“妊娠期用药风险评估与沟通药师门诊”的咨询内容和特殊案例分析

Analysis of Questions and Special Cases of the Pharmacist Outpatient with Risk Assessment and Communication of Drugs in Pregnancy

关键词:  妊娠期  药物  咨询  药学服务

Key words:  pregnancy  drug  counsel  pharmacy services

摘要:

目的 通过调查"妊娠期用药风险评估与沟通药师门诊"（简称"药师门诊"）患者咨询的问题，了解妊娠用药的基本情况，筛选出典型案例，探讨分析妊娠期用药安全的影响因素及原则，为女性妊娠期的安全用药提供参考。方法 对2012年9月-2017年8月在药师门诊咨询的对象共3 405例，采用直接对话形式进行咨询、沟通、教育，并记录。结果 咨询者中女性占90.84%，男性占9.16%。妊娠用药对胎儿影响为咨询的主要问题，且大部分为确诊妊娠前用药，占咨询人数的59.15%，妊娠早期用药占37.53%，其他占3.32%。从妊娠期用药患者中筛选出典型案例，临床药师重点评估药物对胎儿的致畸风险。案例涉及女方使用的孕激素、雌激素、降糖药、抗菌药物、精神药、抗凝剂及父母双方使用的兴奋剂。结论 临床药师开展的门诊妊娠期妇女用药咨询服务模式针对性强，不仅改善妊娠期妇女对药物治疗的正确认识和态度，也大大提高了临床药师的专业知识水平。

Abstract:

OBJECTIVE To investigate the questions of pregnant askers in the pharmacist outpatient with risk assessment and communication of drugs in pregnancy, pharmacists understood the basics of pregnancy medication, and screened out typical cases, then explored the influencing factors and principles of drug safety during pregnancy. It provided reference for safe drug use in women during pregnancy. METHODS Communicated with 3 405 questioners directly in this counseling outpatient during September 2012-August 2017, and then consulted, communicated, educated and recorded. RESULTS The consultants with female were 90.84%; with male were 9.16%. The chief problem was drug-used in pregnancy, 59.15% counselors were took drugs before the diagnosis of pregnancy; 37.53% counselors were used drugs during pregnancy; 3.32% ones asked questions other than medicines. To select the typical and special records with medicaitons in gestation, the clinic pharmacists focused on assessing the teratogenic risk of drugs on fetus. These cases involved progesterone, estrogens, hypoglycemic agents, antibiotics, psychotropic substances, anticoagulants, and stimulants used by both parents. CONCLUSION It is targeted that the pharmacists carried out this individualized pharmacy services for gravidas in outpatient. It not only gets more knowledge for pregnant women, but also enhances their attitudes of medications, even improves the professional knowledge of clinical pharmacists.