1例HIV-PJP患者的药学监护探讨  

A case report of one HIV-PJP patient:discussion on pharmaceutical care

作　　者：王玥媛 陈昆 刘梦颖[4] 方洁[2] WANG Yueyuan;CHEN Kun;LIU Mengying;FANG Jie(Department of Pharmacy,Personalized Drug Therapy Key Laboratory of Sichuan Province,Sichuan Academy of Medical Sciences,Sichuan Provincial People’s Hospital,the Hospital affiliated to University of Electronic Science and Technology of China,Chengdu 610072,China;Department of Pharmacy,Ruijin Hospital affiliated to School of Medicine,Shanghai Jiao Tong University,Shanghai 200025,China;Department of Pharmacy,the Hospital affiliated to Southwest Medical University,Sichuan Luzhou 646000,China;Department of Pharmacy,Nanjing Drum Tower Hospital affiliated to Medical College of Nanjing University,Nanjing 210008,China)

机构地区：[1]四川省医学科学院,四川省人民医院,电子科技大学附属医院药学部,个体化药物治疗四川省重点实验室,成都610072 [2]上海交通大学医学院附属瑞金医院药剂科,上海200025 [3]西南医科大学附属医院药学部,四川泸州646000 [4]南京大学医学院附属鼓楼医院药学部,南京210008

出　　处：《上海医药》2020年第23期101-104,共4页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:探讨人类免疫缺陷病毒(HIV)患者继发耶氏肺孢子菌肺炎(PJP)重症感染患者的抗感染治疗和药学监护策略。方法:临床药师参与1例HIV合并PJP导致呼吸衰竭患者的治疗,协助医生制定给药方案,从治疗药物监测(TDM)、剂量调整、疗效观察和不良反应监测等方面进行药学监护。结果:患者接受标准剂量复方磺胺甲噁唑(SMZ-TMP)治疗后,药物浓度达到理想靶值,症状得到了有效的控制,突发严重腹泻后SMZ-TMP监测浓度显著下降,导致病情的反复。结论:重症感染的患者病情复杂多变,临床药师运用TDM能够协助临床优化治疗方案。Objective:To explore anti-infective treatment and pharmaceutical care strategies for a patient with severe infection of Pneumocystis jirovecii pneumonia(PJP)secondary to human immunodeficiency virus(HIV).Methods:Clinical pharmacist participated in the treatment of a patient with respiratory failure caused by HIV combined with PJP,assisted the doctor in formulating the drug administration plan,and performed pharmaceutical care in terms of therapeutic drug monitoring(TDM),dose adjustment,efficacy observation and adverse reaction monitoring.Results:After receiving the standard dose of trimethoprim-sulfamethoxazole(SMZ-TMP),the drug concentration reached the target value and symptoms were controlled.However,the SMZ-TMP concentration decreased significantly after severe diarrhea,which led to the recurrence of the disease.Conclusion:Clinical pharmacists can assist the clinical physician in developing and optimizing the treatment plan by TDM since the conditions of patients with severe infections are complicated and changeable.

关 键 词：复方磺胺甲噁唑 治疗药物监测 耶氏肺孢子肺炎 药学监护 

分 类 号：R519.8[医药卫生—内科学] R512.91[医药卫生—临床医学]