1例头孢哌酮钠舒巴坦钠联用华法林诱发消化道出血分析  

Gastrointestinal Bleeding Induced by Cefoperazone Sodium and Sulbactam Sodium Combined with Warfarin:A Case Analysis

作　　者：郭柳青 罗敏[1] 徐珽[1] 邓盛齐 GUO Liuqing;LUO Min;XU Ting;DENG Shengqi(Department of Clinical Pharmacy,West China Hospital of Sichuan University,Chengdu,Sichuan,China 610041;Sichuan Industrial Institute of Antibiotics of Chengdu University,Chengdu,Sichuan,China 610052)

机构地区：[1]四川大学华西医院临床药学部,四川成都610041 [2]成都大学四川抗菌素工业研究所,四川成都610052

出　　处：《中国药业》2021年第3期88-91,共4页China Pharmaceuticals

摘　　要：目的为头孢哌酮钠舒巴坦钠联用华法林发生急性消化道出血患者的药学监护提供参考。方法分析四川大学华西医院2019年2月收治的1例头孢哌酮钠舒巴坦钠联用华法林抗诱发消化道出血患者的临床资料,结合临床药学专业知识,对药物治疗方案、消化道出血机制、救治措施等进行分析。结果该患者出现急性消化道出血后,临床药师建议立即停用上述2种药物,改用凝血酶、生长抑素和奥美拉唑以抑酸、止血、护胃;并输注A型Rh阳性血浆及对症补液,更换抗菌药物为哌拉西林钠他唑巴坦钠,3 d后病情稳定。结论临床药师应加强对抗凝治疗患者联合用药的药学监护,避免不良事件发生,保障用药安全、合理。Objective To provide a reference for pharmaceutical care of patients with acute gastrointestinal bleeding induced by cefoperazone sodium and sulbactam sodium combined with warfarin.Methods The clinical data of a patient with gastrointestinal bleeding induced by cefoperazone sodium and sulbactam sodium combined with warfarin in West China Hospital of Sichuan University in February2019 were analyzed.Combined with professional knowledge of clinical pharmacy,the drug treatment scheme,gastrointestinal bleeding mechanism and rescue measures were analyzed by a clinical pharmacist.Results Clinical pharmacists suggested that the above two drugs should be stopped immediately when found that the patient had acute gastrointestinal bleeding,and thrombin,somatostatin and omeprazole should be used to inhibit acid,stop bleeding and protect stomach;RhA positive blood and symptomatic rehydration should be infused,and piperacillin sodium and tazobactam sodium should be replaced.The patient’s condition was stable after 3 d.Conclusion Clinical pharmacists should strengthen the pharmaceutical care of drug combination in patients receiving anticoagulant therapy to avoid adverse events,and ensure the safety and rationality of drug use.

关 键 词：头孢哌酮钠舒巴坦钠 华法林 药物相互作用 消化道出血 药学监护 

分 类 号：R95[医药卫生—药学]