1例慢性肾脏病合并淋巴结结核患者的药学监护  

Pharmaceutical Care for One Patient with Chronic Kidney Disease Complicated with Lymph Node Tuberculosis

作　　者：刘德凤 匡扶[2] 余娴[3] 

机构地区：[1]重庆医科大学药学院,重庆400016 [2]重庆医科大学附属第二医院药学部 [3]重庆医科大学附属第二医院Ⅰ期临床试验研究室

出　　处：《中国药师》2018年第9期1620-1623,共4页China Pharmacist

基　　金：重庆市卫生计生委重点项目(编号:2016ZDXM010)

摘　　要：1例63岁慢性肾脏病合并淋巴结结核患者,因抗结核药物不良反应和罹患感染,多次调整抗结核药物治疗方案。此次入院时的用药方案为莫西沙星0.4 g,po,qd、乙胺丁醇0.75 g,po,qd、吡嗪酰胺0.75 g,po,tid。考虑患者出现的药物不良反应,临床药师建议停用乙胺丁醇,加用利福喷丁0.45 g,po,biw;建议维生素B_6剂量加大到50 mg·d^(-1),吡嗪酰胺剂量调整为1.125 g tiw;根据淋巴结结核疗程及治疗中断的情况,建议抗结核治疗疗程为6个月,待补足治疗中断的药物剂量后再评估是否停药。医师采纳临床药师建议,但治疗疗程尚存争议。患者出院后随访得知其眼部及下肢症状均有好转。A 63-year-old patient with chronic kidney disease （CKD） complicated with lymph node tuberculosis suffered from the adverse reactions of anti-tuberculous drugs and infection, therefore, the anti-tuberculous treatment regimen was adjusted repeatedly. In the recent admission, the patient was given moxifloxacin 0.4 g, po, qd, ethambutol 0.75 g, po, qd and pyrazinamide 0.75 g, po, qd. According to the adverse reactions in the patient, clinical pharmacists suggested ethambutol withdrawal and additionally using rifapen- fine 0.45g, po, biw and vitamin B6 50 mg· d-1, and the dose of pyrazinamide was risen to 1. 125 g tiw. The course of treatment was set at 6 months according to the treatment course of lymph node tuberculosis and the treatment interruption, and drug withdrawal was e- valuated again after the dose supplement for the treatment interruption. The physicians adopted the suggestions of clinical pharmacists, while the treatment course remained controversial. After discharged from hospital and followed up, the patient was with improved ocular and lower limb symptoms.

关 键 词：慢性肾脏病 淋巴结结核 药学监护 

分 类 号：R692[医药卫生—泌尿科学] R522[医药卫生—外科学]