| 引用本文: | 严磊,寿军,周权,王华芬.交叉过敏的临床药学干预[J].中国现代应用药学,2012,29(11):1050-1054. |
| YAN Lei,SHOU Jun,ZHOU Quan,WANG Huafen.Clinical Pharmacological Intervention on Cross Allergy[J].Chin J Mod Appl Pharm(中国现代应用药学),2012,29(11):1050-1054. |
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| 摘要: |
| 目的 促进临床医护人员对药物交叉过敏的意识，防范用药失误发生。方法 对药物说明书禁忌症中有关交叉过敏的描述进行信息分析和数据挖掘。对药物咨询、用药失误和近似错误在线呈报系统记录进行分析。实施临床药学综合性干预措施，并评估干预效果。结果 除药理作用相似的27类同类药品交叉过敏外，还存在涉及多个药理作用类别的交叉过敏药物7大类。化学结构相似是引起交叉过敏的主要原因。一些交叉过敏禁忌的描述涉及赋形剂。部分禁忌症有关交叉过敏的描述不科学，缺乏临床指导意义。部分同类品种以及国内产品与进口产品的相关描述可能存在差异。涉及多个药理作用类别的交叉过敏问题比较隐蔽。药师进行持续的临床药学干预后，临床对交叉过敏的认知水平有大幅提高，近似错误和用药失误的发生下降97%。结论 若不注意交叉过敏问题，临床会有严重的安全隐患。药师经过临床药学综合干预，效果显著。信息技术的应用以及数据的维护至关重要。 |
| 关键词: 交叉过敏 临床药学 安全用药 禁忌症 数据挖掘 |
| DOI： |
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| Clinical Pharmacological Intervention on Cross Allergy |
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YAN Lei, SHOU Jun, ZHOU Quan, WANG Huafen
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The 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
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| Abstract: |
| OBJECTIVE To promote the clinical awareness of cross allergy and prevent the occurrence of medical errors. METHODS Prescribing information on cross allergy in “Contraindications” was derived from a software. Records of drug counseling, cases of medical errors and near misses in an online reporting system were analyzed. Data mining was performed. Clinical pharmacological interventions were conducted and the effects were evaluated. RESULTS Besides 27 kinds of drugs within pharmacologically similar class involving cross allergy, there were seven kinds of drugs with complete different pharmacological effects. Similarity in chemical structures was the main case of cross allergy. Excipients were related with cross allergy. Prescribing information in some drugs had unscientific descriptions on cross allergy associated contraindications, lacking clinical value in guiding safe use of medication. There were difference in descriptions on cross allergy in some drugs within pharmacologically similar clas, and some domestic and imported products. The problem of cross allergy of drugs involving different pharmacological effects was dangerous and not easy to be detected. After pharmacological interventions, awareness was greatly increased and the occurrence rate of medical errors and similar mistake decreased by 97%. CONCLISION Severe potential safety hazard might exist if more attentions are not paid to cross allergy aspect. The comprehensive pharmacological interventions are very effective. Applications of information technology and data maintenance are pivotal for continuous quality improvement in cross allergy aspect. |
| Key words: cross allergy clinical pharmacy safe use of drug contraindication data mining |
