1例甲氨蝶呤治疗银屑病合并脑梗塞患者的病例分析

One Case Analysis of Treatment by Methotrexate on Psoriasis Patient with Cerebral Infarction

关键词:  甲氨蝶呤  银屑病  脑梗塞  临床药师

Key words:  methotrexate (MTX)  psoriasis  cerebral infarction  clinical pharmacist

摘要:

目的 通过对1例甲氨蝶呤治疗银屑病合并脑梗塞患者的病例进行分析，为临床治疗过程中药物相互作用、不良事件的判断和治疗提供思路。方法 临床药师参与1例给予甲氨蝶呤治疗后出现严重黏膜炎、骨髓抑制的银屑病合并脑梗塞患者的治疗过程，临床药师建议暂停服抗血小板药阿司匹林，密切监测血常规、凝血功能等情况。结果 医师采纳临床药师建议，嘱患者暂停服阿司匹林，使用白介素-11升血小板的同时，密切监测血常规、凝血功能、血压控制情况。10 d后，病情基本恢复，血象正常，安排出院。结论 临床药师在临床工作中，应积极发挥应有作用，与临床医师通力协作，积极开展药品不良事件监测工作，详细询问患者既往用药史，采取有效的干预措施，共同促进合理用药，提升治疗效果。

Abstract:

OBJECTIVE To provide ideas for the clinical course of drug interactions and adverse events by analyzing a case for a psoriasis patient with cerebral infarction treated by methotrexate. METHODS Clinical pharmacist participated in the whole process of a psoriasis patient with cerebral infarction who was suffered severe mucositis and myelosuppression by taking methotrexate. Clinical pharmacist recommended to suspend the antiplatelet drug aspirin, closely monitoring blood routine, coagulation function and so on. RESULTS Physician adopted clinical pharmacist's suggestion, ask patients to stop taking aspirin and use interleukin-11 to elevate platelets while closely monitoring blood routine, blood coagulation function and blood pressure control. The patient was getting better after 10 d, the blood picture was getting normal and arranged discharge. CONCLUSION In clinical work, clinical pharmacists shall actively play its due role in collaboration with clinicians, carry out the monitoring of adverse drug events, and ask patients about the history of previous medication. In order to promote rational drug use and improve treatment effect.