临床药师参与1例椎间神经鞘瘤切除术后脓肿分枝杆菌感染的药学监护
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篇名: 临床药师参与1例椎间神经鞘瘤切除术后脓肿分枝杆菌感染的药学监护
TITLE: Participation of clinical pharmacists in pharmaceutical care for a patient with Mycobacterium abscess infection after the resection of intervertebral schwannoma
摘要: 目的 为治疗脓肿分枝杆菌感染的药学监护提供思路。方法对临床药师参与的1例椎间神经鞘瘤切除术后脓肿分枝杆菌感染患者的诊疗方案进行分析。临床药师根据创口分泌物细菌培养及药敏试验结果,及时处理治疗过程中出现的药物不良反应,针对患者服用阿米卡星(0.4g,静脉滴注,q12h)后引起的耳鸣,建议停用阿米卡星,改为利奈唑胺,但该患者在服用利奈唑胺后出现膝关节痛,临床药师再次建议停用利奈唑胺,继续使用阿米卡星,并将剂量调整为0.8g,静脉滴注,q24h;同时对患者进行用药指导并嘱患者出院后定期复查随访。结果临床医师采纳了临床药师的建议,该患者未再出现耳鸣、膝关节痛等不适,肝肾功能也无异常。结论临床药师及时协助临床医师调整用药方案,提高了患者用药的有效性和安全性。
ABSTRACT: OBJECTIVE To provide ideas for pharmaceutical care of Mycobacterium abscess infection. METHODS The diagnosis and treatment plan ,about a patient with M. abscess infection after resection of intervertebral neurilemmoma participated by clinical pharmacists ,was analyzed . According to the results of bacterial culture and drug sensitivity test of wound secretion ,the clinical pharmacist timely dealed with the adverse drug reactions during the treatment . For the tinnitus caused by the patient taking amikacin(0.4 g,intravenous drip ,q12 h),it was suggested to stop amikacin and replace it with linezolid ;however,the patient suffered from knee pain after taking linezolid . The clinical pharmacist once again suggested stopping linezolid ,continuing to use amikacin,and adjusting the dose to 0.8 g,intravenous drip ,q24 h;at the same time ,the patients were given medication guidance and ordered to have regular follow -up after discharge . RESULTS The physicians adopted the suggestions of clinical pharmacists , and the patient did not suffer from tinnitus ,knee pain and other discomfort ,and the liver and kidney functions were normal . CONCLUSIONS Clinical pharmacists timely assist clinicians to adjust the medication plan ,which improves the effectiveness and safety of patients ’medication.
期刊: 2022年第33卷第18期
作者: 吴燕燕,王璨,杨昕炜,孔文强,胡雪莲
AUTHORS: WU Yanyan ,WANG Can,YANG Xinwei ,KONG Wenqiang ,HU Xuelian
关键字: 临床药师;脓肿分枝杆菌;皮肤;软组织;感染;不良反应;药学监护
KEYWORDS: clinical pharmacist ;Mycobacterium abscess ;skin;soft tissue ;infection;ADR;pharmaceutical care
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