临床药师参与1例大疱性表皮松解型药疹的治疗实践  

Clinical Pharmacists′Practice in the Treatment of Drug-Induced Bullosa Epidermolysis:A Case Report

作　　者：符馨尹 林小茹 张纯萍 FU Xinyin;LIN Xiaoru;ZHANG Chunping(The First Affiliated Hospital of Hainan Medical University,Haikou,Hainan,China 570102;Wenchang People′s Hospital,Haikou,Hainan,China 571399)

机构地区：[1]海南医学院第一附属医院,海南海口570102 [2]海南省文昌市人民医院,海南海口571399

出　　处：《中国药业》2023年第18期I0001-I0004,共4页China Pharmaceuticals

基　　金：海南省自然科学基金[819QN368]。

摘　　要：目的探讨临床药师在大疱性表皮松解型药疹[又称中毒性表皮松解症(TEN)]治疗中的作用。方法回顾临床药师参与的1例TEN的治疗全程,通过协助医师整理患者既往用药史及查询相关文献和指南,为医师筛选引起该药疹的可疑药物,并建议医师在后续治疗中应避免选用头孢菌素类药物和非甾体抗炎药,选用物理降温及其他交叉过敏反应发生率低的抗感染药物治疗。结果医师采纳药师的建议并执行后,患者皮疹明显改善,感染指标恢复正常。后续也及时阻止了含非甾体抗炎成分的滴眼液使用,保障了疗效。结论临床药师可帮助医师筛选出引起TEN的可疑药物,并提供合理的治疗建议,保障治疗的有效性和安全性。Objective To investigate the role of clinical pharmacists in the treatment of drug-induced bullosa epidermolysis[also known as toxic epidermal necrolysis(TEN)].Methods The clinical pharmacists'practice in the treatment of a case of TEN was analyzed retrospectively.By assisting physicians in collecting the patient's previous medication history,the clinical pharmacists screened out suspected drugs inducing the drug eruption based on relevant studies and guidelines,and suggested that physicians should avoid the use of cephalosporins and non-steroidal anti-inflammatory drugs in the subsequent treatment,and choose physical cooling and other anti-infective drugs with low incidence of cross-allergic reactions for treatment.Results The physicians adopted the suggestions of pharmacists.Then,the patient's skin rashes significantly improved,and the infection indicators returned to normal.The use of eye drops containing non-steroidal anti-inflammatory ingredients was prevented in time in the subsequent treatment,which ensured the treatment effect.Conclusion Clinical pharmacists can assist physicians in screening out suspected drugs inducing TEN,and provide reasonable suggestions for treatment to ensure the effectiveness and safety of treatment.

关 键 词：大疱性表皮松解型药疹 头孢菌素 非甾体抗炎药 临床药师 交叉过敏 药品不良反应 药学监护 

分 类 号：R969.3[医药卫生—药理学]