基于药品说明书的儿童用药信息调查和儿童不适宜用药评价

发布时间：2018-04-12 16:47

本文选题：儿童 + 药品说明书　；参考：《安徽中医药大学》2017年硕士论文

【摘要】：目的:儿童作为一个特殊群体,不合理用药现象时有发生。由于指导合理用药的主要工具是药品说明书,因此本文基于药品说明书对儿童用药信息进行调查,并根据说明书中有关的儿童用药信息,拟定评价儿童不适宜用药的依据,从而分析儿童不适宜用药情况,为儿童合理用药评价标准体系的建立提供本底资料。方法:1.调查某三甲医院所有在用药品说明书中的儿童用药信息;2.统计说明书中提及的儿童禁用以及儿童不宜使用的药物,并进行分类整理,建立适用于本研究的儿童不适宜用药依据;3.抽取2015年8月至2015年12月在医院就诊的儿童患者病历,并以上述依据为衡量工具分析某院儿童不适宜用药情况。结果:1.本文共调查医院在用药品说明书共1412份,其中注射类药物说明书共533份,口服类药物说明书共718份,外用药说明书共161份。按药物种类划分,主要涉及15大类。含儿童“用法用量”项的共433份,占30.67%,含“儿童用药”项的有980份,占69.41%,提及有关儿童的“不良反应”的有125份,占8.85%。2.说明书中提及儿童“禁用”的药物有76种,提及儿童“不宜使用”的药物有190种。依照药物分类,儿童禁用的药物居前的分别是神经系统用药、消化系统用药以及中成药。儿童不宜使用的药物居前的分别是神经系统用药、激素及其有关药物、抗微生物药物、消化系统用药。3.本次共抽取儿童患者病历2700份,住院患儿1200份,平均联合用药数量为18.73±16.88种;门诊患儿1500份,平均联合用药数量为3.05±1.73种。根据儿童不适宜用药依据,统计所得不适宜用药的病历共735例,占27.22%,使用的禁用药物有10种,不宜使用的药物为72种。不适宜用药频率最高的药物有托烷司琼、氟比洛芬酯、喜炎平、阿托品、右美托咪定。(本文所提到的儿童禁用和不宜使用的药物,均为在某些年龄范围内儿童禁用或不宜使用,并非所有的年龄段儿童,具体可参见儿童禁用和不宜使用一览表。)结论:通过对说明书中的儿童用药信息进行调查,以及利用儿童不适宜用药依据对某院患儿病历进行回顾性研究,发现儿童用药依旧存在着一些问题,影响儿童不适宜用药的因素也很多,临床医生应尽量避免儿童不适宜药物的使用,有关部门也应该采取相应的措施和拟定解决的方案,减少儿童不适宜用药的发生。
[Abstract]:Objective: as a special group, irrational use of drugs occurs from time to time.Because the main tool to guide the rational use of drugs is the drug instructions, this paper investigates the drug use information of children based on the drug instructions, and draws up the basis for evaluating children's unsuitable use of drugs according to the relevant information of children's drug use in the instructions.Therefore, it can provide background information for the establishment of the evaluation standard system of rational drug use in children by analyzing the situation of unsuitable drug use in children.Method 1: 1.To investigate the information of drug use for children in the instructions of a third Class A Hospital.The disabling and unsuitable drugs for children mentioned in the statistical instruction were classified and sorted to establish the basis for the unsuitable use of drugs for children in this study.The medical records of children from August 2015 to December 2015 were collected, and the unsuitable drug use for children in a hospital was analyzed based on the above data.The result is 1: 1.A total of 1412 medical instructions were collected, of which 533 were for injection drugs, 718 for oral drugs and 161 for foreign drugs.According to the type of drugs, mainly involved in 15 categories.There were 433 "usage dosage" items for children (30.67%), 980 items (69.41%) for "children's medication", and 125 (8.85.2.) for children's "adverse reactions".There are 76 "forbidden" drugs and 190 "unfit" drugs for children in the manual.According to drug classification, the top drugs banned by children are nervous system drugs, digestive system drugs and proprietary Chinese medicines.A total of 2700 medical records of children were selected, 1200 of them were hospitalized, the average number of combined drugs was 18.73 卤16.88, and 1500 of outpatients were 3.05 卤1.73.According to the basis of unsuitable use of drugs for children, 735 cases (27.2222%) were found to be unfit for drug use, 10 kinds of banned drugs were used and 72 kinds of drugs were not suitable for use.The most frequently used drugs are tropisetron, flurbiprofen, Xiyanping, atropine, dexmetomidine.(the drugs that are prohibited and unsuitable for children mentioned herein are prohibited or unsuitable for children within certain age ranges, and not for all ages. See the list of prohibited and unsuitable use for children.)Conclusion: through the investigation of the information of children's drug use in the instruction book and the retrospective study on the medical records of children in a hospital, it is found that there are still some problems in the use of drugs by children.There are many factors that affect children's unsuitability to use drugs. Clinicians should try their best to avoid the use of children's unsuitable drugs, and relevant departments should also take corresponding measures and draw up solutions to reduce the occurrence of children's unsuitable drugs.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R985

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