Heerey A, Barry M, Ryan M, Kelly A
Department of Pharmacology and Therapeutics, University of Dublin, Trinity College, Dublin, Ireland.
Ir J Med Sci. 2000 Jul-Sep;169(3):176-9. doi: 10.1007/BF03167690.
Seven percent of acute hospital admissions result from adverse drug reactions, of which 25% are due to drug interactions. Adverse effects of statin drugs occur in 3% of patients, mainly due to co-prescribing with other lipid-lowering agents or agents that alter their metabolism.
The aim of this study was to investigate co-prescribing of the frequently-used statin medications with interacting drugs.
Data from the General Medical Services (GMS) scheme of the Eastern Health Board from January to December 1998 were used in this study. Using the coding index for statins, co-prescribing was identified when concomitant medications were administered under the same GMS claim number.
Of 7,602 patients prescribed statins, co-prescribing of simvastatin, atorvastatin and fluvastatin with competing substrates or inhibitors of their metabolism occurred in 32, 26 and 13.4% of prescriptions issued. Thirty-four per cent of patients on simvastatin, 28% on atorvastatin and 16% on fluvastatin were prescribed medications with drug interaction potential.
Co-prescribing of statins with competing substrates or inhibitors of their metabolism occurred in up to one-third of prescriptions issued. When statins are co-prescribed with recognised inhibitors of drug metabolism, pravastatin, which does not undergo significant hepatic metabolism, is the statin of choice.
急性医院住院病例中有7%是由药物不良反应导致的，其中25%是由药物相互作用引起的。他汀类药物的不良反应发生在3%的患者中，主要是由于与其他降脂药物或改变其代谢的药物联合使用。
本研究的目的是调查常用他汀类药物与相互作用药物的联合使用情况。
本研究使用了东部卫生委员会1998年1月至12月的全科医疗服务（GMS）计划数据。使用他汀类药物的编码索引，当在同一GMS索赔编号下同时使用伴随药物时，确定联合用药情况。
在7602例开具他汀类药物的患者中，辛伐他汀与阿托伐他汀和氟伐他汀与竞争性底物或其代谢抑制剂的联合使用分别出现在32%、26%和13.4%的处方中。服用辛伐他汀的患者中有34%、服用阿托伐他汀的患者中有28%、服用氟伐他汀的患者中有16%被开具了具有药物相互作用潜力的药物。
他汀类药物与竞争性底物或其代谢抑制剂的联合使用出现在高达三分之一的处方中。当他汀类药物与公认的药物代谢抑制剂联合使用时，不经过显著肝代谢的普伐他汀是首选的他汀类药物。
