视神经脊髓炎谱系疾病预防发作的治疗进展及1例患儿的用药监护

发布时间：2018-05-23 14:27

本文选题：视神经脊髓炎谱系疾病 + 免疫抑制剂　；参考：《中国新药杂志》2017年08期

【摘要】：目的:总结预防视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorder,NMOSD)发作的药物选择及应用情况,提高对该病预防发作治疗的认识,为临床选择用药提供依据。方法:通过Pub Med检索近年来NMOSD治疗的相关文献,对其免疫抑制剂的选择进行总结分析,并对临床工作中发现的1例NMOSD患儿免疫抑制剂的选择进行分析。结果:预防NMOSD发作,首选利妥昔单抗,其次为霉酚酸酯,再次为硫唑嘌呤。如以上3种免疫抑制剂疗效欠佳,建议换用二线治疗药如甲氨蝶呤、米托蒽醌或环磷酰胺等。基于该患儿的个体差异,建议选择霉酚酸酯治疗,并对其进行药学监护。结论:临床药师对该患儿提出了个体化治疗建议,进一步促进了临床用药的安全性、有效性和合理性。
[Abstract]:Objective: to summarize the choice and application of drugs to prevent the onset of neuromyelitis optica spectrum disordern (NMOSD), to improve the understanding of the prevention and treatment of neuromyelitis, and to provide evidence for clinical choice of drug use. Methods: Pub Med was used to search the relevant literatures of NMOSD therapy in recent years, and the selection of immunosuppressants was summarized and analyzed, and the selection of immunosuppressants in one case of NMOSD was analyzed. Results: to prevent NMOSD attack, rituximab was the first choice, followed by mycophenolate mofetil and azathioprine. If the above three immunosuppressants are not effective, it is recommended to switch to two-line therapies such as methotrexate, mitoxantrone or cyclophosphamide. Based on the individual differences, mycophenolate mofetil is recommended to be treated and monitored by pharmacology. Conclusion: the clinical pharmacist put forward individualized treatment suggestion to the child, which further promoted the safety, effectiveness and rationality of the clinical medication.
【作者单位】：北京大学第一医院药剂科;河北省人民医院药学部;北京大学第一医院儿科;
【分类号】：R744.52

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