CAJ | 학술논문

1例78岁老年男性患者,因发热2 d入院,既往合并系统性血管炎、高血压、肝功能损伤.入院后给予美罗培南、莫西沙星抗感染、醋酸泼尼松龙控制血管炎及降压、保肝等治疗.临床药师评估其初始治疗方案,并持续关注其药物治疗,对患者进行全程药学监护,在发生替考拉宁相关肾损伤、抗生素相关大疱性皮肤反应及药物相关肝损伤时进行及时的用药分析,与医生充分沟通并建议停用替考拉宁、莫西沙星、夫西地酸等相关可疑药物,患者病情稳定,治疗32 d出院.
1례78세노년남성환자,인발열2 d입원,기왕합병계통성혈관염、고혈압、간공능손상.입원후급여미라배남、막서사성항감염、작산발니송룡공제혈관염급강압、보간등치료.림상약사평고기초시치료방안,병지속관주기약물치료,대환자진행전정약학감호,재발생체고랍저상관신손상、항생소상관대포성피부반응급약물상관간손상시진행급시적용약분석,여의생충분구통병건의정용체고랍저、막서사성、부서지산등상관가의약물,환자병정은정,치료32 d출원.
One 78-year-old male patient was admitted to hospital due to fever for two days with systemic vasculitis, hypertention and hepatic insufficiency. After admission, several treatments were given to him including anti-infection therapy with meropenem and moxifloxacin, anti-vasculitis therapy with prednisolone acetate, anti-hypertention therapy, liver protection therapy and so on. The initial antibiotics regime and the continuing hospital medication were evaluated by clinical pharmacist and the whole-range pharmaceutical care was carried out. Timely medication analysis and suggestions involving teicoplanin-related renal injury, antibiotic-related epidermolysis bullosa and antibiotic-related hepatic injury were given to physician.Teicoplanin, moxifloxacin and fusidic acid were discontinued for suspicious drug-related ADRs. The patient was in stable situation and he was discharged from hospital on the thirty-second day.