临床药师在化脓性脑膜炎个体化治疗中的作用

发布时间：2018-04-20 16:45

本文选题：个体化用药 + 抗感染治疗　；参考：《中国药房》2017年20期

【摘要】：目的:探讨临床药师在化脓性脑膜炎患者个体化治疗中的作用。方法:临床药师参与1例耐药金黄色葡萄球菌致化脓性脑膜炎患者的药物治疗,根据患者临床症状,协助医师制订初始治疗方案;通过查阅相关指南和国内外文献,建议联合应用地塞米松以减轻其炎症反应;根据药敏试验结果,结合万古霉素血药浓度监测和群体药动学模型拟合结果,建议将万古霉素的剂量减至0.5 g,ivgtt,q12 h;并行抗感染治疗效果评价、不良反应监测、肾功能监测等药学监护。结果:医师部分采纳临床药师建议,患者病情好转,且未发生万古霉素相关不良反应,并于入院第16天出院。结论:临床药师参与化脓性脑膜炎患者的药物治疗过程,结合相关指南、文献以及病原学检查、血药浓度监测、药动学模型拟合等结果,协助医师及时优化了治疗方案,在保证抗感染治疗效果的同时,预防和减少了药品不良反应的发生。
[Abstract]:Objective: to explore the role of clinical pharmacists in individualized treatment of suppurative meningitis. Methods: the clinical pharmacist participated in the drug treatment of a case of drug-resistant Staphylococcus aureus induced suppurative meningitis. According to the clinical symptoms of the patient, the clinical pharmacist assisted the physician to formulate the initial treatment plan. It was suggested that dexamethasone should be used in combination with dexamethasone to attenuate its inflammatory reaction, according to the results of drug sensitivity test, combined with the results of blood concentration monitoring of vancomycin and the fitting results of population pharmacokinetic model. It was suggested that the dosage of vancomycin should be reduced to 0.5 g / g iv GTT / Q 12 h, and pharmacological monitoring should be carried out to evaluate the efficacy of anti-infective therapy, monitor adverse reactions, monitor renal function, and so on. Results: the physician partly accepted the clinical pharmacist's suggestion that the patient's condition was improved and there was no vancomycin related adverse reaction and was discharged on the 16th day of admission. Conclusion: clinical pharmacists are involved in the course of drug treatment for patients with suppurative meningitis. Combined with relevant guidelines, literature, etiology examination, blood drug concentration monitoring, pharmacokinetic model fitting and so on, the clinical pharmacists can help doctors to optimize the treatment plan in time. At the same time, it can prevent and reduce adverse drug reactions.
【作者单位】：南昌大学第二附属医院药学部;上海长海医院药学部;
【基金】：江西省科技计划专项项目(No.20151BAB215041)
【分类号】：R742.9

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