高原肺水肿治疗药物的超适应证用药现状分析

摘要

目的:分析高原肺水肿治疗药物的超适应证使用现状,为促进高原地区各医疗机构合理用药,建立相关管理流程提供参考.方法:以"高原肺水肿""治疗""Altitude illness""Treatment"等为关键词,组合查询自建库起至2017年9月的中国知网、PubMed、Embase等数据库,阅读文献后筛选提取高原肺水肿治疗药物,对比其在我国上市制剂的药品说明书信息,并进行归纳、总结和分析.结果:归纳文献中提及的高原肺水肿治疗药物,最终统计出硝苯地平、西地那非、他达拉非、氨茶碱等16种治疗药物,这些药物在我国上市的相应制剂说明书中,均未查见有高原肺水肿的适应证.结论:目前普遍存在高原肺水肿治疗药物超适应证用药现象,规范医院超说明书用药管理迫在眉睫.建议完善高原肺水肿治疗药物超说明书管理流程,促进药物的合理使用.%OBJECTIVE:To analyze the situation of off-indication drug use of drugs for high altitude pulmonary edema (HAPE),and to provide reference for promoting rational drug use in medical institutions of plateau area and establishing relevant management process. METHODS:By taking"HAPE""treatment""Altitude illness""Treatment"as keywords,retrieving from CNKI,PubMed,Embase database during build up to Sept. 2017,drugs for HAPE were screened and extracted after reading the literatures. Drug package inserts of listed preparations were compared,summarized and analyzed. RESULTS:Drugs for HAPE in literatures were screened,and 16 kinds of drugs were summarized finally as nifedipine,sildenafil,tadalafil,aminophylline,etc. Indication of HAPE was not found in drug package inserts of those listed preparations. CONCLUSIONS:At present,there is a universal phenomenon of off-indication drug use of drugs for HAPE,and it is imminent to regulate the management of off-label drug use in the hospital. It is suggested to improve the off-label drug use management flow of drugs for HAPE so as to promote rational drug use.