临床药师参与处置哌拉西林他唑巴坦与莫西沙星致三系减少患者的药学实践及体会  

Clinical pharmacists'participation in the management of piperacillin-tazobactam and moxifloxacin-induced hematologic toxicity:pharmaceutical practice and experience

作　　者：刘东京 唐敏 Liu Dongjing;Tang Min(Institute of Clinical Pharmacy,Southwest University Hospital,Chongqing 400715,China;Department of Pharmacy,Southwest Hospital,Army Medical University,Chongqing 400038,China)

机构地区：[1]西南大学医院临床药学研究所,重庆400715 [2]陆军军医大学西南医院药学部,重庆400038

出　　处：《保健医学研究与实践》2024年第2期99-103,共5页Health Medicine Research and Practice

基　　金：西南大学医院科研项目(xdyykyjj2021xm01)。

摘　　要：目的分析1例患者发生三系减少的可能原因与处置办法,为临床哌拉西林他唑巴坦(TZP)与莫西沙星(MFX)的安全合理使用提供参考。方法临床药师参与了1例使用TZP与MFX后发生三系减少患者的药学会诊与药学监护,综合考虑患者的用药情况和发病过程,对三系减少发生的可能原因进行分析和文献复习,并提出了处置建议。结果临床药师综合考虑患者的用药情况和病程,分析三系减少可能是由TZP与MFX引起的,遂建议停用TZP与MFX,并调整抗感染方案及给予对症处理。结论TZP与MFX存在血液系统的不良反应,临床药师应不断加强学习,在临床开展药学实践工作时发挥自身作用,提供相关药学监护,保障患者用药安全合理。Objective This paper aims to analyze the possible causes and management strategies for pancytopenia in a patient,in order to provide support for the safe and rational use of piperacillin-tazobactam(TZP)and moxifloxacin(MFX)in clinical practice.Methods Clinical pharmacists participated in the pharmaceutical consultation and monitoring of a patient who developed pancytopenia after using TZP and MFX.Considering the patient's medication history and disease progression,the possible causes of pancytopenia were analyzed through literature review,and disposal suggestions were proposed.Results Clinical pharmacists comprehensively considered the patient's medication history and disease course,and analyzed that the pancytopenia may be caused by TZP and MFX.Therefore,it was recommended to discontinue TZP and MFX,adjust the anti-infection regimen,and provide symptomatic treatment.Conclusion TZP and MFX have adverse reactions on the hematologic system.Clinical pharmacists should continuously strengthen their learning,play their role in clinical pharmaceutical practice,provide relevant pharmaceutical monitoring,and ensure the safe and rational use of medications for patients.

关 键 词：临床药师 药学实践 哌拉西林他唑巴坦 莫西沙星 三系减少 

分 类 号：R969.3[医药卫生—药理学]