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首页> 外文期刊>Journal of Young Pharmacists >Comparison of Drug Related Problems Associated with Use of Narrow Therapeutic Index Drugs and Other Drugs in Hospitalized Patients
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Comparison of Drug Related Problems Associated with Use of Narrow Therapeutic Index Drugs and Other Drugs in Hospitalized Patients

机译：住院患者使用窄治疗指数药物和其他药物相关药物相关问题的比较

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Objectives: To identify and categorize types of Drug Related Problems (DRPs), assess various risk factors for developing DRPs and delineate if drugs with narrow therapeutic index or non-narrow therapeutic index drugs cause greater number of DRPs. Methods: Patients from General Medicine, Surgery, Psychiatry, Cardiac and Intensive Care Unit (ICU) departments of a tertiary care teaching hospital were included. Data was collected prospectively over eight months from medical history, medication charts, case notes and laboratory data. Only those patients prescribed at least five drugs were included. Pediatric and Oncology patients and pregnant women were excluded from the study. Narrow therapeutic index (NTI) drugs (Insulin, digoxin, warfarin, levothyroxine, aminoglycoside antibiotics, carbamazepine, lithium and phenytoin) were compared with non NTI-drugs to delineate patterns of DRPs between both groups. Results: A total of 200 patients were enrolled in the study, and 172 DRPs were identified. The most common DRPs were: drug interactions (63%), inappropriate drug use (10.5%) and adverse drug reactions (10.5%). Polypharmacy and duration of hospitalization were established as significant risk factors for developing DRPs. NTI-drugs had a greater risk of developing DRPs (0.22) versus non-NTI drugs (0.08). Two categories of DRPs were found to be more significantly associated with NTI-drugs: ADRs and inappropriate drug use. Conclusion: While ADR and inappropriate drug use were more common with NTI-drugs, in clinical practice other non NTI-drugs: Anti-psychotic drugs (quetiapine, amisulpride etc.) and NSAIDs (aspirin) showed a high tendency for interactions and needed frequent monitoring.
机译：目的：对药物相关问题（DRP）的类型进行识别和分类，评估形成DRP的各种风险因素，并确定治疗指数狭窄的药物或非狭窄治疗指数的药物是否导致更多的DRP。方法：纳入三级教学医院的普通医学，外科，精神病学，心脏和重症监护病房（ICU）部门的患者。前八个月从病史，用药图表，病例记录和实验室数据中收集数据。仅包括那些开处方至少五种药物的患者。儿科和肿瘤科患者和孕妇被排除在研究之外。将窄治疗指数（NTI）药物（胰岛素，地高辛，华法令，左旋甲状腺素，氨基糖苷类抗生素，卡马西平，锂和苯妥英钠）与非NTI药物进行比较，以描绘两组之间DRP的模式。结果：总共200名患者参加了研究，并鉴定了172个DRP。最常见的DRP是：药物相互作用（63％），药物使用不当（10.5％）和药物不良反应（10.5％）。建立多药房和住院时间是发展DRP的重要危险因素。与非NTI药物（0.08）相比，NTI药物产生DRP的风险更大（0.22）。发现两种类型的DRP与NTI药物更为相关：ADR和不适当的药物使用。结论：尽管NDR药物更常见于ADR和药物滥用，但在临床实践中，其他非NTI药物：抗精神病药物（喹硫平，氨磺必利等）和NSAID（阿司匹林）显示出很高的相互作用倾向，需要经常使用监控。

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