頁籤選單縮合
題名 | Carbamazepine藥敏基因檢測提示機制=Effectiveness of HLA-B*1502 Screening and Remindering System on Preventing Carbamazepine-Induced SJS/TEN |
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作者姓名(中文) | 盧柏先; 鄭吉元; 陳琦華; 甯孝真; 陳玉瑩; | 書刊名 | 藥學雜誌 |
卷期 | 30:2=119 2014.06[民103.06] |
頁次 | 頁117-122 |
分類號 | 418.21 |
關鍵詞 | 藥物過敏基因檢測; 藥品不良反應; 史帝文生氏強生症候群; 毒性表皮壞死溶解症; Carbamazepine; Stevens-Johnson syndrome; Toxic epidermal necrolysis; HLA-B*1502; |
語文 | 中文(Chinese) |
中文摘要 | 本院自2011年7月於門、急、住醫囑系統,建置藥敏基因檢測提示機制,於用藥 前提示執行 HLA-B 基因檢測,避免帶有 HLA-B*1502基因患者因使用 carbamazepine 造成 SJS/TEN,本研究為評估此醫令系統提示機制執行成效。研究執行時間自藥敏 基因檢測提示機制建置前半年至建置後一年 (2011年1月1日至2012年6月30日),藥物 過敏基因檢測件數總件數共2630筆,其中 HLA-B*1502陽性232筆 (8.8%)。藥敏基因 檢測提示機制系統上線前半年,檢測藥敏基因件數172筆 (約28筆/月),HLA-B*1502 陽性18筆 (10.5%),同時期本院藥品不良反應通報資料庫,病人因服用本院處方 carbamazepine 引起 SJS/TEN 案例共3例。而提示機制上線後一年,檢測件數2458筆 (約204筆/月),HLA-B*1502陽性214筆 (8.7%),這一年中沒有一個病人因服用本院處 方 carbamazepine 引起 SJS/TEN 之通報案例發生。利用藥敏基因檢測提示機制,可及 早檢測出帶有特殊藥物過敏基因病人,避免藥品不良反應發生而導致住院,甚至危害 生命。如此可避免不必要之龐大醫療費用支出並且有效降低社會成本。 |
英文摘要 | Carbamazepine is the main cause of the Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in Taiwan. Carbamazepine-induced SJS-TEN is strongly associated with the HLA-B*1502 allele. We integrated the HLA-B*1502 screening remindering system with physician order system in July 2011. The genetic test number and HLA-B*1502 positive number was collected from 2011 January (half year before system use) to 2012 June (one year after system use). Number of carbamazepine induced adverse event reported on adverse drug reaction database at the same period were also collected. The study included total 2630 patients take genetic test and of these 232 (8.8%) were HLA-B*1502 positive. After implementing the system, genetic test number increase from 28 patients per month to 204 patients per month. And there was no case taking carbamazepine induced SJSTEN was reported. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。