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糖尿病管理中基于药物治疗的问题:还有很多工作要做!

Pharmacotherapy-Based Problems in the Management of Diabetes Mellitus: Needs Much More to be Done!

作者信息

Ali N, Shah Swa, Khan J, Rehman S, Imran M, Hussian I, Shehbaz N, Jamshed H, Khan S

机构信息

Department of Pharmacy, University of Malakand, Chakdara, Khyber Pakhtunkhwa, Pakistan.

出版信息

J Young Pharm. 2010 Jul;2(3):311-4. doi: 10.4103/0975-1483.66801.

Abstract

A total of 856 diabetic patients were evaluated for pharmacotherapy-based problems like for possible drug interactions, adverse drug reactions, and other mismatches, if any. Poor correlation between the advised insulin therapy and patients' fasting blood glucose levels (12%, n=103) was observed. To most of the patients (41.66%, n= 357), insulin therapy was advised in combination with glucocorticoides, thiazides diuretics, and propranolol. Prescribing beta blocker (propranolol) with insulin is contraindicated. The higher incidence of diabetic foot patients was in the mean age of 57±3.4 years that was controlled with combination therapy of insulin and oral antidiabetics (63.0%, n=516). 11.1% of the treated patients could not take the prescribed therapy due to poor acceptance of insulin therapy due to its syringe needle prick. 41.66% risks of potential drug interactions, 7.93% adverse drug reactions, and 6.6% mismatches were recorded, as per the international approved algorithm, for managing a diabetes mellitus that reflects poor health care system. All these events necessitate for coordinating with other health professionals to make the therapy safer in the better interest of the patients. It is concluded that in practice prescribing pattern carries more risks for patients. It is imperative to improve the practice of pharmacotherapeutics rather than to practice in routine.

摘要

共对856名糖尿病患者进行了评估,以查找基于药物治疗的问题,如可能的药物相互作用、药物不良反应及其他不匹配情况(如有)。观察到建议的胰岛素治疗与患者空腹血糖水平之间的相关性较差(12%,n = 103)。对大多数患者(41.66%,n = 357),建议胰岛素治疗联合糖皮质激素、噻嗪类利尿剂和普萘洛尔。胰岛素与β受体阻滞剂(普萘洛尔)联用是禁忌的。糖尿病足患者的高发年龄平均为57±3.4岁,采用胰岛素和口服降糖药联合治疗进行控制(63.0%,n = 516)。11.1%的接受治疗患者因胰岛素治疗需注射针头而接受度差,无法采用规定的治疗方法。根据国际认可的管理糖尿病的算法,记录到41.66%的潜在药物相互作用风险、7.93%的药物不良反应及6.6%的不匹配情况,这反映出医疗保健系统不佳。所有这些情况都需要与其他医疗专业人员协调,以使治疗对患者更安全、更有利。得出的结论是,在实际中,处方模式给患者带来更多风险。必须改进药物治疗的实践,而不是按常规行事。

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本文引用的文献

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Med Res Rev. 2009 Jan;29(1):125-95. doi: 10.1002/med.20142.
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Review article: diabetes, genetics and ethnicity.综述文章:糖尿病、遗传学与种族
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