Goh C L
Singapore Med J. 1989 Jun;30(3):285-9.
This paper reviews an approach to the evaluation and documentation of suspected adverse drug reaction (ADR). I propose an algorithm for the evaluation of suspected ADR. I recommend that the adverse drug reaction scoring system(ASS) or the adverse drug reactions probability scale(APS) be used when evaluating suspected ADR. In these two scoring systems, points are allotted according to response to a series of questions on events relating to the clinical manifestations of the suspected ADR. Depending on the total points scored the probability of the suspected ADR are classified as definite, probable, possible and unlikely. When a patient's suspected ADR is classified as definite, then no further investigation is necessary. The patient should be considered sensitive to the drug. In a case where the suspected ADR is classified as probable or possible then further investigations should be considered to confirm the diagnosis. If the nature of ADR is life threatening only in-vitro test should be done. If the nature of ADR is not life threatening, in-vivo and oral provocative test dosing may be considered. It should be considered if the suspected drug in question cannot be substituted and when it is very frequently prescribed.
本文综述了一种评估和记录疑似药物不良反应（ADR）的方法。我提出了一种评估疑似ADR的算法。我建议在评估疑似ADR时使用药物不良反应评分系统（ASS）或药物不良反应概率量表（APS）。在这两种评分系统中，根据对一系列与疑似ADR临床表现相关事件问题的回答来分配分数。根据总得分，疑似ADR的概率分为肯定、很可能、可能和不太可能。当患者的疑似ADR被分类为肯定时，则无需进一步调查。该患者应被视为对该药物敏感。如果疑似ADR被分类为很可能或可能，则应考虑进一步调查以确诊。如果ADR的性质仅危及生命，则应仅进行体外试验。如果ADR的性质不危及生命，则可考虑进行体内和口服激发试验给药。应考虑所涉疑似药物是否无法替代以及其处方频率是否很高。
