Charpiat B, Henry A, Leboucher G, Tod M, Allenet B
Joseph-Fourier University-Grenoble 1, CNRS, TIMC-IMAG UMR 5525, Themas, Domaine de la Merci, 38706 La Tronche cedex, France.
Ann Pharm Fr. 2012 Jul;70(4):213-8. doi: 10.1016/j.pharma.2012.05.002. Epub 2012 Jun 19.
Paracetamol is the most commonly used analgesic and antipyretic. Reviews of hospital use of paracetamol are scarce. Little is known about the appropriateness of the dose of paracetamol prescribed for hospitalized adults. The aim of this study was to report on the nature and the frequency of the overdosed prescription of paracetamol observed in adult patients over a 4.5-year period in a teaching hospital.
Prescription analysis by pharmacists was performed once a week in six medical and three surgical departments and daily in a post-emergency unit. In cases of prescription error, the pharmacist notified the physician through an electronic alert when a computerized prescription order entry system was available or otherwise by face-to-face discussion. For each drug-related problem detected, the pharmacists recorded relevant details in a database.
From October 2006 to April 2011, 44,404 prescriptions were reviewed and 480 alerts related to the overdosed prescription of paracetamol were made (1% of analyzed prescriptions). The extent of errors of dosage was within the intervals [90-120 mg/kg/d] and greater than 120 mg/kg/d for 87 and 11 patients respectively, who were prescribed a single non-combination paracetamol containing product. Sixty alerts concerned co-prescription of at least two paracetamol containing products with similar frequency for computerized (1.4/1000) or handwritten (1.2/1000) prescriptions.
Prescriptions of paracetamol for hospitalized adults frequently exceed the recommended dosage.
These results highlight the need for increased awareness of unintentional paracetamol overdose and support the initiation of an educational program aimed at physicians and nurses.
对乙酰氨基酚是最常用的止痛和解热药物。关于医院使用对乙酰氨基酚的综述较为匮乏。对于住院成人患者所开对乙酰氨基酚剂量的合理性知之甚少。本研究的目的是报告在一家教学医院4.5年期间成年患者中观察到的对乙酰氨基酚过量处方的性质和频率。
药剂师每周对六个内科和三个外科科室进行一次处方分析，在急诊后病房则每天进行分析。在出现处方错误的情况下，若有计算机化处方录入系统，药剂师通过电子警报通知医生，否则通过面对面讨论通知。对于检测到的每个与药物相关的问题，药剂师在数据库中记录相关细节。
从2006年10月至2011年4月，共审查了44404张处方，发出了480条与对乙酰氨基酚过量处方相关的警报（占分析处方的1%）。对于开具单一不含复方的对乙酰氨基酚产品的患者，剂量错误程度在[90 - 120毫克/千克/天]区间内的有87人，大于120毫克/千克/天的有11人。60条警报涉及至少两种含对乙酰氨基酚产品的联合处方，计算机化处方（1.4/1000）和手写处方（1.2/1000）的频率相似。
住院成人的对乙酰氨基酚处方经常超过推荐剂量。
这些结果凸显了提高对对乙酰氨基酚无意过量的认识的必要性，并支持启动针对医生和护士的教育项目。
