今日药学

2020, v.30(08) 569-572

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新型隐球菌脑膜炎患者的抗真菌治疗分析与药学监护
Analysis of Antifungal Drug Treatment and Pharmaceutical Care for Patient with New Type Cryptococcal Meningitis

付昱;朱喜梅;
FU Yu;ZHU Ximei;Department of Pharmacy,The Third Affiliated Hospital of Sun Yat-sen University;

摘要(Abstract):

目的探讨新型隐球菌脑膜炎患者抗真菌治疗的特点以及药学监护的关注点。方法临床药师通过查阅临床指南、中英文文献等,分析1例新型隐球菌脑膜炎患者的抗真菌治疗的诊疗方案。结果该患者未严格按照指南选择抗真菌药物,但也获得了较好的治疗效果。治疗期间出现低血钾症及轻微尿素氮和肌酐升高,通过补钾和调整两性霉素B剂量防治不良反应。出现胃口差、恶心等胃肠反应,考虑为氟胞嘧啶的不良反应,减量后有所改善。结论对于抗真菌治疗方案的选择,应既遵循指南又不失灵活应用。抗真菌药物所引起的不良反应可作为药师的重点监护点。
OBJECTIVE To explore the characteristics of antifungal drug treatment and the focus of pharmaceutical cares for patients with new type cryptococcal meningitis. METHODS The antifungal drug treatment in 1 case of new type cryptococcal meningitis was analyzed by clinical pharmacists through consulting clinical guidelines and literature research. RESULTS Although the patient with antifungal drug treatment was not entirely consistent with the guidelines,a good therapeutic effect was achieved. During treatment,the patient developed hypokalemia and had a slight increase in BUN and Cr. The adverse reactions were alleviated by potassium supplementation and adjusting amphotericin B dose.Gastrointestinal reactions such as appetite loss and nausea were considered to be the adverse reactions of flucytosine,and the symptoms were alleviated by dose reduction. CONCLUSION The selection of antifungal drug treatment should not only follow the guidelines,but also note flexible application. The adverse reactions caused by antifungal drugs can be a focus of the pharmaceutical cares.

关键词(KeyWords): 新型隐球菌脑膜炎;抗真菌治疗;临床药师;药学监护
new type cryptococcal meningitis;antifungal drug treatment;clinical pharmacist;pharmaceutical care

Abstract:

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基金项目(Foundation): 广东省医院药学研究基金(2019YX25)

作者(Author): 付昱;朱喜梅;
FU Yu;ZHU Ximei;Department of Pharmacy,The Third Affiliated Hospital of Sun Yat-sen University;

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