摘要
目的评估和管理沙库巴曲缬沙坦相互作用,促进心力衰竭患者合理用药。方法对韶关市粤北人民医院使用的处方前置审核系统优化前2021年9月至2022年2月拦截的沙库巴曲缬沙坦相互作用进行风险评估,提取处方前置审核系统优化后2022年4月至9月拦截的相互作用进行效果评价。结果优化前,药物相互作用警示数12680次,沙库巴曲缬沙坦相互作用占比29.6%。风险评估后,将沙库巴曲缬沙坦合用血管紧张素转化酶抑制剂(ACEIs)5级警示上调为8级,直接拦截,医生修改医嘱后方可通过;将合用血管紧张素Ⅱ受体拮抗剂(ARBs)保持5级警示,合用他汀类5级警示下调为4级,需药师审方。优化后,处方前置审核系统拦截的药物相互作用11190次,沙库巴曲缬沙坦相互作用1206次,占比下降18.8%,其中11次8级拦截,38次5级拦截。结论沙库巴曲缬沙坦相互作用经过风险评估,通过处方前置审核系统分级管理,可防范联合用药造成的严重风险,保障临床用药安全。
Objective To evaluate and manage the interaction of Sacubitril Valsartan,so as to promote rational use of drugs in patients with heart failure.Methods Risk assessment of Sacubitril Valsartan interaction in Yue Bei People's Hospital intercepted by the prescription pre-checking system before optimization from September 2021 to February 2022 was conducted.The interactions intercepted by the prescription pre-checking system after optimization from April to September 2022 were extracted to evaluate the effect.Results Before optimization,the number of drug interaction alerts was 12680,with Sacubitril Valsartan interactions accounting for 29.6%.After risk assessment,the alert for Sacubitril Valsartan combined with angiotensin converting enzyme inhibitors(ACEIs)was upgraded from level 5 to level 8,which could be directly blocked and it can be approved after doctors modified their clinical advice.The alert for combined use of angiotensin receptor blockers(ARBs)was maintained at level 5,and the alert for combined use of statins was reduced from level 5 to level 4,which required pharmacists'check.After optimization,the prescription pre-checking system intercepted 11190 drug interactions,and Sacubitril Valsartan interactions 1206 times,reduced by 18.8%,including 8-level intercepts for 11 times and 5-level intercepts for 38 times.Conclusion After risk assessment of Sacubitril Valsartan interaction and hierarchical management through the prescription pre-checking system,serious risks caused by combined drug use can be prevented and the safety of clinical medication can be ensured.
作者
赖日英
肖健
何蓉蓉
LAI Riying;XIAO Jian;HE Rongrong(Department of Pharmacy,Yue Bei People's Hospital,Guangdong Province,Shaoguan512026,China)
出处
《中国当代医药》
CAS
2023年第13期141-144,共4页
China Modern Medicine
