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一家三级护理医院自愿报告的药物不良反应概况:一项为期15个月的前瞻性研究。

The profile of voluntary reported adverse drug reactions at a tertiary care hospital: a fifteen month prospective study.

作者信息

Dang Amit, Bhandare P N

机构信息

Director, Geronimo Healthcare Solutions Private Limited.

出版信息

J Clin Diagn Res. 2012 Nov;6(9):1504-9. doi: 10.7860/JCDR/2012/4340.2544.

Abstract

OBJECTIVES

The present study was undertaken to provide the health professionals who were working at a tertiary care hospital, with a simple method to report Adverse Drug Reactions (ADRs) and to monitor, document and to evaluate them according to the set criteria.

METHOD AND MATERIALS

This study was conducted over a period of 15 months from 1st Jan' 2008 to 31st March 2009 at Goa Medical College and Hospital (Goa, India). The evaluation of the data was done for various parameters, which included patient demographics and drug and reaction characteristics. An assessment was also done for the outcome, causality and the severity of the drug reactions.

RESULTS

A total of 265 ADRs were reported. Among the drugs, the ß-lactam antibiotics were implicated the maximum number of times (54, 20.37%), followed by fluoroquinolones (35, 13.20%), antiretrovirals (33, 12.45%) and antiepileptics (31, 11.69%). Females showed more ADRs (142, 54%) than males (123, 46%). The skin was involved in about 57.73% (153) of the ADRs, while the CNS and the vascular system were involved in 8.67% (23) and 8.30% (22) of the ADRs. Most of the ADRs were categorized as "Type II" (203, 77%) against "Type I" (62, 23%) by Rawlins and Thompson's classification. The causality assessment was done by the Naranjo Algorithm and 62.26% (165) were seen to fall in the "probable category" as compared to 29.05% (77) in the "highly probable" one. Out of all the ADRs which were reported, 34.71% (148) were "severe", in accordance with the Modified Hartwig and Siegel's scale.

CONCLUSION

The present work was a humble attempt to set up a well organized ADR reporting system at our government hospital. The systematic tracking and monitoring of ADRs can shed light on their extensiveness and their patterns of occurrence.

摘要

目的

开展本研究是为了给在一家三级护理医院工作的卫生专业人员提供一种简单的方法来报告药品不良反应(ADR),并根据既定标准对其进行监测、记录和评估。

方法与材料

本研究于2008年1月1日至2009年3月31日在印度果阿邦医学院及医院(果阿)进行,为期15个月。对数据进行了各种参数的评估,包括患者人口统计学信息以及药物和反应特征。还对药物反应的结果、因果关系和严重程度进行了评估。

结果

共报告了265例药品不良反应。在这些药物中,β - 内酰胺类抗生素涉及次数最多(54次,占20.37%),其次是氟喹诺酮类(35次,占13.20%)、抗逆转录病毒药物(33次,占12.45%)和抗癫痫药物(31次,占11.69%)。女性出现的药品不良反应(142例,占54%)比男性(123例,占46%)更多。皮肤不良反应约占57.73%(153例),而中枢神经系统和血管系统的不良反应分别占8.67%(23例)和8.3%(22例)。根据罗林斯和汤普森的分类,大多数药品不良反应被归类为“II型”(203例,占77%),而“I型”为(62例,占23%)。采用纳朗霍算法进行因果关系评估,62.26%(165例)被判定为“可能”类别,相比之下,“很可能”类别的占29.05%(77例)。根据改良的哈特维希和西格尔量表,在所有报告的药品不良反应中,34.71%(148例)为“严重”不良反应。

结论

本研究是在我们的政府医院建立一个组织良好的药品不良反应报告系统的一次初步尝试。对药品不良反应进行系统的跟踪和监测可以揭示其广泛性和发生模式。

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本文引用的文献

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Developing an adverse drug reaction reporting system at a teaching hospital.在一家教学医院建立药物不良反应报告系统。
Basic Clin Pharmacol Toxicol. 2008 Apr;102(4):408-11. doi: 10.1111/j.1742-7843.2008.00217.x. Epub 2008 Feb 29.
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Adverse drug reaction monitoring in a secondary care hospital in South India.印度南部一家二级护理医院的药物不良反应监测
Br J Clin Pharmacol. 2008 Feb;65(2):210-6. doi: 10.1111/j.1365-2125.2007.02993.x. Epub 2007 Jul 27.

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