Day Richard O, Snowden Leone, McLachlan Andrew J
Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, New South Wales, Australia.
School of Medical Sciences, Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Intern Med J. 2017 May;47(5):501-512. doi: 10.1111/imj.13404.
Adverse drug-drug interactions are a significant cause of adverse events and outcomes. Their incidence is rising, with more patients taking more drugs, and newer, more precise but often more hazardous drugs becoming available. Despite considerable information, including computerised alerts about potential adverse drug-drug interactions, prescribers increasingly override alerts, possibly symptomatic of the immense problem of evaluating the risk of an interaction in a particular patient. Many reports emanate from small studies often of normal and young volunteers, entirely different from the real world where, more often, older patients with multiple health conditions are receiving many more than the two drugs identified in the drug interaction report. Focusing on those drug-drug interactions that are clinically relevant is necessary, and increasingly, tools and reliable sources of this information are easily accessible.
药物不良相互作用是不良事件和后果的一个重要原因。其发生率正在上升，因为越来越多的患者服用越来越多的药物，并且有更新的、更精确但往往更具危险性的药物可供使用。尽管有大量信息，包括关于潜在药物不良相互作用的计算机化警报，但开处方者越来越多地忽略这些警报，这可能表明在评估特定患者相互作用风险这一巨大问题上存在症状。许多报告来自小型研究，这些研究通常针对正常和年轻志愿者，与现实世界完全不同，在现实世界中，更多时候是患有多种健康问题的老年患者正在服用比药物相互作用报告中确定的两种药物多得多的药物。关注那些具有临床相关性的药物相互作用是必要的，而且越来越容易获得有关此信息的工具和可靠来源。
