医院门诊患者克拉霉素与他汀类药物潜在代谢性相互作用处方分析

Analysis of the Outpatient Prescriptions of Metabolic Interactions Between Clarithromycin and Statins

关键词:  克拉霉素  他汀类药物  药物相互作用

Key words:  clarithromycin  statins  drug-drug interactions

摘要:

目的 分析门诊患者克拉霉素与他汀类药物代谢性相互作用处方，促进合理用药。方法 通过医院合理用药软件系统抽取2017年1月1日—2018年12月31日使用克拉霉素联合他汀类药物的所有门诊处方，以Micromedex药物相互作用数据库为基础，鉴别出潜在的代谢性药物相互作用（pDDIs）并进行严重性分级，结合CNKI、VIP、万方及PubMed数据库收载的克拉霉素与他汀类药物相互作用致不良反应个案报道文献进行分析。结果 共收集到克拉霉素联合使用他汀类药物处方41张，发生pDDIs处方30张，其中阿托伐他汀24张，辛伐他汀6张，严重性分级均为“Major （B）”。检索出克拉霉素与他汀类药物相互作用致不良反应个案报道12例，其中发生横纹肌溶解11例。结论 该院克拉霉素与他汀类药物存在pDDIs，且辛伐他汀超剂量使用，需要加强监测和干预，减少用药风险。

Abstract:

OBJECTIVE To analyze the outpatient prescriptions of metabolic interactions between clarithromycin and statins, and promote rational drug use. METHODS Outpatient prescriptions of using clarithromycin in combination with statins from January 1, 2017 to December 31, 2018 through rational drug software system in a hospital were surveyed. Based on the Micromedex database of drug interactions, potential drug-drug interactions(pDDIs) were identified and classified into categories of potential clinical outcome. The case reports of adverse reactions between clarithromycin and statins were collected from CNKI, VIP, Wanfang and PubMed and analyzed. RESULTS A total of 41 prescriptions of clarithromycin combined with statins were enrolled. There were 30 prescriptions for pDDIs, including 24 atorvastatin prescriptions and 6 simvastatin prescriptions. The severity level of pDDIs was determined by Major(B). Twelve cases of adverse reactions caused by interaction between clarithromycin and statins were included. In which, 11 cases occurred rhabdomyolysis. CONCLUSION There are pDDIs between clarithromycin and statins in the hospital, and simvastatin showed overdose medication. It is necessary for hospital to strengthen monitoring and intervention to reduce the risk of medication.