2018 年至 2021 年间扑热息痛过量用药法规的影响:法国一所大学医院的回顾性单中心研究

IF 1.8 Q4 TOXICOLOGY
T. De Sousa , N. Fouilhé , X. Fonrose , M. Lepelley
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引用次数: 0

摘要

目的 2020 年初,法国采取了两项监管措施,以限制扑热息痛的使用和过量用药的发生:撤销药房的开放使用权,并在药盒上标注警示语,提醒人们过量使用扑热息痛会对肝脏造成危害。因此,我们分析了格勒诺布尔大学医院在监管措施实施前两年(2018-2019 年)和实施后两年(2020-2021 年)的每一次扑热息痛用药过量,并在第 12 小时时通过血浆剂量 > 50 mg/L(普雷斯科特图表中的毒性线)进行了确认。其中176起发生在监管措施之前,148起发生在监管措施之后。性别比例主要为女性,监管措施前为 3.8,监管措施后为 2.8。平均年龄为 29.5 岁,两个时期的平均年龄相似。儿童用药过量(18 岁以下)占用药过量总数的 29%,在两个时期内保持稳定。两个时期内,扑热息痛血浆剂量的中位值相似:100 毫克/升,但在监管措施实施后,出现了更严重的过量用药(扑热息痛血浆剂量高达 946 毫克/升)。讨论2018 年至 2021 年期间,法国一所大学医院的扑热息痛过量用药前后分析表明,过量用药减少了 8%。然而,2020 年因 COVID-19 大流行而造成的限制可能会影响这一结果。儿科中毒事件占很大比例的原因可能是青少年自愿中毒事件增加以及家长对儿童用药错误。中毒原因(自愿与否)及其临床后果尚不清楚。结论:其他预防措施可以针对患者进行最大剂量教育,或强制要求医生开具扑热息痛处方。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of regulations on paracetamol overdoses between 2018 and 2021: Retrospective monocentric study in a French university hospital

Objective

In early 2020 in France, two regulatory measures have been applied in order to limit access to paracetamol and occurrence of overdose: withdrawal of open access in pharmacy and warning message on medicine boxes about the hepatic risk in case of paracetamol overdose. So far, the impact of these measures has not been evaluated.

Method

Therefore, we analyzed every paracetamol overdose, confirmed by a plasma dosage > 50 mg/L at the 12th hour (toxicity line in the Prescott chart), performed at the Grenoble University Hospital, two years before (2018–2019) and after (2020–2021) the regulatory measures.

Results

In total, 324 paracetamol overdoses were included. 176 occurred before the regulatory measures and 148 after. Sex ratio was largely female, 3.8 before and 2.8 after the regulatory measures. The mean age is young and similar over the 2 period: 29.5 years-old. Pediatric overdoses (under 18 years of age) represented 29% of all overdoses, stable over the 2 periods. The median value of plasma paracetamol dosage was similar during the 2 periods: 100 mg/L, but more severe overdoses (paracetamol plasma dosage up to 946 mg/L) occurred after the regulatory measures.

Discussion

This before/after analysis of paracetamol overdoses between 2018 and 2021 in a French university hospital showed a reduction of 8%. However, the confinement in 2020 due to the COVID-19 pandemic could affect this result. The significant proportion of poisonings in pediatrics could be explained by an increase in voluntary poisonings among adolescents and administration errors by parents to children. The reason for the poisoning, voluntary or not, and the clinical consequences were not known. It would be interesting to carry out the same study in other university hospitals, over a longer period and with clinical data.

Conclusion

Other preventive measures could target patient education on the maximum dose, or on medical prescription of paracetamol compulsory.

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来源期刊
CiteScore
0.90
自引率
33.30%
发文量
393
审稿时长
47 days
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