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心脏病患者的药物不良反应。无心力衰竭患者与有心力衰竭患者的比较。

Adverse drug reactions (ADRs) in patients with heart diseases. Comparison between patients without and with heart failure.

作者信息

Ruiz I, Ortiz M

出版信息

Int J Clin Pharmacol Ther Toxicol. 1984 Nov;22(11):595-601.

PMID:6500756
Abstract

Adverse drug reactions (ADRs) may be more frequent in patients who present some diseases. By means of an intensive prospective drug surveillance work, 492 patients with heart diseases, hospitalized at the Department of Medicine of the Clinical Hospital of the University of Chile, were studied in order to determine the frequency and characteristics of ADRs. ADRs were significantly more frequent in patients with heart failure (HF) (30.0%) than in those without HF (22.7%)(p less than 0.05). Patients presenting HF developed more metabolic disturbances than patients not presenting HF (p less than 0.001). Furosemide was the most frequently used drug in both groups, but treatment with it was longer in patients with HF who presented a significantly higher frequency of adverse reactions to this diuretic (p less than 0.05). 89.9% of ADRs in patients without HF and 93.8% of ADRs in those with HF, were dose-related effects. Analyses of some predisposing factors to ADRs, such as age, number of drugs administered, duration of hospitalization, ADR or allergy histories and presence of a renal failure, did not explain differences found between ADRs in patients without and with HF. These findings suggest that heart failure may be a determinant of frequency and characteristics of ADRs.

摘要

患有某些疾病的患者中药物不良反应(ADR)可能更为常见。通过一项密集的前瞻性药物监测工作,对智利大学临床医院内科收治的492例心脏病患者进行了研究,以确定ADR的发生率和特征。心力衰竭(HF)患者中ADR的发生率(30.0%)显著高于无HF患者(22.7%)(p<0.05)。出现HF的患者比未出现HF的患者发生更多的代谢紊乱(p<0.001)。两组中最常用的药物都是呋塞米,但在出现对该利尿剂不良反应频率显著更高的HF患者中,使用呋塞米的治疗时间更长(p<0.05)。无HF患者中89.9%的ADR以及有HF患者中93.8%的ADR为剂量相关效应。对一些ADR的易感因素进行分析,如年龄、用药数量、住院时间、ADR或过敏史以及肾衰竭的存在情况,并未解释无HF患者和有HF患者之间ADR的差异。这些发现表明心力衰竭可能是ADR发生率和特征的一个决定因素。

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