老年用药的安全性调查及其应对策略分析

谭健初

[摘要]目的 了解我院老年人用药情况并给出相应对策。方法 选择我院2015年1～12月的11 148例>65歲的住院患者，对患者日用药种类、不良反应涉及的器官/系统分类、注射剂用药排名前10位情况等进行分析。结果 11148例老年患者每日用药情况显示，以15种以上居多，占62.77%；不良反应对人体的损害共计51例，涉及到全身各器官/系统，其临床表现也多种多样，其中累及最多的是消化系统损害，主要表现为恶心、呕吐、腹痛、腹泻、肝损害、呃逆；注射剂用药排名前10位的药物除舒血宁、特布他林外，其余均为剂量用药不合理。结论 我院老年患者用药不合理现象较为严重，应给予老年人用药监管，以降低不良反应发生率，保证老年用药的安全性和有效性。

[关键词]老年用药；合理性；对策

[中图分类号] R195 [文献标识码] A [文章编号] 1674-4721（2017）07（b）-0157-03

[Abstract]Objective To understand the status of elderly medication in our hospital，and to give corresponding countermeasures.Methods 11148 cases of elderly hospitalized patients with the age more than 65 were chosen from January to December in 2015 in our hospital，the conditions of drug kinds，adverse reactions involved organ/system classification，injection drug use in the top ten were analyzed.Results 11148 cases of elderly patients with daily medication showed that more than 15 kinds was the most，accounted for 62.77%；a total of 51 cases was found with adverse reactions to the harm of human body，involved the whole body each organ/system，its clinical manifestations were diverse，which affects the most was the digestive system damage，mainly for nausea，vomiting，abdominal pain，diarrhea，liver damage，hiccups.In the top 10 drugs of injection drug use，in addition to Shuxuening，Terbutaline，the rest were with unreasonable medication dose.Conclusion The unreasonable phenomenon with drug use in elderly patients is relatively serious，it should be given the old drug regulation，reduce the incidence of adverse reactions，ensure the elderly medication safety and effectiveness.

[Key words]Elderly medication；Rationality；Countermeasures

临床用药对于疾病的预防、诊断及治疗等常伴有一定的双重性，在药物发挥治疗作用的同时往往不可避免出现用药后的不良反应。药物安全性是保证临床合理用药的重要依据。随着医药科技的不断进步，药物的品种成倍增加，目前我国可用的处方药物已超过10 000种[1-3]。老年人是用药的特殊群体，其生理学及药代动力学的改变也增加了其药物不良反应的概率，严重者出现因药源性疾病而住院的情况[4-6]，因此，如何预防并降低药物不良反应发生率，提高其服药安全性至关重要。本研究通过调查我院收治的因不合理使用药品所致不良反应的老年患者，为改善其用药质量，避免药物的不良反应提供数据参考，现报道如下。