摘要
目的分析重症监护室(ICU)常用静脉药物的配伍稳定性,为临床用药安全提供参考。方法于2022年4月1-30日调研并确认河北省人民医院ICU常用静脉药物,然后以此为检索词,在PubMed、中国知网、万方数据等数据库中查询相关配伍稳定性研究文献。借助Micromedex数据库进行手动筛选,随后对纳入文献的配伍稳定性结果进行描述性分析。结果收集到该院ICU常用静脉药物32种,混合输注组合39种。共纳入40项研究,仅有2项研究符合所有的质量要求;18项研究对其方法进行了验证,保证了可重复性;33项研究评估了物理稳定性,包括沉淀形成、pH变化;32项研究评估了化学稳定性,主要为含量/浓度变化。共得到666种可能的两两配伍组合,其中254种组合有配伍稳定性结果,包括176种稳定、68种不稳定、10种相互矛盾;412种组合没有配伍稳定性结果。在该院ICU的两两药物组合中,42种组合稳定、14种组合不稳定、2种组合相互矛盾。结论pH、溶媒、辅料、配制浓度等是影响配伍稳定性的因素;该院ICU常用静脉药物存在配伍不稳定的药物组合,且稳定性研究方法有所局限,配伍稳定性数据尚无法满足临床的实际需求。
OBJECTIVE To analyze the compatible stability of commonly used intravenous drugs in the intensive care units(ICU),and to provide a reference for improving medication safety in clinic.METHODS The commonly used intravenous drugs in the ICU of Hebei General Hospital were investigated and confirmed in April 1-30,2022,and used as keywords to retrieve the relevant literature about compatible stability from PubMed,CNKI,Wanfang Data and other databases,and manually filtered with Micromedex database at the same time.Then,the compatible stability results of the included literature were analyzed descriptively.RESULTS Totally 32 commonly used intravenous drugs and 39 mixed infusion combinations were collected from ICU of this hospital.A total of 40 studies were included,only 2 studies followed all quality requirements;18 studies validated their methods to guarantee correct reproducibility;33 studies evaluated physical stability,including precipitate formation and pH changes;32 studies evaluated chemical compatibility,mainly content/concentration changes.A total of 666 possible two-drug combinations were obtained from the included literature,of which 254 combinations of stability data were available,including 176 were stable,68 were unstable,and 10 were contradictory.Totally 412 combinations had no stability results.Among two-drug combinations in ICU of this hospital,42 combinations were stable,14 combinations were unstable,and 2 combinations were contradictory.CONCLUSIONS The pH,solvent,excipients and preparation concentration are the factors that affect the stability.There are drug combinations with unstable compatibility of commonly used intravenous drugs in ICU of this hospital.The stability study methods are limited,and the stability data cannot meet the actual clinical needs.
作者
何雪茹
范理菊
李宵
王智
周鑫
董占军
HE Xueru;FAN Liju;LI Xiao;WANG Zhi;ZHOU Xin;DONG Zhanjun(Graduate School of Hebei Medical University,Shijiazhuang 050011,China;Dept.of Pharmacy,Hebei General Hospital,Shijiazhuang 050057,China)
出处
《中国药房》
CAS
北大核心
2023年第6期752-757,共6页
China Pharmacy
基金
河北省医学科学研究课题(No.20210037)。
关键词
重症监护室
静脉药物
混合输注
配伍稳定性
文献分析
intensive care unit
intravenous drugs
mixed infusion
compatible stability
literature analysis
