临床药师参与颅脑损伤患者鼻饲给予丙戊酸钠的药学监护

Pharmaceutical Care of Clinical Pharmacist Involved in the Nasogastric Feeding of Sodium Valproate to Patients with Craniocerebral Injury

关键词:  临床药师  丙戊酸  鼻饲给药  血药浓度监测

Key words:  clinical pharmacist  valproic acid  nasogastric feeding  therapeutic drug monitoring

摘要:

目的 通过血药浓度监测，探讨临床药师对颅脑损伤患者鼻饲给予丙戊酸钠的药学监护模式。方法 利用HPLC检测颅脑损伤患者鼻饲给予及静脉给予丙戊酸钠后丙戊酸的血药浓度，研究不同给药方式对丙戊酸血药浓度的影响，探讨临床药师药学监护的作用。结果 丙戊酸钠鼻饲给药严重影响血浆药物浓度，其血药浓度均达不到有效参考范围。经临床药师建议后，丙戊酸钠改为静脉给药，血药浓度较鼻饲给药升高，达窗率提高，差异有统计学意义（P<0.01）。结论 临床药师在临床治疗团队中充分运用血药浓度监测方法及扎实的药学知识，在临床药物治疗过程中起到重要作用。

Abstract:

OBJECTIVE To investigate the mode of clinical pharmacist participating in the nasogastric feeding sodium valproate of patients with craniocerebral injury by therapeutic drug monitoring. METHODS An HPLC method was used to monitor the plasma concentration of valproic acid by nasogastric feeding and intravenous dripping sodium valproate in patients with craniocerebral injury. The effects of different dosage forms on the concentration of valproic acid and the role of clinical pharmacist in pharmaceutical care was studied. RESULTS The nasogastric feeding of sodium valproate significantly affected the plasma drug concentration. The plasma drug concentration couldn't reach the effective reference range. After the clinical pharmacist suggested, the nasogastric feeding of sodium valproate was changed to intravenous administration, the concentration of plasma drug increased, and the success rate increased. The difference was statistically significant (P<0.01). CONCLUSION In the medical team, clinical pharmacists shall make full use of their advantages in drug characteristics to carry out clinical pharmaceutical care.