Al Khaja Khalid A J, Al-Haddad Mohammed K, Al-Offi Adel R, Abdulraheem Masooma H, Sequeira Reginald P
Department of Pharmacology & Therapeutics, Arabian Gulf University, Manama, Kingdom of Bahrain.
Fundam Clin Pharmacol. 2009 Apr;23(2):253-8. doi: 10.1111/j.1472-8206.2008.00662.x.
There are concerns about the safety of the dextropropoxyphene and acetaminophen fixed-dose combination, particularly in patients with psychiatric morbidity, which has led to a phased withdrawal of this fixed-dose combination in many countries. A retrospective prescription audit was conducted to evaluate the dextropropoxyphene + acetaminophen fixed-dose combination prescribing pattern in the major psychiatric hospital of Bahrain. The data analysis was performed using SPSS/PC+ version 14.0. Prescriptions with the dextropropoxyphene + acetaminophen fixed-dose combination comprised 11.8% of all dispensed prescriptions and in most instances for outpatients undergoing substance abuse rehabilitation. Nearly half of the patients received >or=20 tablets of this fixed-dose combination (mean +/- SD: 30.9 +/- 13.1; range 20-126) as multiple doses. The dextropropoxyphene + acetaminophen fixed-dose combination was often co-prescribed with psychotropics, such as benzodiazepines (BZDs) (25.4%), BZDs + antidepressants (62.9%), BZDs + antipsychotics (3.7%) and BZDs + anticonvulsants (1.9%). Approximately 40% of prescriptions with the dextropropoxyphene + acetaminophen fixed-dose combination were written 'as required' (prn), basis. Despite poor safety and efforts to restrict or withdraw worldwide, the dextropropoxyphene + acetaminophen fixed-dose combination continues to be irrationally prescribed to outpatients undergoing substance abuse rehabilitation in Bahrain. Health policy decision-makers should introduce a phased withdrawal of this drug from clinical use. In the meanwhile, it is important to create awareness among prescribers of the risks associated with over-dosage of the dextropropoxyphene + acetaminophen fixed-dose combination and its interaction with other psychotropic medications.
右丙氧芬和对乙酰氨基酚固定剂量复方制剂的安全性受到关注，尤其是在患有精神疾病的患者中，这导致许多国家逐步停用这种固定剂量复方制剂。在巴林的主要精神病医院进行了一项回顾性处方审核，以评估右丙氧芬+对乙酰氨基酚固定剂量复方制剂的处方模式。使用SPSS/PC+14.0版进行数据分析。右丙氧芬+对乙酰氨基酚固定剂量复方制剂的处方占所有配药处方的11.8%，在大多数情况下是给正在接受药物滥用康复治疗的门诊患者开具的。近一半的患者接受了≥20片这种固定剂量复方制剂（平均±标准差：30.9±13.1；范围20 - 126），分多次服用。右丙氧芬+对乙酰氨基酚固定剂量复方制剂常与精神药物联合开具，如苯二氮䓬类药物（BZD）（25.4%）、BZD + 抗抑郁药（62.9%）、BZD + 抗精神病药（3.7%）和BZD + 抗惊厥药（1.9%）。大约40%的右丙氧芬+对乙酰氨基酚固定剂量复方制剂处方是“按需”开具的。尽管安全性不佳且全球都在努力限制或停用，但右丙氧芬+对乙酰氨基酚固定剂量复方制剂仍在巴林被不合理地开给正在接受药物滥用康复治疗的门诊患者。卫生政策决策者应分阶段停用这种药物的临床使用。与此同时，重要的是要让开处方者意识到右丙氧芬+对乙酰氨基酚固定剂量复方制剂过量用药的风险及其与其他精神药物的相互作用。
