| 摘要: |
| 目的:探讨临床药师如何在新型隐球菌性脑膜炎患儿抗真菌治疗中进行药学实践。方法:临床药师参与1例新型隐球菌性脑膜炎儿童的药物治疗过程,从抗菌药物方案制定、给药剂量确定、疗效监护及不良反应处理等方面提供全程化的药学监护。结果:抗真菌治疗期间,患儿出现肾功能损害及低钾血症,临床药师建议医师降低两性霉素B剂量,停用甘露醇、呋塞米以避免加重肾功能损害,同时予以补钾治疗。调整治疗方案后,患儿肾功能恢复正常、未再出现低血钾。经系统抗真菌治疗,患儿病情较治疗前明显好转。此外,临床药师对维持治疗的抗真菌药物的选择给出药学建议,并被临床医师采纳。结论:临床药师全程参与新型隐球菌脑膜炎患儿的监护,为其治疗方案及不良反应的处理提供药学建议,对合理、安全的使用药物起到了良好作用,体现了药学服务的价值。 |
| 关键词: 临床药师 新型隐球菌性脑膜炎 低钾血症 急性肾功能损伤 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2018.12.010 |
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| 基金项目: |
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| Pharmaceutical Practice for a Patient with Cryptococcus Neoformans Meningitis by Clinical Pharmacists |
| Wang Peng1, Qiu Jinchun2, Zhang Yong2, Lu Xiaopeng2, Wang Yingjun3 |
| (1. Wuhu the Second People's Hospital, Anhui Wuhu 241000, China; 2. Children's Hospital of Nanjing Medical University, Jiangsu Nanjing 210000, China) |
| Abstract: |
| Objective: To investigate the development of pharmaceutical practice in the antifungal therapy for children with cryptococcal meningitis by clinical pharmacists. Methods: The clinical pharmacists participated in the drug treatment process of one children with cryptococcal meningitis, and provided whole-process pharmaceutical care from the aspects of participating into the formulation of antifungal drug treatment program and the determination of dosage, the monitoring of efficacy and the treatment of adverse drug reactions. Results: During antifungal therapy, renal dysfunction and hypokalemia occurred in the children. The clinical pharmacists recommended that the clinicians should reduce the dose of amphotericin B, stop mannitol and furosemide to avoid aggravating renal dysfunction, and potassium was given. After adjusting the treatment plan, the renal function of the child returned to normal state and hypokalemia did not observe again. After systemic antifungal treatment, the patient爷s condition were improved significantly. In addition, pharmaceutical recommendations were given for the selection of antifungal drugs for maintenance therapy and were adopted by the clinicians. Conclusion: Clinical pharmacists are fully involved in the monitoring of children with cryptococcal meningitis, providing pharmaceutical advice for the treatment scheme and the management of adverse drug reactions, which plays a positive role in the rational and safe use of drugs and reflects the value of pharmaceutical services. |
| Key words: clinical pharmacists cryptococcus neoformans meningitis low serum potassium acute renal injury |
