摘要
目的:分析临床药师在长疗程使用万古霉素致患者急性肾损伤治疗中的药学监护过程。方法:临床药师通过定期监测患者的万古霉素血药浓度和肾功能,及时发现万古霉素引起的急性肾损伤不良反应;临床药师参与治疗方案的调整并及时监测到患者使用利奈唑胺也发生类似不良反应,再次调回原治疗方案,并根据其肾功能调整万古霉素的剂量和溶媒用量,加用护肾药物(还原型谷胱甘肽、复方α-酮酸片)并根据肾功能变化调整还原型谷胱甘肽的用量。结果:患者先后通过替代药物的使用、调整万古霉素剂量并水化疗法、加用护肾药物、调整护肾药物剂量等一系列措施,其肾功能得到明显改善,确保疗程为6周。结论:通过定期监测万古霉素血药浓度和肾功能,及时发现万古霉素引起的急性肾损伤,临床药师通过参与替代治疗方案的制订、万古霉素剂量的调整并水化治疗及护肾药物等措施,确保了患者的疗效。
Objective:To analyze the pharmaceutical care process of clinical pharmacists in the Clinical medication in patient with acute kidney injury induced by vancomycin taken for a long period of time.Methods:Clinical pharmacists timely detected the adverse reactions caused by vancomycin to acute kidney injury by regularly monitoring the blood concentration and renal function of the patients.Clinical pharmacists participated in the treatment of adjustment and timely monitoring the patients with linezolid and adverse reactions,once again back to the original treatment,according to the renal function to adjust the dose of vancomycin and solvent consumption,and reduced glutathione compound with protecting kidney drμgs alpha-keto acid piece based on adjusting the dose of reduced glutathione renal function.Results:Throμgh a series of measures such as the use of alternative drμgs,the adjustment of vancomycin dose and hydration,the addition of kidney-protecting drμgs,and the adjustment of kidney-protecting drμg dose,the renal function of the patients was significantly improved,and the duration of treatment was ensured to be full of 6 weeks.Conclusion:Clinical pharmacists timely detected vancomycin induced acute kidney injury by regular monitoring of vancomycin serum concentration and renal function.Clinical pharmacists participated in the formulation of alternative treatment regimens,vancomycin dosage adjustment,hydration and kidney-care drμgs to ensure that patients complete the course of treatment.The efficacy of the patients was ensured.
作者
张乃菊
张帆
陈天平
刘金春
ZHANG Nai-ju;ZHANG Fan;CHEN Tian-ping;LIU Jin-chun(The First Affiliated Hospital of Bengbu Medical College,Anhui Bengbu 233004,China;Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)
出处
《抗感染药学》
2020年第11期1676-1679,共4页
Anti-infection Pharmacy
基金
蚌埠医学院自然科学重点项目(编号:BYKY2019054ZD)
白求恩医学科学研究基金(编号:SG056EN)
江苏省药学会-奥赛康医院药学基金科研课题(编号:A201907)。
关键词
万古霉素
长疗程
急性肾损伤
临床药师
药学实践
vancomycin
long course
acute kidney injury
clinical pharmacist
pharmacy practice
