临床药师参与1例播散性马尔尼菲青霉病治疗的病例分析  

Case Analysis of the Participation of Clinical Pharmacists in Drug Treatment of Disseminated Penicilliosis Marneffei

作　　者：刘晓萍[1] 张庆[2] 孟莹[3] 

机构地区：[1]暨南大学医学院附属清远医院药学部,广东清远511518 [2]南方医科大学南方医院药学部,广州510515 [3]南方医科大学南方医院呼吸内科,广州510515

出　　处：《中国药房》2013年第42期4023-4026,共4页China Pharmacy

摘　　要：目的:通过对1例播散性马尔尼菲青霉病患者进行药学监护,探讨临床药师在药物治疗中的作用。方法:临床药师参与1例播散性马尔尼菲青霉病患者的治疗工作,结合患者具体的病理生理情况,从抗真菌药物对马尔尼菲青霉菌的体外活性、到达感染部位的药物浓度及药品不良反应等多方面进行分析。建议临床医师选择伏立康唑200 mg、q12h,静脉滴注5 d后改为200 mg、q12h,口服序贯治疗的方案治疗马尔尼菲青霉病;口服异烟肼0.3 g、qd,莫西沙星0.4 g、qd联合抗结核治疗;并对患者进行药学监护。结果:经治疗后患者病情明显好转,临床症状逐渐消失,影像学检查提示病灶吸收。结论:抗真菌药的体外活性、到达感染部位的药物浓度及药品不良反应等都应是临床药师需要考虑的重点。临床药师提供药学服务,及时进行药学监护,可提高患者用药的有效性及安全性。OBJECTIVE： To explore the role of clinical pharmacists in drug therapy by providing pharmaceutical care for a case of disseminated penicilliosis marneffei. METHODS： Through participating in the treatment for a case of disseminated penicilli- osis marneffei, considering about the patient＇s pathophysiologic conditions, clinical pharmacists analyzed in vitro activity of an- ti-fungal drugs for penicillium marneffei, drug concentration of infection site and adverse drug reactions. Clinical pharmacists sug- gested physicians to adopt the following plan： i.v. dripping of voriconazole 200 rag, q12h, for 5 days, and then oral sequential therapy plan of voriconazole 200 mg, ql2h for penicilliosis mameffei; oral administration of isoniazid 0.3 g, qd combined with moxifloxacin 0.4 g, qd for anti-tuberculosis treatment. They also provided pharmaceutical care for patients. RESULTS： After treat- ment, the disease condition was relieved significantly, and clinical symptoms disappeared gradually. The lesions were absorbed ob- viously based on the imaging findings. CONCLUSIONS： The activity of anti-fungal agents in vitro, the concentration of drugs in infective site, ADR and other aspects are all important parts which should be considered by clinical pharmacist. The participation of clinical pharmacists and timely pharmaceutical care can obviously improve drug efficacy and safety.

关 键 词：马尔尼菲青霉病 临床药师 药学监护 

分 类 号：R978.1[医药卫生—药品] R969.3[医药卫生—药学]