临床药师参与1例复杂性尿路感染患者抗癫痫治疗的药学实践  

Pharmaceutical Practice of Clinical Pharmacists Participated in a Case of Complicated Urinary Tract Infection Treated by Antiepileptic

作　　者：张在丽[1] 钟晗[1] 崔敏[1] 胡利明 王永辉 Zhang Zaili;Zhong Han;Cui Min;Hu Liming;Wang Yonghui(Department of Pharmacy,Renji Hospital,School of Medicinem,Shanghai Jiaotong University,Shanghai 200127,China;Department of Pharmacy,Wenling First People＇s Hospital;Department of Pharmacy,Henan Zhumadian Central Hospital)

机构地区：[1]上海交通大学医学院附属仁济医院药学部,上海200127 [2]浙江省温岭市第一人民医院药学部 [3]河南省驻马店市中心医院药学部

出　　处：《药物流行病学杂志》2018年第7期470-473,共4页Chinese Journal of Pharmacoepidemiology

基　　金：上海市临床药学重点专科建设项目(编号:2016-40044-002);上海市卫生计生系统重要薄弱学科建设项目(编号:2016ZB0304)

摘　　要：对临床药师参与的1例复杂性尿路感染伴癫痫患者使用美罗培南的病例进行分析讨论,分享复杂尿路感染合并癫痫患者药物治疗的经验。临床药师认为美罗培南与丙戊酸钠存在用药禁忌,可降低丙戊酸钠的血药浓度,增加癫痫发作风险,且两药间的相互作用无剂量依赖性,建议调整抗感染方案并进行用药监护。密切监测丙戊酸血药浓度及患者癫痫症状,并证实了其与美罗培南存在的药物相互作用。临床药师的参与提高了药物治疗的的有效性和安全性,并为临床合理用药提供参考。Clinical pharmacist participated in a case of complicated urinary tract infection with epilepsy, analyzed and discussed the treatment process, to share the experience of drug therapy for complicated urinary tract infection combined with epilepsy. The clinical pharmacist believed that meropenem and valproate were contraindicated, meropenem can reduce the blood concentrations of valproic acid sodium, and increase the risk of seizures. In particularly, the interaction between the two drugs was not dose-dependent. The clinical pharmacist recommended adjusting the anti-infection regimen and administering the medication, closely monitored the blood drug concentration of valproic acid and epileptic symptoms, and the drug interactions with meropenem were confirmed. The clinical pharmacists participation improves the efficacy and safety of drug treatment, and provides reference for rational drug use.

关 键 词：美罗培南 丙戊酸 复杂性尿路感染 癫痫 药物相互作用 

分 类 号：R97[医药卫生—药品]