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[1]骆雨璇,陈醒,王楠,等.审方药师对某院生殖科门诊超说明书用药的分析与思考[J].医学研究与战创伤救治(原医学研究生学报),2022,24(5):500-503.[doi:10.3969/j.issn.1672-271X.2022.05.011]
　LUO Yu-xuan,CHEN Xing,WANG Nan,et al.Analysis and thinking of the examiner’s pharmacist on the off-label medicines in a reproductive department of a hospital[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(5):500-503.[doi:10.3969/j.issn.1672-271X.2022.05.011]
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审方药师对某院生殖科门诊超说明书用药的分析与思考()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第24卷
期数:
2022年5期
页码:
500-503
栏目:
药学研究
出版日期:
2022-11-02

文章信息/Info

Title:
Analysis and thinking of the examiner’s pharmacist on the off-label medicines in a reproductive department of a hospital
作者:
骆雨璇; 陈醒; 王楠; 陈旭青; 王兴东
作者单位：210002南京，东部战区总医院（原南京军区南京总医院）医疗保障中心药剂科（骆雨璇、王楠、陈旭青、王兴东）；210002南京，无锡联勤保障中心药品仪器监督检验站（陈醒）
Author(s):
LUO Yu-xuan1; CHEN Xing2; WANG Nan1; CHEN Xu-qing1; WANG Xing-dong 1
（1.Department of Pharmacy, Medical Supplies Center, General Hospital of Eastern Theater Command, PLA, Nanjing 210002, Jiangsu, China；2.Wuxi Joint Logistics Supporting Center Supervision And Inspection Station for Drug And Instrument, Nanjing 210002，Jiangsu, China)
关键词:
生殖科; 超说明书用药; 审方药师; 合理用药
Keywords:
reproductive department;  off-label medicines;  examiner pharmacist;  rational use of drugs
分类号:
R95
DOI:
10.3969/j.issn.1672-271X.2022.05.011
文献标志码:
A
摘要:
目的通过对某院生殖科门诊超说明书用药进行合理性分析，为药师在审方过程中遇到类似问题提供参考。方法采用回顾性分析法，选取某院2021年1-12月生殖科门诊的所有医嘱，共58518条，结合循证证据判断用药医嘱是否超说明书，并对其合理性进行分析。结果某院生殖科门诊超说明书用药17968条，超说明书用药比例30.71%，主要类型包括超适应证用药（60.27%）、超剂量用药（26.79%）、超给药途径用药（10.43%）、超适应人群给药（1.53%）以及超禁忌证用药（0.98%），主要涉及药品包括地屈孕酮片（17.99%）、胰激肽原酶肠溶片（13.75%）、雌二醇/雌二醇地屈孕酮片（10.73%）等。经合理性分析后，其中合理医嘱17535条，占97.59%；不合理医嘱433条，占2.41%，涉及药品吲哚美辛栓、羟乙基淀粉注射剂、莫西沙星片、沙丁胺醇片和莉芙敏片。结论某院生殖科门诊超说明书用药较为普遍，根据循证医学证据以及相关指南、专家共识分析基本合理，但也存在一定的用药风险，建议通过一定的管理手段促进临床用药更为安全、合理。
Abstract:
ObjectiveTo provide a reference for pharmacists to meet the similar problems during review of prescriptions by analyzing the rationality of off-label medicines in a Reproductive Department of a hospital.MethodsA retrospective analysis method was used to select all prescriptions in a Reproductive Outpatient Clinic in a hospital from January to December 2021. A total of 58 518 prescriptions combined with evidence-based evidences were analyzed to determine whether the prescriptions exceeded the instructions and analysis its rationality.ResultsThere were 17 968 (30.71%) off-label medicines in the Reproductive Department of a hospital. The main types include over-indication medication (60.27%), over-dose medication (26.79%), over-administration route (10.43%), over-adapted population administration (1.53%), and over-contraindication medication (0.98%). The drugs included dydrogesterone tablets (17.99%), pancreatic kininogenase enteric-coated tablets (13.75%), estradiol/estradiol dydrogesterone tablets(10.73%) and so on. After a reasonableness analysis, 17535 prescriptions (97.59%) were reasonable prescriptions, while 433 prescriptions (2.41%) were unreasonable prescriptions. Irrational medication involved drugs such as indomethacin suppositories, hydroxyethyl starch injections, moxifloxacin tablets, salbutamol tablets and Livmin tablets.ConclusionThe off-label medicines in the Reproductive Department of a hospital are relatively common. The analysis based on evidence-based medicine evidence, relevant guidelines, and expert consensus is basically reasonable, however, there is still a certain medication risk. It is recommended to strictly manage off-label medications through certain management methods.

