内科病区老年患者潜在的药物相互作用

Potential Drug–drug Interactions in Elderly Patients in the Internal Medicine Ward

关键词:  药物相互作用  老年患者  药物不良反应

Key words:  drug-drug interactions  elderly patients  adverse drug reactions

摘要:

目的 探讨内科病区老年患者用药中的药物相互作用情况。方法 查阅电子病历，将2014年10月—2015年6月宁波市妇女儿童医院内科病区收治入院的老年(年龄≥65周岁)患者纳入研究对象，并对其用药情况进行回顾性调查研究，以药品说明书为依据，评判其是否存在药物相互作用，并对可能由其导致的药物不良事件进行统计分析。结果 共163例老年患者纳入研究，医嘱用药中位数是7，潜在的药物相互作用中位数是3，94例患者存在有临床意义的潜在的药物相互作用，占57.7%；临床发生实际药物相互作用有10例，占6.1%，其中8例发生药物不良反应，2例发生药物疗效欠佳。结论 为了保障老年患者用药安全，医师应关注药物的相互作用，尽量减少用药品种数和避免选择相互作用有害的药物以降低药物不良事件的发生率。

Abstract:

OBJECTIVE To investigate drug–drug interactions (DDIs) in the elderly patients in the internal medicine ward, and to provide the basis for clinical medication. METHODS A retrospective study was conducted through looking up the electronic medical records. All patientsaged≥65 years admitted the internal medicine ward of the hospital between June 2015 and October 2014 were included. Drug use situation in the elderly patients during ward stay were investigated and determined whether there was a DDI based on the drug instructions. The drug adverse events caused by DDIs were statistically analyzed. RESULTS A total of 163 patients were ultimately enrolled in the study. The median number of prescribed drugs was 7. The median number of potential DDIs per patient was 3. Potential DDIs were identified in 94 patients, accounted for 57.7%. Actual DDIs were detected in 10 (6.1%) patients. An adverse drug reaction (ADR) resulting from DDIs was detected in 8 patients. In 2 patients, DDIs resulted in diminished therapeutic effect. CONCLUSION In order to ensure the elderly patient safety in medication, physicians should pay attention to DDIs, and try to minimize the number of prescribed drugs and avoid choosing medications that cause adverse DDI to reduce the incidence of DDI-related adverse drug events.