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芬太尼透皮贴剂致胸壁肌肉强直继发呼吸困难的药学监护
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| 篇名： | 芬太尼透皮贴剂致胸壁肌肉强直继发呼吸困难的药学监护 |
| TITLE： | |
| 摘要： | 目的：探讨临床药师在芬太尼透皮贴剂致胸壁肌肉强直继发呼吸困难患者药物治疗中的作用。方法：临床药师参与1例晚期前列腺癌伴重度疼痛患者的药物治疗，通过分析其用药史，结合相关药物药理作用特点和不良反应，协助医师识别和分析芬太尼透皮贴剂致胸壁肌肉强直继发呼吸困难的风险，并根据其症状先后建议暂不停用芬太尼透皮贴剂，加用肌松药盐酸乙哌立松片50 mg，po，tid缓解肌肉强直，停用劳拉西泮片、氟哌啶醇片和盐酸苯海拉明片以减少诱发谵妄的药物因素。结果：医师采纳临床药师建议，患者胸壁肌肉强直和呼吸困难得到缓解，疼痛得到满意控制，于入院第12天带药出院。结论：芬太尼透皮贴剂使用过程中出现的肌肉强直继发呼吸困难易与呼吸中枢抑制混淆，临床药师和医师应及时识别并正确处理。 |
| ABSTRACT： | OBJECTIVE： To investigate the effects of clinical pharmacists on the treatment for muscle stiffness followed by dyspnea induced by Fentanyl transdermal patch. METHODS： Clinical pharmacists participated in drug treatment for a patient with advanced prostate cancer complicating with severe pain. Through analyzing medication history， combined with the characteristics of pharmacological action and ADR， clinical pharmacists assisted physicians to identify and analyze the risk of muscle stiffness followed by dyspnea induced by Fentanyl transdermal patch. According to symptoms， clinical pharmacists suggested not stopping using Fentanyl transdermal patch， using muscle relaxant Eperisone hydrochloride tablets 50 mg，po，tid to relieve muscle stiffness， and stopping using Lorazepam tablets， Haloperidol tablets and Diphenhydramine hydrochloride tablets so as to reduce the risk factor of delirium. RESULTS： Physicians adopted the suggestions of clinical pharmacists. The chest wall muscles stiffness and dyspnea were relieved， and the pain could be controlled. The patient was discharged from the hospital with medicine on the 12th day. CONCLUSIONS： The muscle stiffness followed by dyspnea induced by Fentanyl transdermal patch is easily confused with respiratory central inhibition. Clinical pharmacists and physicians should be identify them timely and dispose it properly. |
| 期刊： | 2017年第28卷第2期 |
| 作者： | 李欣宇，朱深银，邱峰，刘宇 |
| AUTHORS： | LI Xinyu，ZHU Shenyin，QIU Feng，LIU Yu |
| 关键字： | 阿片类药物；芬太尼透皮贴剂；肌肉强直；呼吸困难；临床药师；药学监护 |
| KEYWORDS： | Opioid drugs； Fentanyl transdermal patch； Muscle stiffness； Dyspnea； Clinical pharmacist； Pharmaceutical care |
| 阅读数： | 615 次 |
| 本月下载数： | 12 次 |
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