度不良反应  儿童  安全  探索

Key words:  severe adverse reactions  children  safety  exploration

摘要:

目的 基于量化评分探索易致重度不良反应药品在儿童用药的安全性。方法 按《中国医疗机构药品评价与遴选快速指南》中的赋分方法，提取河北省人民医院药品综合评价数据库中“安全性”项下不良反应评分为1，2分的药品，首先提取不良反应分级为4~5级且发生率≥1%的所有院内药品，即不良反应分级评分为1，2分的药品，得出全院所有容易导致严重不良反应的药品。其次依据这部分药品在“儿童适用性”项下的评价分数，探索易致严重不良反应的药品在儿童用药中的安全性，即分数为0说明该药品儿童禁用，分数为2说明该药品儿童可用。结果 严重不良反应发生率≥10%的药品共18个，包括肿瘤用药15个，免疫抑制剂3个。儿童可用药品13个，禁用药品5个。严重不良反应发生率1%~10%的药品共73个，包括肿瘤用药57个，镇痛药11个，麻醉用药2个，治疗精神障碍药1个，血液系统药1个，眼科用药1个。其中儿童可用药品30个，禁用43个。结论 通过提取量化评价体系“不良反应”项下评分为1，2分的药品，获取全院易致重度不良反应的药品，分析该部分药品在儿童中使用的可行性，利用小程序、信息化手段为临床儿童用药提供参考意义。

Abstract:

OBJECTIVE To explore safety of drugs for children prone to severe adverse reactions based on the evaluation database.METHODS According to the scoring method in the "Quick Guide for Drug Evaluation and Selection in Chinese Medical Institutions", the drugs with 1 or 2 adverse scores under "Safety" in the database of drug comprehensive evaluation of Hebei General Hospital were extracted, first, all the drugs in the hospital with 4-5 grade adverse drug reactions and the incidence rate ≥ 1% were extracted, that was, the drugs with 1 or 2 grade adverse drug reactions were obtained. Secondly, based on the evaluation scores of these drugs in the category of "Child Suitability", the safety of drugs that was prone to serious adverse reactions in children's drugs was explored, that was, a score of 0 indicated that the drug was banned in children, a score of 2 indicated that the drug was available to children. RESULTS There were 18 drugs with ≥ 10% adverse drug reactions, including 15 drugs for tumor and 3 drugs for immunosuppressants. Thirteen drugs were available for children and 5 were banned. The incidence of serious adverse reactions ranged from 1% to 10%. There were 73 drugs including 57 drugs for tumor, 11 drugs for pain relief, 2 drugs for anesthesia, 1 drug for treatment of mental disorders, 1 drug for blood system and 1 drug for ophthalmology. Of these, 30 were available for children and 43 were banned. CONCLUSION Through the extraction of drugs with 1 or 2 points under "Adverse Reactions" in the quantitative evaluation system, the common drugs with serious adverse reactions in the whole hospital are obtained, the feasibility of the use of these drugs in children is analyzed, the use of mini program, information means for clinical children to provide reference of drug use.