Intrapartum magnesium sulfate and the potential for cardiopulmonary drug-drug interactions.
Intrapartum magnesium sulfate and the potential for cardiopulmonary drug-drug interactions.
复制标题
产时硫酸镁和心肺药物相互作用的可能性。
DOI：
10.1097/ftd.0000000000000050
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发表时间：
2014
影响因子：
2.5
通讯作者：
Sherwin,CatherineMT
中科院分区：
文献类型：
--
作者：
Campbell,SarahC;Stockmann,Chris;Balch,Alfred;Clark,ErinAS;Kamyar,Manijeh;Varner,Michael;Korgenski,EKent;Bonkowsky,JoshuaL;Spigarelli,MichaelG;Sherwin,CatherineMT
背景：本研究旨在确定分娩时接受硫酸镁（MgSO 4）的孕妇可能发生心肺药物相互作用的频率。方法：研究了2009年1月至2011年10月期间在Intermountain Healthcare机构住院的孕妇，如果她们接受1剂或更多剂量的MgSO 4。从电子健康记录系统中以电子方式查询合并用药。使用出院管理代码识别不良事件。比较了服用和未服用氨基糖苷类抗生素、抗酸剂/泻药、钙通道阻滞剂、皮质类固醇、利尿剂、神经肌肉阻滞剂和维生素D类似物的妇女的心肺药物相互作用的频率，所有这些药物都是服用MgSO 4的患者的禁忌。在155例（23%）独特的患者中，共鉴定出219种MgSO 4潜在相互作用药物。最常见的潜在相互作用药物包括钙通道阻滞剂（26%）、利尿剂（25%）和抗酸剂/泻药（19%）。住院时间越长，MgSO4相互作用药物的数量越多（P <0.001）. 53名接受呋塞米治疗的妇女中有3名（6%）发生了心脏骤停，而618名未接受呋塞米治疗的妇女中有0名（0%）发生了心脏骤停（Fisher精确检验，P <0.001）。当处方硫酸镁与已知的相互作用药物联合使用时，应谨慎。
Background:This study sought to determine the frequency of possible cardiopulmonary drug–drug interactions among pregnant women who received intrapartum magnesium sulfate (MgSO 4).Methods:Pregnant women admitted to an Intermountain Healthcare facility between January 2009 and October 2011 were studied, if they received 1 or more doses of MgSO 4. Concomitant medications were electronically queried from an electronic health records system. Adverse events were identified using administrative discharge codes. The frequency of cardiopulmonary drug–drug interactions was compared among women who did, and did not, receive aminoglycoside antibiotics, antacids/laxatives, calcium channel blockers, corticosteroids, diuretics, neuromuscular blocking agents, and vitamin D analogs, all of which were contraindicated for patients receiving MgSO 4.Results:Overall, 683 women received intrapartum MgSO 4 during the study period. A total of 219 MgSO 4 potentially interacting drugs were identified among 155 (23%) unique patients. The most commonly identified potentially interacting agents included calcium channel blockers (26%), diuretics (25%), and antacids/laxatives (19%). Longer hospital stays were significantly associated with increasing numbers of MgSO 4 interacting drugs (P< 0.001). Three of 53 (6%) women who received furosemide experienced a cardiac arrest, compared with 0 of 618 (0%) women who did not receive furosemide (Fisher exact test, P< 0.001).Conclusions:Intrapartum administration of drugs that interact with MgSO 4 is common and associated with prolonged hospital stays and potentially cardiopulmonary drug–drug interactions. Caution is warranted when prescribing MgSO 4 in combination with known interacting medications.