| 本文已被：浏览 1497次 下载 197次 |
码上扫一扫！ |
| 服用中药粉末致治疗失败的癫痫患儿药学监护1例 |
| 郭未艳1,2,何忠芳1,武新安1,鲁雅琴1,王颖丽2,关丽1,3,王颖1 |
|
|
| (1. 兰州大学第一医院,甘肃兰州 730000; 2. 西安市第一医院,陕西西安 710002; 3. 新疆生产建设兵团医院,新疆乌鲁木齐 830002) |
|
| 摘要: |
| 目的:探讨儿童癫痫患者的药学监护方法及临床药师参与抗癫痫治疗的实践模式。方法:临床药师参与1例服用中药粉末致治疗失败的儿童癫痫患者的治疗过程,采用治疗药物浓度监测(TDM)的方法测定中药粉末中含有的化学药成分、分析治疗失败原因、制定个体化给药方案,并对患儿长期用药进行指导。结果:TDM示中药粉末中含有苯巴比妥、苯妥英钠、卡马西平三种化学药成分,且三种成分均未达到有效治疗浓度,这是癫痫治疗失败的主要原因。结合儿童用药特点,制定了以拉莫三嗪逐渐替换中药粉末的治疗方案,对出院后长期用药进行宣教,随访效果良好。结论:TDM为儿童癫痫临床治疗及个体化给药提供了有效的证据,是临床药师参与抗癫痫治疗及药学监护的有效手段。 |
| 关键词: 中药粉末 抗癫痫药 儿童 癫痫 治疗药物监测 药学监护 |
| DOI：10.13407/j.cnki.Jpp.1672-108X.2017.04.014 |
|
| 基金项目:甘肃省卫生行业科研计划项目,编号GSWST2012-03 |
|
| Pharmaceutical Care of One Epilepsy Child Taking Traditional Chinese Medicine Powder with Treatment Failure |
| Guo Weiyan1,2 , He Zhongfang1 , Wu Xin'an1 , Lu Yaqin1 , Wang Yingli2 , Guan Li1,3 , Wang Ying 1 |
| (1. First Hospital of Lanzhou University, Gansu Lanzhou 730000, China; 2. The First Hospital of Xi'an, Shannxi Xi'an 710002, China; 3. Xinjiang
Production and Construction Corps Hospital, Xinjiang Urumchi 830002, China) |
| Abstract: |
| Objective: To discuss pharmaceutical care methods in children with epilepsy and practice patterns of clinical pharmacists participating in anti-epileptic therapy. Methods: Pharmacists participated in treatment process of one epilepsy child taking Traditional Chinese medicine (TCM) powder with treatment failure, the chemical ingredients in TCM powder were determined by therapeutic drug mornitoring (TDM), the reasons of treatment failure were analyzed, individualized treatment plan was designed, and medicine guidence was made. Results: TDM results showed the TCM powder contained chemical ingredients including phenobarbital, phenytoin and carbamazepine. And all of the three ingredients did not reach effective therapeutic concentration, which was the main reason for treatment failure. Combined with the characteristics of children's medication, we developed a new therapeutic schedule that lamotrigine gradually replaced the TCM powder, and make long-term medication education, the new regime proved to be effective in follow up. Conclusion: TDM provides valid evidence for clinical treatment of epileptic children and individualized administration. It is an effective means for clinical pharmacists to participate in anti鄄epilepsy treatment and pharmaceutical care. |
| Key words: Traditional Chinese medicine powder anti-epilepsy drugs children epilepsy therapeutic drug monitoring pharmaceutical care |
