临床药师参与1例骨髓增生异常综合征患者继发肺毛霉菌病的抗感染治疗与用药监护

Anti-infective Treatment and Medication Monitoring of Clinical Pharmacists Participating in a Case of Pulmonary Mucormycosis Secondary to a Patient with Myelodysplastic Syndrome

关键词:  临床药师  肺毛霉菌病  药学监护

Key words:  Clinical pharmacists  Pulmonary mucormycosis  Pharmaceutical care

摘要:

目的 探讨临床药师在骨髓增生异常综合征患者继发肺毛霉菌病抗感染治疗中的作用。方法 临床药师参与1例骨髓增生异常综合征患者因继发肺毛霉菌病转入呼吸内科后的抗感染药物治疗实践,积极查阅患者病史及文献,参与药物治疗方案的制定及调整,进行药学服务和监护。结果 在治疗细菌感染的同时,医生采纳临床药师的建议,在明确真菌种类前使用泊沙康唑。明确肺毛霉菌感染后根据肝功能调整为艾沙康唑联合两性霉素B,同时预防不良反应发生。经过治疗后,患者病情好转。结论 临床药师积极参与了患者抗毛霉菌感染的治疗过程,提出合理的诊疗建议并对患者实施了用药监护和用药指导,保障了患者的用药安全性及有效性。

Abstract:

o investigate the role of clinical pharmacists in the anti-infective treatment of pulmonary mucormycosis secondary to a patient with myelodysplastic syndrome. METHODS Clinical pharmacists participated in the anti-infective treatment practice of a patient with myelodysplastic syndrome who was transferred to the respiratory department due to secondary pulmonary mucormycosis, actively consulted the patient's medical history and literature, participated in drug formulation and adjustment plan, and conducted pharmaceutical care and monitoring. RESULTS In addition to the treatment of bacterial infections, the doctors took the advice of the clinical pharmacists to use posaconazole until the fungal species is determined. After confirming pulmonary mucormycosis infection, esaconazole combined with amphotericin B was adjusted according to liver function and prevent adverse reactions at the same time. After the treatments, the patient's condition improved. CONCLUSION Clinical pharmacists actively participated in the anti-mucor infection treatment process of the patient, put forward reasonable diagnosis and treatment suggestions, and implemented medication monitoring and medication guidance for the patient, which ensured the safety and effectiveness of patient's medication.