丙戊酸钠相关性高血氨脑病1例及药学监护讨论  

Clinical Pharmacists Participate in the Pharmaceutical Care of a Case of Sodium Valproate-related Hyperammonemia Encephalopathy

作　　者：仇东婷 张艳娟 QIU Dongting;ZHANG Yanjuan(Department of Pharmacy,People's Hospital of Jizhou District,Tianjin 301900,Tianjin,China)

机构地区：[1]天津市蓟州区人民医院药剂科,天津301900

出　　处：《中国药物滥用防治杂志》2023年第3期423-426,共4页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：丙戊酸诱导的高血氨脑病(VHE)是一种严重但可逆的不良反应,容易被临床医生漏诊、误诊,造成不良后果。临床药师通过参与1例丙戊酸钠联合苯巴比妥抗癫痫治疗过程中出现突发意识障碍、昏睡、癫痫频发并伴血氨升高的药学监护,协助医师及时诊治VHE并对症处理,参与治疗方案的制定,使患者得到及时救治,好转出院。根据VHE的临床特点,临床药师探讨了VHE的发病机制、危险因素及治疗措施,以期临床医师重视VHE,提高VHE的诊治水平,合理规范使用抗癫痫药物,保障患者用药安全,改善患者预后,同时为神经内科临床药师参与临床服务模式提供参考。Valproic acid-induced hyperammonemic encephalopathy(VHE)is a serious but reversible adverse reaction,which is easily missed and misdiagnosed by clinicians,resulting in adverse consequences.Clinical pharmacists participated in the pharmaceutical care of a case of sudden disturbance of consciousness,lethargy,frequent epilepsy and elevated blood ammonia during the anti-epileptic treatment of sodium valproate combined with phenobarbital,and assisted physicians in timely diagnosis and treatment of VHE and symptomatic treatment.Participate in the formulation of treatment plans,so that patients can receive timely treatment and be discharged from hospital.According to the clinical characteristics of VHE,clinical pharmacists discussed the pathogenesis,risk factors and treatment measures of VHE,hoping that clinicians should pay atention to VHE,improve the level of diagnosis and treatment of VHE,rationally regulate the use of antiepileptic drugs,ensure the safety of patients'medication,and improve the prognosis of patients.At the same time,it provides a reference for clinical pharmacists in neurology to participate in the clinical service model.

关 键 词：丙戊酸钠 高氨血症脑病 意识障碍 不良反应 

分 类 号：R969.3[医药卫生—药理学]