Analysis on present status and countermeasures of small dosage splitting in children oral formulations
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摘要: 目的 调查某院儿童片剂、胶囊剂不同微分剂量的医嘱频次,了解分剂量现存的问题,并提出相应的对策,以提高儿童高警示药品及治疗窗狭窄药品的分剂量用药警惕性。 方法 调取2019年1月1日—12月31日住院患儿口服片剂、胶囊剂分剂量的医嘱频次,筛选出用药剂量为≤0.2片/粒和≤0.1片/粒的医嘱频次进行临床应用分析。收集国外文献推荐的医院制剂临时配药方法,对这些典型的微分剂量药品现状提出对策和建议。 结果 儿童医院住院药房日常微分剂量操作频繁,分剂量医嘱频次比率排名前3位的分别为呋塞米片、硝西泮片和盐酸普萘洛尔片,其中2种为儿童高警示药品。≤0.2片/粒和≤0.1片/粒的微分剂量片剂及胶囊剂医嘱微分剂量医嘱频次比率最高的3种药品依次为枸橼酸西地那非片、波生坦片和氟康唑胶囊。 结论 药品个体化精准分剂量的准确度及稳定性直接关系到药品质量。为了保障儿童安全、有效、精准地用药,分剂量制剂的完善和发展需要多方面共同努力。Abstract: Objective To investigate the frequencies of different dosages splitting of tablets and capsules for children, to understand the existing problems and put forward targeted countermeasures so as to arise drug administration warnings in splitting of high-alert medications and drugs with narrow therapeutic window. Methods From January 1 to December 31, 2019, the frequencies of prescriptions of splitting dosage of oral tablets and capsules were obtained, among which the frequencies of splitting prescriptions with dosage of ≤0.2 tablet/capsule and ≤0.1 tablet/capsule were selected, and their clinical applications were analyzed. In this paper, methods of extemporaneous preparations recommended by foreign literature were collected for these typical small dosage splitting medicines, and countermeasures and suggestions were put forward to present situations of these typical drugs with splitting dosage. Results The daily differential small dosage splitting work was frequent in the inpatient pharmacy department of children's hospital, Furosemide tablets, Nitazepam tablets and Propranololol hydrochloride tablets ranked the top three in terms of ratio of dosage splitting frequency, two of them were high-alert drugs for children. The highest frequency of splitting prescriptions with dosage of ≤0.2 tablet/capsule and ≤0.1 tablet/capsule were Sildenafil citrate tablets, Bosentan tablets and Fluconazole capsules. Conclusion Accuracy and stability of individualized accurate dosage splitting are directly related to drug quality. In order to ensure the safe, effective and accurate use of drugs for children, the improvement and development of splitting adult-dosage formulations need jointed efforts of different parts.
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