Population prevalence of high dose paracetamol in dispensed paracetamolopioid prescription combinations an observational study 英文参考文献.docVIP
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Population prevalence of high dose paracetamol in dispensed paracetamolopioid prescription combinations an observational study 英文参考文献
Clarketal.BMCPharmacologyandToxicology2012,12:11
/12/1/11
RESEARCH ARTICLE
OpenAccess
Populationprevalenceofhighdoseparacetamol
indispensedparacetamol/opioidprescription
combinations:anobservationalstudy
RoderickClark1,JudithEFisher2,3,IngridSSketris2*andGraceMJohnston4
Abstract
Background:Paracetamol(acetaminophen)isgenerallyconsideredasafemedication,butisassociatedwith
hepatotoxicityatdosesabovedosesof4.0g/day,andevenbelowthisdailydoseincertainpopulations.
Methods:TheNovaScotiaPrescriptionMonitoringProgram(NSPMP)intheCanadianprovinceofNovaScotiaisa
legislatedorganizationthatcollectsdispensinginformationonallout-of-hospitalprescriptioncontrolleddrugs
dispensedforallNovaScotiaresidents.TheNSPMPprovideddatatotrackallparacetamol/opioidsredeemedby
adultsinNovaScotia,fromJuly1,2005toJune30,2010.Trendsinthenumberofadultsdispensedthese
prescriptionsandthenumbersofprescriptionsandtabletsdispensedoverthisperiodweredetermined.The
numbersandproportionsofadultswhofilledprescriptionsexceeding4.0g/dayand3.25g/dayweredetermined
fortheone-yearperiodJuly1,2009toJune30,2010.Datawerestratifiedbysexandage(65versus65+).
Results:Boththenumberofprescriptionsfilledandthenumberoftabletsdispensedincreasedoverthestudy
period,althoughtheproportionoftheadultpopulationwhofilledatleastoneparacetamol/opioidprescription
waslowerineachsuccessiveone-yearperiod.FromJuly2009toJune2010,onein12adults(n=59,197)filled
prescriptionsforover13millionparacetamol/opioidtablets.Sixpercent(n=3,786)filledprescriptionsthatexceeded
4.0g/dayand18.6%(n=11,008)exceeded3.25g/dayofparacetamolatleastonce.Thesefindingsexclude
non-prescriptionparacetamolandparacetamol–onlyprescribedmedications.
Conclusions:Asubstantialnumberofindividualswhoredeemprescriptionsforparacetamol/opioidcombinations
maybeatriskofparacetamol-relatedhepatotoxicity.Healthcareprofessionalsmustbevigilantwhenprescribing
anddispensingthesemedicationsinordertoreducetheassociatedrisks.
Background
hepatic injury through a toxic metabolite, NAPQI (N-
Para
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