| 摘要: |
| 目的:通过对3 例肾病综合征(NS)合并结核感染患者联合应用环孢素(CsA) 与利福平(RFP) 的监护与干预,探讨临床
药师基于血药浓度监测在药学监护和识别药物相互作用中发挥的作用。方法:临床药师通过血药浓度监测分析与RFP 联用及
停药后的CsA 血药浓度变化情况,揭示RFP 与CsA 的相互作用及持续时间,寻找有效治疗方案。结果:CsA 与RFP 联用后,采
取多种措施,均未上升到有效血药浓度。停用RFP 1 周CsA 血药浓度可上升至有效血药浓度,且RFP 的诱导作用仍然存在。
RFP 可显著降低CsA 的血药浓度,且作用时间持久,应避免二者联用。结论:临床药师通过血药浓度监测,参与优化药物治疗,
成功干预了药物相互作用,保障了患者的用药安全,促进临床合理用药。 |
| 关键词: 利福平 环孢素 血药浓度监测 药物相互作用 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2023.05.005 |
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| 基金项目: |
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| Effect and Intervention of Rifampicin Combined with Cyclosporine A on Nephrotic Syndrome Complicated with Tuberculosis Infection in Children |
| Li Shu1,2, Zhang Aiguo1, Zhao Yiming2, Wang Xiaoling2 |
| (1. North China University of Science and Technology Affiliated Hospital, Hebei Tangshan 063000, China; 2. Beijing Children’s Hospital, Capital Medical University, Beijing 100045, China) |
| Abstract: |
| Objective: To explore the role of blood concentration monitoring by clinical pharmacists in pharmaceutical care and
identification of drug interactions through monitoring and intervening cyclosporine A (CsA) and rifampicin (RFP) in 3 patients with
nephrotic syndrome (NS) complicated with tuberculosis infection. Methods: Blood concentration monitoring was used as a technical
support to analyze the changes of CsA plasma concentration after combination with RFP and withdrawal of RFP, revealing the severity
and duration of their interactions. Based on this, the pharmacists sought an effective treatment. Results: The plasma concentration of
CsA didn’t rise to the effective concentration by taking multiple measures in combination with RFP. However, it rose to be effective
after 7 days’ withdrawal of RFP, and the RFP induction still existed. These results indicated that RFP can significantly and persistently
reduce the blood concentration of CsA, and the combined therapy should be avoided. Conclusion: Through blood drug concentration
monitoring, pharmacists have participated in the optimization of drug treatment, successfully intervened the drug interaction, ensured the
safety of patients, and promoted the rational drug use in clinic. |
| Key words: rifampicin cyclosporine A blood concentration monitoring drug interaction |
