注射用脂溶性维生素的不良反应文献分析及药学监护

目的:指导注射用脂溶性维生素的临床合理用药,为其药学监护提供依据。方法:统计1989-2012年中文科技期刊数据库中收录的17篇关于脂溶性维生素的不良反应、处理方法及转归,结合彩虹集团公司彩虹医院1例脂溶性维生素输注后发生过敏反应的病例,予以总结和分析。结果:该药的严重不良反应如过敏性休克较少出现,大多是较轻的过敏反应,经正确地对症处理,转归较好。但该药不良反应的临床资料偏少,这对该药的药学监护提出了更高的要求。结论:静脉滴注脂溶性维生素导致的不良反应与药液浓度、药物所含主辅料、患者病理生理状况以及输液配制环境、使用方法密切相关。故临床应用时需把握好适应证,加强用药期间的药学监护;其中,详问病史、过敏史和用药史,多观察患者病情变化,迅速有效的对症处理与宣教工作极为重要。

Literature Analysis and Pharmaceutical Care for Fat-soluble Vitamins for Injection

OBJECTIVE： To guide the clinical rational use of fat-soluble vitamins for injection, and to provide reference for pharmaceutical care. METHODS： 17 reports on ADR, processing method and outcome of fat-soluble vitamin included in VIP data- base form 1989 to 2012 were analyzed statistically, based on a ease of allergic reaction induced by fat-soluble vitamin. RESULTS： There were little severe ADR as allergic shock; most cases were slight allergic reaction and recovered well after the correct symp- tomatic treatment. But there were few clinical data of fat-soluble vitamins-induced ADR, which put forward higher pharmaceutical care request for the drug. CONCLUSIONS： ADR induced by intravenous dripping of fat-soluble vitamin is closely associated with drug concentration, main ingredient and excipients, pathologic and physiologic situation of patients, the environment of infusion and preparation and usage method. So clinical application of fat-soluble vitamins for injection should pay more attention to indica- tions, enhance pharmaceutical care during the medication. What＇s more, it is important to inquire the history of medical and aller- gies carefully, observe patients＇ condition, and provide effective and timely symptomatic treatment and education.