Active monitoring study of central nervous system adverse drug reactions due to commonly used carbapenems
10.13699/j.cnki.1001-6821.2024.17.022
- VernacularTitle:碳青霉烯类常用药物致中枢神经系统不良反应的主动监测研究
- Author:
Jing XIAO
1
,
2
;
Hai-Yan LI
;
Dai-Hong GUO
;
Man ZHU
;
Ao GAO
;
Peng LI
;
Li-Qiang CUI
Author Information
1. 解放军总医院医疗保障中心药剂科,北京 100853
2. 重庆医科大学药学院,重庆 400016
- Keywords:
carbapenems;
central nervous system;
adverse drug reactions;
automatic monitoring;
incidence
- From:
The Chinese Journal of Clinical Pharmacology
2024;40(17):2562-2566
- CountryChina
- Language:Chinese
-
Abstract:
Objective To obtain the occurrence and clinical characteristics of central nervous system adverse drug reactions(CNS-ADR)associated with three kinds of carbapenems,and to provide reference for clinical drug safety.Methods Based on adverse drug event active surveillance and assessment system-Ⅱ(ADE-ASAS-Ⅱ),retrospective automated monitoring of inpatients using imipenem,meropenem,and biapenem in a tertiary hospital from January 2022 to December 2022 was conducted.The incidence of carbapenem related CNS-ADR was calculated,and the basic conditions,disease conditions,drug use,occurrence time of ADR and symptoms of patients with CNS-ADR were analyzed by descriptive statistics.Results A total of 2 482 patients with 2 709 times of medication were included in this study,and a total of 93 positive cases of CNS-ADR occurred,with an overall incidence of 3.43％for all three medications,3.98％for imipenem,3.51％for meropenem,and 2.78％for biapenem.The indications for the 93 positive cases of CNS-ADR were mainly pulmonary infections(59.13％)and abdominal infections(25.80％);they occurred mostly within 7 days of the administration of the medication;with a variety of clinical manifestations,with anxiety/irritability being the most common,and epilepsy appearing most frequently in severe cases.Co-administration of proton pump inhibitors and cephalosporins accounted for a greater proportion of positive cases,50.54％of positive cases had a history of surgery,and 69.89％of positive cases were associated with electrolyte disturbances.Conclusion Clinical use of carbapenems should be based on the actual situation of the patient to develop an individualised drug regimen,and special attention should be paid to patients with comorbidities of renal disease,electrolyte disorders,and a history of previous surgery and neurological disorders,in order to reduce the risk of the occurrence of CNS-ADR.
