一例多药联合致“非典型”抗精神病药恶性综合征患者的药学监护体会  

Experience of pharmaceutical care for atypical neuroleptic malignant syndrome in-duced by multiple antipsychotics combination:a case report

作　　者：王天琳[1] 马玉宝 李渊源 夏蕾[3] WANG Tian-lin;MA Yu-bao;LI Yuan-yuan;XIA Lei(Department of Clinical Pharmacy Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Neurology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Pharmacy,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院药学部临床药学中心,北京100853 [2]中国人民解放军总医院第一医学中心神经内科,北京100853 [3]中国人民解放军总医院药学部,北京100853

出　　处：《实用药物与临床》2020年第6期548-551,共4页Practical Pharmacy and Clinical Remedies

基　　金：解放军总医院医疗大数据研发项目(2017MBD-027)。

摘　　要：目的探讨临床药师对"非典型"抗精神病药恶性综合征患者的药学监护经验。方法临床药师参与1例多药联合致"非典型"抗精神病药恶性综合征患者的全程药物综合管理,对患者体温异常进行了药学鉴别,对不典型表现进行了机制分析,为再次面对类似病例提供了合理用药建议。结果经过抗精神病药停药和减量后,患者体温下降,转归良好。结论临床药师在为患者提供全程药学监护过程中,应具备识别、鉴别药品不良反应的敏锐能力,切实帮助临床团队改善患者预后和降低药物风险。Objective To explore the experience of clinical pharmacists in pharmaceutical care for patients with atypical neuroleptic malignant syndrome(NMS)induced by multiple antipsychotics combination.Methods Clin-ical pharmacists took part in integrated pharmaceutical care for one atypical multidrug-induced NMS,discriminated cau-ses of the abnormal body temperature,analyzed the underlining mechanisms of patient's atypical symptoms,and provid-ed reasonable medication recommendations for future similar cases.Results After the antipsychotic drugs were discon-tinued and dose reduced,the patient's temperature dropped and the outcome was good.Conclusion Clinical pharma-cists should be able to identify adverse drug reactions during the full-course of pharmaceutical care for patients,effec-tively helping clinical teams improve patient outcomes and reduce drug risk.

关 键 词：抗精神病药恶性综合征 临床药师 药学监护 

分 类 号：R595.3[医药卫生—内科学]