临床药师对垂体瘤卒中合并哮喘患者的术后药学监护  

Postoperative Pharmaceutical Care of Clinical Pharmacist in Patient with Pituitary Adenoma Apoplexy and Asthma

作　　者：刘静[1] Liu Jing(Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China)

机构地区：[1]四川大学华西医院临床药学部药剂科

出　　处：《药物流行病学杂志》2019年第10期677-680,共4页Chinese Journal of Pharmacoepidemiology

摘　　要：本文介绍1例有哮喘病史的患者行经蝶垂体瘤切除术后哮喘加重的案例。临床药师根据垂体瘤卒中急症特征及氢化可的松药动学特点,为患者制定了个体化的糖皮质激素替代治疗方案。在患者出现明显哮喘症状时及时调整糖皮质激素和支气管扩张剂。使用低剂量的右美托咪定适当镇静改善患者烦躁,避免患者自主呼吸与呼吸机对抗导致哮喘治疗不佳。治疗过程中,临床药师协助医师根据患者情况及时调整治疗方案,充分体现了临床药师在外科围手术期患者药物治疗管理中的价值。This article described a case of asthma exacerbation after transsphenoidal pituitary adenoma resection in a patient with a history of asthma. According to the emergency characteristics of pituitary apoplexy and the pharmacokinetics of hydrocortisone, clinical pharmacist developed an individualized glucocorticoid replacement treatment for patient. A treatment program including stronger anti-inflammatory glucocorticoids and bronchodilators was recommended for patient when asthma symptoms worsen. Proper sedation with low dose of dexmedetomidine improved patient’s irritability, avoiding poor asthma treatment due to confrontation between spontaneous breathing and ventilator. During treatment, the clinical pharmacist assisted the physician to adjust treatment program according to patient’s condition, which fully reflected the value of clinical pharmacist in perioperative drug management.

关 键 词：垂体瘤卒中 经蝶入路 哮喘 糖皮质激素替代治疗 脑脊液鼻漏 药学监护 

分 类 号：R97[医药卫生—药品]