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与患者弱势群体不良反应相关的药物。

Drugs Associated with Adverse Effects in Vulnerable Groups of Patients.

作者信息

Ștefan Claudia Simona, Nechita Aurel, Dragostin Oana-Maria, Fulga Ana, Lisă Elena-Lăcrămioara, Vatcu Rodica, Dragostin Ionut, Velicescu Cristian, Fulga Iuliu

机构信息

Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 35 AL Cuza st, 800010 Galati, Romania.

Faculty of Medicine, "Grigore T Popa" University of Medicine and Pharmacy Iasi, 16 University Street, 700115 Iaşi, Romania.

出版信息

Clin Pract. 2024 May 31;14(3):1010-1020. doi: 10.3390/clinpract14030080.

Abstract

In recent years, a series of recommendations have been issued regarding the administration of drugs because of awareness of the serious side effects associated with certain classes of drugs, especially in vulnerable patients. Taking into account the obligation of the continuous improvement of professionals in the medical fields and the fact that we are in the midst of a "malpractice accusations pandemic", through this work, we propose to carry out a "radiography" of the scientific literature regarding adverse effects that may occur as a result of the interaction of drugs with the physiopathological particularities of patients. The literature reports various cases regarding different classes of drugs administration associated with adverse effects in the elderly people, such as fluoroquinolones, which can cause torsade de pointes or tendinopathy, or diuretics, which can cause hypokalemia followed by torsade de pointes and cardiorespiratory arrest. Also, children are more prone to the development of adverse reactions due to their physiological particularities, while for pregnant women, some drugs can interfere with the normal development of the fetus, and for psychiatric patients, the use of neuroleptics can cause agranulocytosis. Considering the physiopathological particularities of each patient, the drug doses must be adjusted or even completely removed from the treatment scheme, thus requiring the mandatory active participation both of clinician pharmacists and specialists in the activity of medical-pharmaceutical analysis laboratories within the structure of hospitals.

摘要

近年来,由于意识到某些类别的药物存在严重副作用,尤其是在易受影响的患者中,已发布了一系列关于药物管理的建议。考虑到医疗领域专业人员持续提升的义务以及我们正处于“医疗事故指控大流行”之中,通过这项工作,我们提议对有关药物与患者生理病理特性相互作用可能产生的不良反应的科学文献进行一次“审视”。文献报道了各类药物给药与老年人不良反应相关的各种案例,比如氟喹诺酮类药物可导致尖端扭转型室速或肌腱病,利尿剂可导致低钾血症继而引发尖端扭转型室速和心肺骤停。此外,儿童因其生理特性更容易发生不良反应,而对于孕妇,某些药物会干扰胎儿的正常发育,对于精神病患者,使用抗精神病药物会导致粒细胞缺乏症。考虑到每位患者的生理病理特性,必须调整药物剂量,甚至从治疗方案中完全停用,因此要求临床药剂师以及医院结构内医疗药物分析实验室的专家在活动中进行强制性的积极参与。

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