摘要
目的:探讨临床药师在病毒性脑炎伴继发性癫痫患者治疗中的作用。方法:临床药师参与1例病毒性脑炎伴继发性癫痫患者的药物治疗过程,协助医师监测抗癫痫药物血药浓度、药物相互作用,优化抗菌药物治疗方案。治疗过程中临床药师先后建议医师停用美罗培南,更换为注射用头胞哌酮钠舒巴坦钠3 g,ivgtt,q8 h+注射用盐酸万古霉素1 g,ivgtt,q12 h抗感染;调整注射用丙戊酸钠用量为0.4 g,ivgtt,q6 h抗癫痫,并避免药物相互作用,密切监视患者生命体征;停用18种氨基酸注射液及甘油果糖等,以排除药物热。结果:医师采纳临床药师建议。经过48 d的治疗,患者病情得到了有效控制并出院。结论:临床药师参与病毒性脑炎伴继发性癫痫患者的药物治疗过程,根据血药浓度协助医师优化调整方案,可最大程度地减少药物相互作用的发生,确保临床治疗的安全、有效。
OBJECTIVE： To investigate the role of clinical pharmacists in the therapy for viral encephalitis complicating with secondary epilepsy. METHODS： Clinical pharmacists participated in the drug treatment for a patient with viral encephalitis complicating with secondary epilepsy, assisted doctor to monitor the blood concentration of antiepileptic drugs, drug interactions and to optimize antibiotics treatment plan, Clinical pharmacists suggested giving Cefoperazone sodium and sulbactam sodium for injection 3 g, ivgtt, q8 h＋Vancomycin hydrochloride for injection 1 g, ivgtt, q12 h, instead of meropenem for anti-infective treatment; adjusting the dose of valproic acid to 0.4 g, ivgtt, q6 h, for antiepileptic treatment, avoiding drug interaction, closely monitoring vital sign. It was suggested to stop 18 kinds of Amino acid infections and glyceol and fructose so as to exclude drug fever. RESULTS： Physicians adopted the suggestion of clinical pharmacists. Patient＇s condition was effectively controlled after 48 d treatment and then the patient was discharged from the hospital. CONCLUSIONS： Clinical pharmacists participate in the therapy for vi- ral encephalitis complicating with secondary epilepsy and assist physicians to optimize therapy plan according to blood concentration can minimize the occurrence of drug interactions and guaratee the satety and effectivenes of clinical therapy.
出处
《中国药房》
CAS
北大核心
2017年第2期254-257,共4页
China Pharmacy
基金
湖南省自然科学基金资助项目(No.14JJ7021)
关键词
临床药师
病毒性脑炎
继发性癫痫
抗癫痫药物
丙戊酸
美罗培南
药物相互作用
药学监护
Clinical pharmacists
Viral encephalitis
Secondary epilepsy
Antiepileptic drugs
Valproic acid
Meropenem
Drug interactions
Pharmaceutical care
