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临床药师在化脓性脑膜炎个体化治疗中的作用
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| 篇名： | 临床药师在化脓性脑膜炎个体化治疗中的作用 |
| TITLE： | |
| 摘要： | 目的：探讨临床药师在化脓性脑膜炎患者个体化治疗中的作用。方法：临床药师参与1例耐药金黄色葡萄球菌致化脓性脑膜炎患者的药物治疗，根据患者临床症状，协助医师制订初始治疗方案；通过查阅相关指南和国内外文献，建议联合应用地塞米松以减轻其炎症反应；根据药敏试验结果，结合万古霉素血药浓度监测和群体药动学模型拟合结果，建议将万古霉素的剂量减至0.5 g，ivgtt，q12 h；并行抗感染治疗效果评价、不良反应监测、肾功能监测等药学监护。结果：医师部分采纳临床药师建议，患者病情好转，且未发生万古霉素相关不良反应，并于入院第16天出院。结论：临床药师参与化脓性脑膜炎患者的药物治疗过程，结合相关指南、文献以及病原学检查、血药浓度监测、药动学模型拟合等结果，协助医师及时优化了治疗方案，在保证抗感染治疗效果的同时，预防和减少了药品不良反应的发生。 |
| ABSTRACT： | OBJECTIVE： To explore the role of clinical pharmacists participating in the individualized treatment for purulent meningitis. METHODS： Clinical pharmacists participated in the therapy for a patient with purulent meningitis complicated with Staphylococcus aureus infection. According to patient’s condition， clinical pharmacists assisted physicians to formulate preliminary therapeutic plan. Reviewing relevant guidelines， domestic and foreign literatures， clinical pharmacists suggested to combine with dexamethasone so as to relieve inflammatory reaction. According to the results of drug sensitivity test， based on vancomycin plasma concentration monitoring and population pharmacokinetics model fitting， clinical pharmacists suggested to reduce the dose of vancomycin to 0.5 g， ivgtt， q12 h. The pharmaceutical care were conducted throughout the therapy， including efficacy evaluation of anti-infective therapy， ADR monitoring， renal function monitoring， etc. RESULTS： Physicians adopted some suggestions of clinical pharmacists. The disease condition of the patient was recovred， and no ADR related to vancomycin was found. On the 16th day， the patient was discharged from the hospital. CONCLUSIONS： Clinical pharmacists participate in treatment of purulent meningitis， assist physicians to optimize therapy plan based on relevant guideline， literature， etiological examination， blood concentration monitoring and pharmacokinetics model fitting results. It not only guarantee therapeutic efficacy of anti-infective therapy， but also prevent and reduce the occurrence of ADR. |
| 期刊： | 2017年第28卷第20期 |
| 作者： | 于洋，丁楠，熊爱珍，何佳珂 |
| AUTHORS： | YU Yang，DING Nan，XIONG Aizhen，HE Jiake |
| 关键字： | 个体化用药；抗感染治疗；群体药动学模型；临床药师；药学监护；万古霉素 |
| KEYWORDS： | Individualized medication； Anti-infective therapy； Population pharmacokinetics model； Clinical pharmacist； Pharmacokinetic monitoring； Vancomycin |
| 阅读数： | 278 次 |
| 本月下载数： | 15 次 |
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