临床药师对ICU潜在药物相互作用的鉴别和药学干预

目的：本研究描述药物潜在的药物相互作用（pDDIs）在重症监护室（ICU）发生的危险因素和类型,分析临床药师通过药学干预提高ICU患者用药的安全性和有效性。方法：以Micromedex和Medscape药物相互作用数据库为基础鉴别出pDDIs,临床药师根据患者具体病情,并参考相关文献对pDDIs的严重性进行评估和分析,最后对ICU医嘱中pDDIs进行药学干预,并提出具体的建议。结果：一共有560位患者纳入本研究,一共审核了6 105条药物医嘱,分析了420条pDDIs。最常见的药学干预为监测,包括监测实验室检查值、肝肾功等。结论：数据显示ICU的pDDIs发生率较高,临床药师可以评估和干预pDDIs,提高ICU患者用药安全。

Identification of potential drug-drug interactions in an intensive care unit and pharmaceutical intervention by clinical pharmacists

OBJECTIVE To describe the frequency and type of potential drug-drug interactions (pDDIs) in a general intensive care unit (ICU) and to make recommendations to improve the medication safety and efficacy of ICU patients.METHODS Based on the Micromedex and Medscape database of drug interactions,pDDIs were identified and classified into categories of potential clinical outcome and management advice.RESULTS A total of 560 patients were enrolled in this study,with 6 105 medication and 420 potential pDDIs identified and analyzed.The most common pharmaceutical intervention was monitoring,consisting of monitoring laboratory values,liver and kidney functions,electrocardiogram and blood pressure.CONCLUSION Data show that the incidence of pDDIs in ICU is high.Clinical pharmacists can intervene in pDDIs to improve medication safety in ICU patients.