糖皮質(zhì)激素類藥物的用藥誤區(qū)及合理用藥分析

葛選國(guó)

【摘 要】目的：探討糖皮質(zhì)激素類藥物的用藥誤區(qū)及合理用藥。方法：從我院2018年開(kāi)具的處方中抽取400例涉及糖皮質(zhì)激素類藥物的處方，觀察患者用藥后的不良反應(yīng)情況，并對(duì)出現(xiàn)不良反應(yīng)的處方包括藥物品種、用量、用途等進(jìn)行分析，判斷是否合理。結(jié)果：處方中糖皮質(zhì)激素主要應(yīng)用在呼吸科、兒科、皮膚科、風(fēng)濕免疫科、骨科、普外科等。共有14例患者用藥后出現(xiàn)較為嚴(yán)重的不良反應(yīng)，占3.5%，對(duì)處方進(jìn)行分析，主要存在的問(wèn)題包括將糖皮質(zhì)激素替代抗生素或退熱劑來(lái)使用、用藥劑量過(guò)多、療程過(guò)長(zhǎng)、一些慢性病中濫用以及和處方中存在和糖皮質(zhì)激素相互作用的藥物等。結(jié)論：糖皮質(zhì)激素類藥物是臨床常用藥，但如果用藥不當(dāng)反而會(huì)產(chǎn)生較大的不良反應(yīng)，因此在臨床用藥時(shí)，應(yīng)當(dāng)充分結(jié)合患者的臨床癥狀、疾病類型、致病成因，合理開(kāi)具糖皮質(zhì)激素類藥物的治療方案。

【關(guān)鍵詞】糖皮質(zhì)激素;用藥誤區(qū);合理用藥;不良反應(yīng)

abstract objective： to explore the medication errors and rational use of glucocorticoid hormone drugs. Methods： 400 prescriptions involving glucocorticoid drugs were selected from the prescriptions issued by our hospital in 2018， and the adverse reactions of patients were observed. The prescriptions with adverse reactions， including drug varieties， dosage and USES， were analyzed to determine whether they were reasonable. Results： glucocorticoid was mainly used in respiratory department， pediatrics department， dermatology department， rheumatology and immunology department， orthopaedics department and general surgery department. 14 patients appeared more severe adverse reactions of the medicine， accounted for 3.5%， analysis of prescription， the main existing problems including will replace antibiotics and antipyretic to glucocorticoid use， dosage， treatment is too long， too much abuse in some chronic diseases and and prescription and glucocorticoids exist in the interaction of drugs， etc. Conclusion： glucocorticoid drugs are commonly used in clinical practice. However， improper use of glucocorticoid drugs will lead to relatively large adverse reactions. Therefore， in the clinical use of glucocorticoid drugs， the treatment scheme of glucocorticoid drugs should be rationally prescribed based on the patients clinical symptoms， disease types and pathogenic causes.

key words glucocorticoid; Medication errors; Rational drug use; Adverse reactions

【中圖分類號(hào)】R977【文獻(xiàn)標(biāo)識(shí)碼】A【文章編號(hào)】1672-3783（2019）07-03--01

糖皮質(zhì)激素類藥物是臨床常用藥物，具有抗休克、抗感染與抗毒素等治療效果，目前已得到廣泛應(yīng)用，但此類藥物的不良反應(yīng)問(wèn)題較為突出，如果治療方案不合理，將可能導(dǎo)致如感染加重、合用藥物的藥效降低、藥物拮抗、鉀流失過(guò)量、消化道出血甚至更為嚴(yán)重的副作用【1】。故十分有必要明確糖皮質(zhì)激素類藥物的常見(jiàn)用藥誤區(qū)，并加以改進(jìn)，實(shí)現(xiàn)合理用藥。基于此，本文研究就從我院2018年開(kāi)具的處方中抽取400份涉及糖皮質(zhì)激素類藥物的處方，開(kāi)展相關(guān)臨床研究，現(xiàn)具體報(bào)道如下。

1 治療和方法

1.1 一般資料

從我院2018年開(kāi)具的處方中抽取400份涉及糖皮質(zhì)激素類藥物的處方，其中男性226例，女性174例，年齡4-82歲，平均（51.02±2.86）歲。分布：兒科96例，普外科9例，骨科52例，呼吸科78例，風(fēng)濕免疫科76例，皮膚科84例，其他5例。

1.2 方法

觀察患者用藥后的不良反應(yīng)情況，并對(duì)出現(xiàn)不良反應(yīng)的處方包括藥物品種、用量、用途等進(jìn)行分析，主要從適應(yīng)證、用量、療程、配伍等方面判斷處方是否合理。