中国医院用药评价与分析
中國醫院用藥評價與分析
중국의원용약평개여분석
EVALUATION AND ANAL YSIS OF DRUG-USE IN HOSPITALS OF CHINA
2015年
5期
676-677,678
,共3页
临床药师%神经节苷脂%药物热%药学实践
臨床藥師%神經節苷脂%藥物熱%藥學實踐
림상약사%신경절감지%약물열%약학실천
Clinical pharmacist%Ganglioside%Drug fever%Pharmacy practice
目的：临床药师通过参与诊治1例注射用神经节苷脂所致药物热患者的临床实践，以进一步认识药物热，探讨临床药师在药物热诊治中的作用。方法：1例发热乏力查因、阿尔茨海默病的患者使用注射用头孢哌酮／他唑巴坦钠、注射用左氧氟沙星、注射用神经节苷脂治疗，3 d后体温恢复正常，第12日又出现高热。第21日临床药师会诊后认为发热与注射用神经节苷脂引起的药物热相关性大，结合检验指标，感染加重的可能性小，建议停用注射用神经节苷脂和抗菌药物。临床医师同意并采纳药师建议，停药后患者48 h内体温下降至正常，未出现继发感染。结果：药物热的诊断虽然目前缺乏特异性指标，但临床药师可以通过查阅大量文献和所积累的临床经验，总结出药物热的发病机制和临床表现，帮助医师对药物热进行鉴别诊断并及时采取适当的治疗措施。结论：临床药师参与临床查房和会诊，对提高临床诊疗水平、保障患者用药安全、避免和减少患者药源性损害事件的发生具有极大的帮助和促进作用。
目的：臨床藥師通過參與診治1例註射用神經節苷脂所緻藥物熱患者的臨床實踐，以進一步認識藥物熱，探討臨床藥師在藥物熱診治中的作用。方法：1例髮熱乏力查因、阿爾茨海默病的患者使用註射用頭孢哌酮／他唑巴坦鈉、註射用左氧氟沙星、註射用神經節苷脂治療，3 d後體溫恢複正常，第12日又齣現高熱。第21日臨床藥師會診後認為髮熱與註射用神經節苷脂引起的藥物熱相關性大，結閤檢驗指標，感染加重的可能性小，建議停用註射用神經節苷脂和抗菌藥物。臨床醫師同意併採納藥師建議，停藥後患者48 h內體溫下降至正常，未齣現繼髮感染。結果：藥物熱的診斷雖然目前缺乏特異性指標，但臨床藥師可以通過查閱大量文獻和所積纍的臨床經驗，總結齣藥物熱的髮病機製和臨床錶現，幫助醫師對藥物熱進行鑒彆診斷併及時採取適噹的治療措施。結論：臨床藥師參與臨床查房和會診，對提高臨床診療水平、保障患者用藥安全、避免和減少患者藥源性損害事件的髮生具有極大的幫助和促進作用。
목적：림상약사통과삼여진치1례주사용신경절감지소치약물열환자적림상실천，이진일보인식약물열，탐토림상약사재약물열진치중적작용。방법：1례발열핍력사인、아이자해묵병적환자사용주사용두포고동／타서파탄납、주사용좌양불사성、주사용신경절감지치료，3 d후체온회복정상，제12일우출현고열。제21일림상약사회진후인위발열여주사용신경절감지인기적약물열상관성대，결합검험지표，감염가중적가능성소，건의정용주사용신경절감지화항균약물。림상의사동의병채납약사건의，정약후환자48 h내체온하강지정상，미출현계발감염。결과：약물열적진단수연목전결핍특이성지표，단림상약사가이통과사열대량문헌화소적루적림상경험，총결출약물열적발병궤제화림상표현，방조의사대약물열진행감별진단병급시채취괄당적치료조시。결론：림상약사삼여림상사방화회진，대제고림상진료수평、보장환자용약안전、피면화감소환자약원성손해사건적발생구유겁대적방조화촉진작용。
OBJECTIVE:To facilitate clinical pharmacists'understanding on drug fever and explore the role of clinical pharmacists in the diagnosis and treatment of drug fever through participating in the diagnosis and treatment of drug fever induced by Ganglioside for injection.METHODS:A patient with Alzheimer's disease complicating fever and fatigue of unknown origin were treated with cefoperazone/tazobactam, levofloxacin and ganglioside. The body temperature of the patient returned to normal on day 3, but high fever reappeared on day 12.During consultation on day 21 , clinical pharmacists regarded that the fever might be associated with ganglioside use instead of aggravating of infection as indicated by laboratory results, thus clinical pharmacists suggested withdrawal of both ganglioside and antibacterial drugs.After withdrawal of 48 hours, the patient's body temperature returned to normal without appearance of secondary infection.RESULTS: Although there is lack of specific indexes for the diagnosis of drug fever, but clinical pharmacists can sum up the pathogenesis and clinical manifestations of drug fever through review of considerable literature and accumulation of clinical experience, help physicians in the differential diagnosis of drug fever and to take appropriate treatment measures timely.CONCLUSIONS:Clinical pharmacists'participation in clinical rounds and consultation is conducive to the improvement in the clinical diagnosis and treatment, ensurance of patients'medication safety, prevention and reduction of the incidence of drug-induced damages.
