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重症监护病房药物相互作用的频率和类型评估:一项横断面研究。

Assessment of frequency and types of drug interactions in intensive care units: a cross-sectional study.

作者信息

Baghaei Rahim, Torabzadeh Aysan, Sorayya Hamid, Alinejad Vahid

机构信息

Patient Safety Research Center, Clinical Research Institute.

Department of Nursing, School of Nursing and Midwifery.

出版信息

Ann Med Surg (Lond). 2023 Nov 1;86(1):98-102. doi: 10.1097/MS9.0000000000001355. eCollection 2024 Jan.

Abstract

BACKGROUND

Drug interactions can cause adverse reactions, from treatment inefficiency to serious treatment complications in the patient. Due to the complexity of drug therapy and the simultaneous use of several drugs and different drug groups, patients hospitalized in intensive care units are exposed to more drug interactions. Therefore, this study was conducted to investigate the frequency of drug interactions in patients hospitalized in the ICU.

METHODS

In this cross-sectional study, the files of 300 patients hospitalized in the ICU were examined. Drug interactions were determined using Lexicomp software and the book drug iteration facts. Data analysis was done using SPSS 21 software.

FINDINGS

The findings showed that there were a total of 1121 cases of interference. Two hundred thirty-one (77%) patients had moderate interference, 94 (31.3%) patients had mild interference, and 67 patients (22.3%) had severe interference. One hundred eight patients had B-type interference, 223 C-type interference, 116 D-type interference, and 6 X-type interference, so most of the interactions are C-type interference. One hundred eighty-six patients had pharmacokinetic interference and 201 patients had pharmacodynamics interference. The highest interaction was between two drugs, heparin and aspirin with 58 cases.

CONCLUSION

This study highlights the alarming frequency and types of drug interactions observed in ICU. The high prevalence of drug interactions emphasizes the need for improved medication management and vigilance in these critical care settings. Polypharmacy and certain drug combinations were identified as major contributing factors to the occurrence of drug interactions, which calls for regular medication reviews and cautious prescribing practices.

摘要

背景

药物相互作用可导致不良反应,从治疗无效到患者出现严重的治疗并发症。由于药物治疗的复杂性以及多种药物和不同药物组的同时使用,入住重症监护病房的患者面临更多的药物相互作用。因此,本研究旨在调查入住重症监护病房患者的药物相互作用发生频率。

方法

在这项横断面研究中,检查了300例入住重症监护病房患者的病历。使用Lexicomp软件和《药物相互作用事实》一书来确定药物相互作用。使用SPSS 21软件进行数据分析。

结果

结果显示共有1121例相互作用情况。231例(77%)患者存在中度相互作用,94例(31.3%)患者存在轻度相互作用,67例(22.3%)患者存在重度相互作用。108例患者存在B型相互作用,223例存在C型相互作用,116例存在D型相互作用,6例存在X型相互作用,因此大多数相互作用为C型相互作用。186例患者存在药代动力学相互作用,201例患者存在药效动力学相互作用。相互作用最多的两种药物是肝素和阿司匹林,共58例。

结论

本研究突出了在重症监护病房观察到的药物相互作用的惊人频率和类型。药物相互作用的高发生率强调了在这些重症监护环境中改善药物管理和提高警惕的必要性。多种药物联合使用和某些药物组合被确定为药物相互作用发生的主要促成因素,这就需要定期进行药物审查和谨慎的处方做法。

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