参考文献/References:

[1]佚名. 男性生殖相关基因检测专家共识[J]. 中华男科学杂志,2020,26(9):844-851.
[2]徐婧，吴凡，李言，等．77776条生殖医学中心门诊用药医嘱点评与分析[J]．中国医院用药评价与分析，2018，18（1）：113-116．
[3]张波,郑志华,李大魁. 超药品说明书用药参考[M]. 北京:人民卫生出版社,2013:2.
[4]陈秀丽, 赵双, 刘诗卉,等. 通过案例说明超说明书用药规范管理及适用条件[J]. 中国医院, 2021,25(8):69-71.
[5]Rijken TM, Haadsma ML,Hammer C,et al. Effectiveness of indometacin to prevent ovulation in modified natural-cycle IVF: A randomized controlled trial[J]. ReprodBiomedOnline,2013,27:297-304.
[6]王晓宁，刁红录，张昌军．羟乙基淀粉预防卵巢过度刺激综合征的应用进展[J]．重庆医学，2019,48(6）：1018-1020．
[7]石玉华，蒋琪.辅助生殖治疗中卵巢过度刺激综合征的防治[J].山东大学学报，2019，57（10）：13-19.
[8]Practice Committee of the American Society for Reproductive Medicine. Electronic address：ASRM@asrm.org；Practice Committee of the American Society for Reproductive Medicine. Prevention and treatment of moderate and severe ovarian hyperstimulation syndrome：a guide line[J].Fertil Steril， 2016，106(7)：1634-1647.
[9]夏晓珊, 吕小超. 莫西沙星与左氧氟沙星治疗尿路感染的临床效果比较[J]. 临床合理用药杂志, 2020, 13(17):24-25.
[10]郭佳音，郭志玲，董少卿，等. 不同氟喹诺酮类抗菌药物对泌尿系统感染患者的临床疗效及其经济学比较[J]. 抗感染药学，2018，15（3）：479-480.
[11]李婷婷，孙吉，李慧. 3种喹诺酮类药治疗尿路感染效果的Meta分析[J].中国现代医学杂志，2018，28(33）：76-82.
[12]张延华,朱永红,刘美仑. 2019年某部医院超说明书用药现状及管理策略分析[J]. 现代药物与临床,2021,36(5):1061-1064.
[13]杨翔,张瑗,陈阳希,等. 高龄老年患者不合理用药情况调查及影响因素分析[J]. 医学研究生学报,2018,31(1):39-43.
[14]陈威,黄婧,于西全. 某院生殖中心门诊超说明书用药调查分析[J]. 中国药师,2017,20(10):1805-1808.
[15]张蓉晖, 周华, 方崇波,等. 审方药师规范化培训体系建立与实施[J]. 中医药管理杂志,2019,27(21):96-99.
[16]陈醒, 袁力, 王楠. 医院门诊处方前置审核的实施效果初探[J]. 东南国防医药, 2020,22(5):541-543.
[17]刘金玉, 曾露, 郭敏,等. 多学科合作与循证助力处方前置审核模式构建[J]. 中国医院药学杂志,2021,41(9):948-952.

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更新日期/Last Update: 2022-11-16