1例多种可疑药物致重型药疹患者的药学监护
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摘要
药学监护是临床药师的工作重点之一,本文通过临床药师参与1例重症药疹患者的治疗,体现了临床药师在药物不良反应的判断、治疗及临床合理用药中发挥着重要作用。临床药师通过分析患者的既往用药史,寻找出可疑致敏药物,协助医师优化治疗方案,并对患者实施全程药学监护,患者重症药疹得到良好救治。
Pharmaceutical care is one of the priorities of clinical pharmacists. This article shows the positive significance of clinical pharmacists in the judgment, treatment and rational use of drugs through the treatment of one patient with severe drug eruption. By analyzing the patients' medication history, clinical pharmacists searched for suspected allergenic drugs. Clinical pharmacists assisted doctors to optimize the treatment plan, and implemented comprehensive pharmaceutical care on the patient, the patients' severe drug eruption was well treated.
Pharmaceutical care is one of the priorities of clinical pharmacists. This article shows the positive significance of clinical pharmacists in the judgment, treatment and rational use of drugs through the treatment of one patient with severe drug eruption. By analyzing the patients' medication history, clinical pharmacists searched for suspected allergenic drugs. Clinical pharmacists assisted doctors to optimize the treatment plan, and implemented comprehensive pharmaceutical care on the patient, the patients' severe drug eruption was well treated.
引文
[1]包振宇,邹先彪.重症药疹的研究进展[J].实用皮肤病学杂志,2015,8(2):112-115.
[2]汪小柳,李锐,方红.38例重症药疹临床分析[J].实用皮肤病学杂志,2010,3(3):137-140.
[3]仝实.儿童应用复方氨基比林发生重症药疹2例[J].基层医学坛,2018,22(26):3736,3738.
[4]包新华,舒军,蒋从仁.复方氨基比林注射液致药疹1例[J].人民军医,2011,54(11):943.
[5]安小兰,张红卫.复方氨基比林致重度剥脱性皮炎1例报告[J].医学理论与实践,2010,23(11):1371.
[6] Mallal S,Nolan D,Witt C,et al. Association between presence of HLA-B*5701,HLA-DR7,and HLA-DQ3 and hypersensitivity to HIV-1 reverse-transcriptase inhibitor abacavir[J]. Lancet,2002,359(9308):727-732.
[7] Chung W H, Hung S I, Hong H S, et al. Medical genetics:a marker for Stevens-Johnson syndrome[J]. Nature, 2004,428(6982):486.
[8] Chung W H,Hung S I,Chen Y T. Human leukocyte antigens and drug hypersensitivity[J]. Curr Opin Allergy Clin Immunol,2007,7(4):317-323.
[9]中华人民共和国国家卫生和计划生育委员会.药物代谢酶和药物作用靶点基因检测技术指南(试行)概要[J].实用器官移植电子杂志,2015,3(5):257-267.
[10]卫生部.糖皮质激素类药物临床应用指导原则:卫办医政发[2011]23号[EB/OL].(2011-02-16)[2018-08-12]. http://www. nhfpc. gov. cn/yzygj/s3585u/201102/91566d6e98df4916b8aa018e37605603. shtml.
[11]中国医师协会皮肤科医师分会自身免疫性疾病亚专业委员会.糖皮质激素治疗免疫相关性皮肤病专家共识(2018年)[J].中华临床免疫和变态反应杂志,2018,12(1):1-5.
[12]李文娟.人免疫球蛋白联合糖皮质激素治疗重症药疹的临床回顾性研究[D].济南:山东大学齐鲁医学院,2018.
[13]徐含,刘大华.注射用甲泼尼龙琥珀酸钠联合大剂量免疫球蛋白静脉注射治疗重症药疹[J].医药论坛杂志2018,39(1):131-133.
[14]丁高中,孙杰,鲁严.重症药疹免疫机制研究进展[J].中国麻风皮肤病杂志,2015,31(1):21-24.
[15]刘宪军.临床药师参与全院会诊的实践和体会[J].中国药房,2011,22(42):4018-4020.
[2]汪小柳,李锐,方红.38例重症药疹临床分析[J].实用皮肤病学杂志,2010,3(3):137-140.
[3]仝实.儿童应用复方氨基比林发生重症药疹2例[J].基层医学坛,2018,22(26):3736,3738.
[4]包新华,舒军,蒋从仁.复方氨基比林注射液致药疹1例[J].人民军医,2011,54(11):943.
[5]安小兰,张红卫.复方氨基比林致重度剥脱性皮炎1例报告[J].医学理论与实践,2010,23(11):1371.
[6] Mallal S,Nolan D,Witt C,et al. Association between presence of HLA-B*5701,HLA-DR7,and HLA-DQ3 and hypersensitivity to HIV-1 reverse-transcriptase inhibitor abacavir[J]. Lancet,2002,359(9308):727-732.
[7] Chung W H, Hung S I, Hong H S, et al. Medical genetics:a marker for Stevens-Johnson syndrome[J]. Nature, 2004,428(6982):486.
[8] Chung W H,Hung S I,Chen Y T. Human leukocyte antigens and drug hypersensitivity[J]. Curr Opin Allergy Clin Immunol,2007,7(4):317-323.
[9]中华人民共和国国家卫生和计划生育委员会.药物代谢酶和药物作用靶点基因检测技术指南(试行)概要[J].实用器官移植电子杂志,2015,3(5):257-267.
[10]卫生部.糖皮质激素类药物临床应用指导原则:卫办医政发[2011]23号[EB/OL].(2011-02-16)[2018-08-12]. http://www. nhfpc. gov. cn/yzygj/s3585u/201102/91566d6e98df4916b8aa018e37605603. shtml.
[11]中国医师协会皮肤科医师分会自身免疫性疾病亚专业委员会.糖皮质激素治疗免疫相关性皮肤病专家共识(2018年)[J].中华临床免疫和变态反应杂志,2018,12(1):1-5.
[12]李文娟.人免疫球蛋白联合糖皮质激素治疗重症药疹的临床回顾性研究[D].济南:山东大学齐鲁医学院,2018.
[13]徐含,刘大华.注射用甲泼尼龙琥珀酸钠联合大剂量免疫球蛋白静脉注射治疗重症药疹[J].医药论坛杂志2018,39(1):131-133.
[14]丁高中,孙杰,鲁严.重症药疹免疫机制研究进展[J].中国麻风皮肤病杂志,2015,31(1):21-24.
[15]刘宪军.临床药师参与全院会诊的实践和体会[J].中国药房,2011,22(42):4018-4020.