摘要
1例60a女性患者,因间断发热、头痛2月余入院。腰穿脑脊液涂片墨汁染色找到隐球菌,诊断隐球菌性脑膜炎。参照隐球菌性脑膜炎治疗指南,采用两性霉素B联合氟胞嘧啶进行抗真菌治疗,并对两性霉素B的剂量调整及不良反应进行监测。在应用两性霉素B过程中,患者出现低血钾及心电图异常,立即停药,根据每日血钾监测情况,积极给予静脉滴注氯化钾和口服枸橼酸钾对症治疗;同时对患者高颅压进行监护。患者接受抗真菌药物治疗2个多月后,症状较前改善。
A 60-year-old female patient with fever and headache for 2 months was hospitalized. According to the result of CSF test, the patient was diagnosed as cryptococcal meningitis. Clinical pharmacist timely assessed the drug therapy, and combination use of amphotericin B and flucytosine for anti-fungal treatment was suggested according to guideline of cryptococcal meningitis. The pharmaceutical cares on dosage adjustment and monitoring the ADRs of amphotericin B were carried out. The patient developed hypokalemia and electrocardiogram （ECG） abnormalities during using amphotericin B, so the drug was stopped and the positive symptomatic treatment with the intravenous infusion of potassium chloride and oral potassium citrate was given. Meanwhile, the intracranial pressure of the patient was monitored. The symptoms of the patient improved after more than 2-month treatment.
出处
《中国药物应用与监测》
CAS
2010年第4期234-236,共3页
Chinese Journal of Drug Application and Monitoring
关键词
隐球菌性脑膜炎
抗真菌药物
两性霉素B
氟胞嘧啶
临床药师
药学监护
Cryptococcal meningitis
Anti-fungal drug
Amphotericin B
Flucytosine
Clinical pharmacist
Pharmaceutical care
