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西班牙一家医院成年肿瘤住院患者中的潜在药物相互作用:流行病学及危险因素

Potential drug-drug interactions in oncological adult inpatients at a Spanish hospital: epidemiology and risk factors.

作者信息

Fernández de Palencia Espinosa M Ángeles, Díaz Carrasco M Sacramento, Alonso Romero José Luis, de la Rubia Nieto Amelia, Espuny Miró Alberto

机构信息

Servicio de Farmacia, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.

Servicio de Oncología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.

出版信息

Int J Clin Pharm. 2015 Dec;37(6):1021-7. doi: 10.1007/s11096-015-0195-z. Epub 2015 Sep 21.

Abstract

BACKGROUND

Oncological patients are at high risk for drug-drug interactions (DDIs), which may contribute to therapeutic failure or lead to serious adverse events.

OBJECTIVE

To determine the prevalence of potential DDIs in medication lists, to describe the most frequent DDIs and to investigate the possible risk factors associated with them. A prospective cohort study was performed at the Oncology Department of a tertiary hospital over a 12-week period. Twice a week, every inpatient's treatment sheet was collected and screened through two databases: Micromedex™ and Drug Interaction Facts™. All identified potential DDIs with a moderate or higher severity rating were recorded. Multivariate analysis was used to identify risk factors associated with DDIs.

RESULT

A total of 1956 DDIs were detected in 699 treatment sheets. The prevalence of treatment sheets with DDIs was 81.0 % and 32.6 % by Micromedex™ and Drug Interaction Facts™, respectively. Central nervous depressant agents and antiemetics were the most commonly involved groups in DDIs. A higher number of non-antineoplastic drugs was related with potential DDIs [adjusted-OR 1.398 and 1.613 by Micromedex™ and Drug Interaction Facts™, respectively]. CONCLUSION The prevalence of potential DDIs was widely variable among databases. The main risk factor associated with DDIs was a higher number of non-antineoplastic medicines.

摘要

背景

肿瘤患者发生药物相互作用(DDIs)的风险很高,这可能导致治疗失败或引发严重不良事件。

目的

确定用药清单中潜在DDIs的发生率,描述最常见的DDIs,并调查与之相关的可能风险因素。在一家三级医院的肿瘤科进行了一项为期12周的前瞻性队列研究。每周两次收集每位住院患者的治疗单,并通过两个数据库进行筛查:Micromedex™和《药物相互作用事实》™。记录所有识别出的严重程度为中度或更高的潜在DDIs。采用多变量分析来识别与DDIs相关的风险因素。

结果

在699份治疗单中总共检测到1956例DDIs。通过Micromedex™和《药物相互作用事实》™检测到有DDIs的治疗单的发生率分别为81.0%和32.6%。中枢神经抑制剂和止吐药是DDIs中最常涉及的药物类别。非抗肿瘤药物数量较多与潜在DDIs相关[通过Micromedex™和《药物相互作用事实》™调整后的OR分别为1.398和1.613]。结论:各数据库中潜在DDIs的发生率差异很大。与DDIs相关的主要风险因素是较多的非抗肿瘤药物。

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