临床药师参与1例病毒性脑炎伴继发性癫痫患者的药学监护

发布时间：2018-01-14 16:17

本文关键词：临床药师参与1例病毒性脑炎伴继发性癫痫患者的药学监护　出处：《中国药房》2017年02期 　论文类型：期刊论文

【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。
[Abstract]:Objective: to explore the role of clinical pharmacists in the treatment of viral encephalitis with secondary epilepsy. Methods: clinical pharmacists participated in the course of drug treatment of a case of viral encephalitis with secondary epilepsy. Assist physicians in monitoring antiepileptic drug concentrations, drug interactions, and optimization of antimicrobial treatment protocols. During the course of treatment, clinical pharmacists have advised physicians to stop meropenem. The rats were replaced with cephaloperazone sodium sulbactam sodium (3 g / g iv) q8 h and vancomycin hydrochloride (1 g / g iv) for 12 h. The dosage of sodium valproate for injection was adjusted to 0.4 g / g iv GTT Q6 h for antiepileptic, and the drug interaction was avoided, and the vital signs of the patients were monitored closely. 18 kinds of amino acid injection and glycerol fructose were stopped in order to eliminate drug fever. Results: the doctor accepted the advice of clinical pharmacist. After 48 days of treatment. Conclusion: clinical pharmacists participate in the course of drug treatment of patients with viral encephalitis and secondary epilepsy, and help doctors to optimize the adjustment scheme according to the concentration of blood drugs. It can minimize the occurrence of drug interaction and ensure the safety and effectiveness of clinical treatment.
【作者单位】：广西壮族自治区民族医院/广西医科大学附属民族医院药剂科;中南大学湘雅三医院药学部;新乡医学院第一附属医院药学部;
【基金】：湖南省自然科学基金资助项目(No.14JJ7021)
【分类号】：R742.1;R512.3
【正文快照】： 病毒性脑炎是一种常见的中枢神经系统感染性疾病,其中以单纯疱疹病毒性脑炎最常见,约1/3的患者出现继发性癫痫[1-2]。而在继发性癫痫中,有2.7%~27%的癫痫发作易发展为难治性癫痫[3],大大增加了临床诊治难度,其治疗目标为首先针对原发病进行抗病毒治疗以去除病因,再对加重原发

【相似文献】