耶氏肺孢子虫肺炎患者复方磺胺甲噁唑剂量调整分析  

Analysis of the dose adjustment of compound sulfamethoxazole in a patient with pneumocystis pneumonia

作　　者：姚芳 路敏[1] 孔妍 周颖[1] 崔一民[1] 张晓东 YAO Fang;LU Min;KONG Yan;ZHOU Ying;CUI Yi-min;ZHANG Xiao-dong(Department of Pharmacy,Peking University First Hospital,Beijing 100034,China;Department of Pharmacy,Inner Mongolian Maternal and Child Care Hospital,Hohhot 010020,Inner Mongolian Autonomous Region,China;Department of Cosmetics,Inner Mongolian Institute for Drug Control,Hohhot 010020,Inner Mongolian Autonomous Region,China)

机构地区：[1]北京大学第一医院药学部,北京100034 [2]内蒙古自治区妇幼保健院药剂科,内蒙古自治区呼和浩特010020 [3]内蒙古自治区药品检验研究院化妆品室,内蒙古自治区呼和浩特010020

出　　处：《中国临床药理学杂志》2022年第3期267-269,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：近年来,随着免疫抑制药、肿瘤化疗药物的应用,耶氏肺孢子虫肺炎的发病率呈明显上升趋势,而复方磺胺甲噁唑是治疗耶氏肺孢子虫肺炎的一线药物。本文为1例免疫球蛋白A(Ig A)肾病患者口服免疫抑制药发生肺孢子虫肺炎,给予复方磺胺甲噁唑口服治疗后,出现恶心、呕吐等消化道药物不良反应,临床药师分析考虑其可能存在剂量较大、代谢异常等因素引起的药物蓄积,根据患者的复方磺胺甲噁唑血药浓度及肌酸酐清除率,给予剂量调整与治疗方案的优化,并分析调整后的剂量对治疗效果和药物不良反应的影响,平衡疗效与风险,为医护人员提供药学专业指导,为患者提供个体化的药学服务,促进耶氏肺孢子虫肺炎患者合理、有效、安全用药,同时通过该病例提升临床药师工作能力和价值。In recent years,with the application of immunosuppressants and tumor chemotherapeutic drugs, the incidence of pneumocystis pneumonia has increased significantly. Compound sulfamethoxazole is a first line drug for the treatment of pneumocystis pneumonia. Based on a case of pneumocystis in an immunoglobulin A( IgA) nephropathy patient treated with oral immunosuppressants. The patient developed nausea,vomiting and other digestive tract adverse drug reactions after oral administration of compound sulfamethoxazole,the clinical pharmacists analyzed and considered the drug accumulation caused by possible factors such as high dose,metabolic abnormality,and gave dose adjustment and treatment regimen optimization based on the serum concentration of compound sulfamethoxazole and creatinine clearance rate of patients,it also analyzes the influence of the adjusted dose on the therapeutic effect and adverse reactions,balances the therapeutic effect and risks,provides professional guidance for medical staff and individual pharmaceutical care for patients,to promote the rational,effective and safe use of drugs in patients with pneumocystis pneumonia,and to enhance the work ability and value of clinical pharmacists through the case.

关 键 词：复方磺胺甲噁唑 肺孢子虫肺炎 剂量调整 

分 类 号：R978.1[医药卫生—药品]