Kogut Stephen J
Department of Pharmacy Practice, University of Rhode Island, 41 Lower College Rd., Kingston, RI 02881, USA.
J Manag Care Pharm. 2011 Sep;17(7):547-51. doi: 10.18553/jmcp.2011.17.7.547.
Drug risks may be ignored or under appreciated, overemphasized, misinterpreted, or in some cases presented in ways that do not wholly reflect the evidence base and clinical experience. Often the available evidence pertaining to drug interactions is grounded upon theoretical concerns, very small trials, or case reports, and thus it is often very challenging to balance the potential risks and benefits of a particular therapy when drug interactions are present. While prescribers and pharmacists may fail to heed interaction alerts provided by decision support systems, it is also possible that the overstatement of risks can cause providers to avoid utilizing a clinically beneficial therapy. The case of the interaction between triptan antimigraine medications and selective serotonin reuptake inhibitor/selective serotonin-norepinephrine reuptake inhibitor (SSRI/SNRI) antidepressants provides an example of how the presentation of drug risk may unduly influence the utilization of drug therapy.
药物风险可能被忽视、未得到充分重视、被过度强调、被误解,或者在某些情况下,其呈现方式并未完全反映证据基础和临床经验。通常,与药物相互作用相关的现有证据基于理论担忧、非常小的试验或病例报告,因此,当存在药物相互作用时,平衡特定治疗的潜在风险和益处往往极具挑战性。虽然开处方者和药剂师可能会忽视决策支持系统提供的相互作用警报,但风险的过度陈述也可能导致医疗服务提供者避免使用临床上有益的治疗方法。曲坦类抗偏头痛药物与选择性5-羟色胺再摄取抑制剂/选择性5-羟色胺-去甲肾上腺素再摄取抑制剂(SSRI/SNRI)抗抑郁药之间相互作用的案例,说明了药物风险的呈现方式可能如何过度影响药物治疗的使用。