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1例AECOPD伴良性前列腺增生患者使用支气管扩张药致急性尿潴留的药学监护
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| 篇名： | 1例AECOPD伴良性前列腺增生患者使用支气管扩张药致急性尿潴留的药学监护 |
| TITLE： | |
| 摘要： | 目的：探讨临床药师在慢性阻塞性肺疾病急性加重期（AECOPD）合并良性前列腺增生（BPH）患者药物治疗中的作用。方法：临床药师参与1例AECOPD合并BPH患者的药物治疗过程，参考临床指南和相关文献，结合患者疾病史、支气管扩张药作用特点及急性尿潴留症状，建议停用吸入用异丙托溴铵溶液，加用非那雄胺胶囊5 mg，po，qd缩小前列腺体积、改善梗阻+盐酸特拉唑嗪片2 mg，po，qd松弛尿道平滑肌，并密切监测有无相关不良反应发生；建议患者出院后选用沙美特罗替卡松粉吸入剂，并给予用药指导。结果：医师部分采纳临床药师建议。患者病情稳定，未再出现排尿困难，准予带药出院。结论：支气管扩张药的合理应用直接关系到AECOPD患者临床症状的缓解及其预后。临床药师通过结合患者疾病史、药物作用特点和临床症状，指出了使用抗胆碱药可能存在的风险，协助医师制订和调整了治疗方案，保证了患者用药的安全性和有效性。 |
| ABSTRACT： | OBJECTIVE： To investigate the role of clinical pharmacists on drug therapy for acute exacerbations of chronic obstructive pulmonary disease（AECOPD）patients with benign prostatic hyperplasia （BPH）. METHODS： Clinical pharmacists participated in drug therapy for a AECOPD patient with BPH. According to clinical guideline and relevant literatures， based on the history of disease， the characteristics of bronchodilators and the symptoms of acute urinary retention， it was suggested to stop taking Ipratropium bromide solution for inhalation but receive Finasteride capsules 5 mg， po， qd， to reduce prostate volume and improve obstruction+Terazosin hydrochloride tablets 2 mg， po， qd， to relax urethral smooth muscle； the occurrence of ADR was monitored closely. Salmeterol xinafoate and fluticasone propionate powder for inhalation was suggested and medication guidance for patients after discharge was given by clinical pharmacists. RESULTS： Physicians adopted some suggestions of clinical pharmacists. The patient was stable and had no dysuria. The patient was allowed to leave the hospital with drugs. CONCLUSIONS： Rational use of bronchodilators is directly related to the remission of clinical symptoms and prognosis in AECOPD patients. In view of patient’s disease history， drug characteristics and clinical symptoms， clinical pharmacists point to possible risks of anticholinergics use， and assist physicians to formulate and adjust therapy plan so as to guarantee the safety and effectiveness of drug use. |
| 期刊： | 2017年第28卷第20期 |
| 作者： | 何霖，杨培洪，程模，蔡雨君 |
| AUTHORS： | HE Lin，YANG Peihong，CHENG Mo，CAI Yujun |
| 关键字： | 临床药师；药学监护；慢性阻塞性肺疾病急性加重期；良性前列腺增生；支气管扩张药；急性尿潴留 |
| KEYWORDS： | Clinical pharmacist； Pharmaceutical care； Acute exacerbations of chronic obstructive pulmonary disease； Benign prostatic hyperplasia； Bronchodilators； Acute urinary retention |
| 阅读数： | 341 次 |
| 本月下载数： | 9 次 |
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