患者安全:印度尼西亚日惹格罗西亚精神病院氯氮平的不良反应及其处理。
Patient safety: adverse effects of Clozapine and their management at the Psychiatric Hospital Ghrasia in Yogyakarta, Indonesia.
机构信息
Department of Pharmacology & Clinical Pharmacy, School of Pharmacy, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Indonesia.
School of Pharmacy, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Indonesia.
出版信息
J Med Life. 2023 Nov;16(11):1652-1657. doi: 10.25122/jml-2023-0145.
Clozapine is an atypical antipsychotic indicated for treating patients resistant to antipsychotic therapy when other medications in this class have no therapeutic effect. Clozapine has greater efficacy but more side effects than other atypical antipsychotics (e.g., agranulocytosis, seizures, sedation, and weight gain). Side effects can cause discomfort to patients and can affect patient compliance, interfering with therapeutical outcomes. This study aims to identify the side effects of clozapine use in patients at the Psychiatric Hospital Grhasia, in Yogyakarta, Indonesia. Using a cross-sectional design, this research provides a retrospective descriptive analysis using medical records of patients at the Psychiatric Hospital Ghrasia Yogyakarta. Inpatient and outpatient medical records of patients who had received a clozapine prescription from January to December 2019 were analyzed. In the 336 patients that met the inclusion criteria, the incidence of side effects from clozapine use was 16.07% (95%, CI:2.2-4.1), with the most frequent being dizziness, vomiting, diarrhea, and hypersalivation. There was no effect of age, gender, profession, or patient's disease on their incidence. The management of side effects is classified into three aspects: the drug is stopped, the patient is given additional therapy, and the patient is not given therapy. The results showed that the use of clozapine at the Psychiatric Hospital Ghrasia Yogyakarta was relatively safe. Identification of side effects is necessary to determine the follow-up treatment.
氯氮平是一种非典型抗精神病药,用于治疗对其他抗精神病药物治疗无效的患者。氯氮平比其他非典型抗精神病药(如粒细胞缺乏症、癫痫发作、镇静和体重增加)具有更好的疗效,但副作用也更多。副作用会给患者带来不适,并影响患者的依从性,从而影响治疗效果。本研究旨在确定印度尼西亚日惹格拉萨里亚精神病院使用氯氮平的患者的副作用。本研究采用横断面设计,对格拉萨里亚精神病院 2019 年 1 月至 12 月期间接受氯氮平处方的患者的病历进行回顾性描述性分析。对符合纳入标准的 336 名患者的住院和门诊病历进行了分析。在使用氯氮平的 336 名患者中,副作用的发生率为 16.07%(95%CI:2.2-4.1),最常见的是头晕、呕吐、腹泻和唾液分泌过多。年龄、性别、职业或患者疾病对其发生率没有影响。副作用的管理分为三个方面:停药、给予额外治疗和不给治疗。结果表明,日惹格拉萨里亚精神病院使用氯氮平相对安全。识别副作用对于确定后续治疗非常必要。
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