评价三级转诊医院住院猫咪的胃保护剂使用情况。
Evaluation of gastroprotectant administration in hospitalized cats in a tertiary referral hospital.
机构信息
Department of Medicine and Epidemiology, University of California-Davis School of Veterinary Medicine, Davis, CA, USA.
VCA East Bay Veterinary Emergency Hospital, Antioch, CA, USA.
出版信息
J Feline Med Surg. 2023 Oct;25(10):1098612X231201769. doi: 10.1177/1098612X231201769.
OBJECTIVES
The primary objective of this study was to evaluate the prescription patterns and appropriateness of the use of gastroprotectant medication in cats.
METHODS
Pharmacy dispensation logs from an academic tertiary referral center were reviewed between 1 January 2018 and 31 December 2018. Cats that were administered proton pump inhibitors (PPIs), histamine-2 receptor antagonists (H2RAs), sucralfate, misoprostol, antacids or a combination were included. Data regarding medication, dosage, formulation, duration of administration, completeness of discharge instructions and clinical rationales for administration were obtained from medical records. The appropriateness of gastroprotectant use was assessed according to the American College of Veterinary Internal Medicine consensus statement guidelines.
RESULTS
Of the 110 cases, 67 (60.9%) were prescribed a gastroprotectant medication without an appropriate indication. The most common reason for prescription was acute kidney injury in 26/67 (38.8%). PPIs were the most common gastroprotectant medication administered in 95/110 (86.3%) cats, followed by sucralfate in 18/110 (16.4%) and H2RAs in 11/110 (10%). Of the 35 cases in which gastroprotectant therapy was indicated, the medication chosen or dosage administered was considered suboptimal in 16 (45.7%). Instructions regarding the duration of administration, potential adverse effects and timing of administration in relation to meals or other medications were inconsistently provided in discharge instructions to pet owners. Of the 29 cases discharged with omeprazole, only 13 (44.8%) instructions included a duration of administration, while 6 (20.7%) recommended continuing gastroprotectants indefinitely until further notice, 16 (55.2%) discussed the timing of the administration in relation to a meal and six (20.7%) mentioned potential adverse effects; none advised tapering of omeprazole before discontinuation.
CONCLUSIONS AND RELEVANCE
When prescribed, gastroprotectant medications were frequently prescribed injudiciously to cats in this referral population over a 12-month period. Discharge instructions to pet owners also often lacked information and recommendations regarding optimal administration, potential adverse effects, and tapering or discontinuation of the medications.
目的
本研究的主要目的是评估猫科动物胃保护药物的处方模式和使用的适宜性。
方法
回顾 2018 年 1 月 1 日至 2018 年 12 月 31 日期间，一家学术性三级转诊中心的药房配药记录。纳入接受质子泵抑制剂（PPIs）、组胺 2 受体拮抗剂（H2RAs）、硫糖铝、米索前列醇、抗酸剂或联合治疗的猫。从病历中获得有关药物、剂量、制剂、给药时间、出院医嘱的完整性以及给药的临床理由等数据。根据美国兽医内科学会共识声明指南评估胃保护剂使用的适宜性。
结果
在 110 例病例中，67 例（60.9%）在无适当指征的情况下开具了胃保护剂。最常见的处方原因是 26/67（38.8%）例急性肾损伤。在 110 例猫中，最常用的胃保护剂是 PPI（95/110，86.3%），其次是硫糖铝（18/110，16.4%）和 H2RA（11/110，10%）。在 35 例有胃保护剂治疗指征的病例中，所选药物或给予的剂量被认为是不理想的，有 16 例（45.7%）。在向宠物主人提供的出院医嘱中，关于给药持续时间、潜在不良反应以及与进餐或其他药物的给药时间的说明不一致。在 29 例出院时给予奥美拉唑的病例中，只有 13 例（44.8%）的医嘱中包含给药持续时间，而 6 例（20.7%）建议无限期继续使用胃保护剂，直至另行通知，16 例（55.2%）讨论了与进餐相关的给药时间，6 例（20.7%）提到了潜在的不良反应；没有建议在停药前逐渐减少奥美拉唑的剂量。
结论和相关性
在这一转诊人群中，在 12 个月期间，胃保护药物的处方常常被不恰当地用于猫。向宠物主人提供的出院医嘱也常常缺乏有关最佳给药、潜在不良反应以及药物的逐渐减少或停用的信息和建议。
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