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印度南部一家三级护理医院对儿科肿瘤患者药物不良反应和药物相互作用的监测。

Surveillance of adverse drug reactions and drug-drug interactions with pediatric oncology patients in a south Indian tertiary care hospital.

作者信息

Joseph Bency, Scott Julius X, Rajanandh M G

机构信息

Department of Pharmacy Practice, Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.

Department of Pediatric Oncology, Sri Ramachandra Medical College, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.

出版信息

J Oncol Pharm Pract. 2020 Jul;26(5):1103-1109. doi: 10.1177/1078155219882081. Epub 2019 Oct 25.

Abstract

OBJECTIVE

The present study was conducted to evaluate the pattern of occurrence of adverse drug reactions and drug-drug interaction in a pediatric oncology unit of a tertiary care hospital.

METHODS

A prospective, observational study was conducted in the Department of Pediatric Oncology, Sri Ramachandra Medical College and Hospital, India. Patients were monitored actively for the occurrences of any adverse drug reaction during the study period. Patient's demographic details, clinical, and treatment data were collected for drug-drug interaction analysis. The detected adverse drug reaction was assessed for causality, severity, and preventability. Drug-drug interaction identified was rated based on their level of urgency and the nature of actions necessary to respond to an interaction.

RESULTS

Of 176 patients, 118 were detected for the occurrence of various adverse drug reaction. The majority of the cases were suffering with acute lymphocytic leukemia (67.9%). Vincristine was noted for a maximum number of adverse drug reaction in cytotoxic drugs. Rash is the most frequently occurred reaction. Assessment of causality showed that the majority of cases are "probable" (60.16%). In evaluating the severity of adverse drug reactions, 57.6% reactions were moderately severe and 74.5% of the reactions were preventable. Upon assessing the drug-drug interaction, 38.13% of the prescription needs to be monitored and 10 drug-drug interactions were under the risk category of "X." The majority of the adverse drug reaction was moderately severe in nature and those were preventable.

CONCLUSION

Since pediatrics are vulnerable population, they must have a thorough surveillance system for adverse drug reaction and drug-drug interaction; thereby, a positive impact on the medication-use system and improved patient care can be achieved.

摘要

目的

本研究旨在评估一家三级医院儿科肿瘤病房中药物不良反应和药物相互作用的发生模式。

方法

在印度斯里兰卡拉马钱德拉医学院医院儿科肿瘤学系进行了一项前瞻性观察研究。在研究期间,对患者积极监测任何药物不良反应的发生情况。收集患者的人口统计学细节、临床和治疗数据用于药物相互作用分析。对检测到的药物不良反应进行因果关系、严重程度和可预防性评估。识别出的药物相互作用根据其紧急程度和应对相互作用所需采取行动的性质进行评级。

结果

176例患者中,118例被检测出发生了各种药物不良反应。大多数病例患有急性淋巴细胞白血病(67.9%)。在细胞毒性药物中,长春新碱引起的药物不良反应数量最多。皮疹是最常出现的反应。因果关系评估显示,大多数病例为“可能”(60.16%)。在评估药物不良反应的严重程度时,57.6%的反应为中度严重,74.5%的反应是可预防的。在评估药物相互作用时,38.13%的处方需要监测,10种药物相互作用属于“X”类风险等级。大多数药物不良反应在性质上为中度严重,且是可预防的。

结论

由于儿科患者是弱势群体,必须建立完善的药物不良反应和药物相互作用监测系统;从而,可对用药系统产生积极影响并改善患者护理。

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