一例重症胰腺炎伴肾功能亢进患者的药学监护
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- 英文论文题名：Pharmaceutical care of patient with severe acute pancreatitis with Augmented Renal Clearance
- 论文作者：何娟 ; 李庆云 ; 余丽芳 ; 叶盛英 ; 韩志云 ; 盛慧球
- 年：2016
- 作者机构：上海交通大学医学院附属瑞金医院药剂科;中国人民解放军第二五四医院药剂科;大理大学附属医院药剂科;上海交通大学医学院附属瑞金医院急诊科;
- 论文关键词：重症胰腺炎 ; 肾功能亢进 ; 药学监护
- 英文论文关键词：Severe acute pancreatitis ; ARC ; Pharmaceutical care
- 会议召开时间：2016-09-27
- 会议录名称：中国药学会第十三届青年药学科研成果交流会论文集
- 语种：中文
- 分类号：R576;R692
- 学会代码：YYWS
- 会议名称：中国药学会第十三届青年药学科研成果交流会
- 会议地点：中国江西南昌
- 主办单位：中国药学会
- 学会名称：中国药学会
- 页数：6
- 文件大小：505k
- 原文格式：O
- 会议级别：全国
摘要
目的:探讨临床药师对重症胰腺炎伴肾功能亢进患者治疗中的药学监护方法。方法:以一例重症胰腺炎腹腔感染患者的诊治过程为例,从抗感染方案的制定、血药浓度监测及药物剂量的调整、药学监护等方面讨论重症急性胰腺炎伴肾功能亢进患者的药学监护工作。结果:临床药师针对该患者的肾功能亢进情况,提出了优化的给药方案,并积极给予药学监护,取得了较好的疗效。结论:临床药师发挥自身专业特长,找准切入点,协助临床医师优化药物治疗方案,降低不良反应,促进临床合理用药。
Objective To discuss drugs pharmaceutical intervention and monitoring method of clinical pharmacists for severe acute pancreatitis of a patient with Augmented Renal Clearance(ARC).Methods:In a case of diagnosis and treatment of severe acute pancreatitis patients with abdominal cavity infection,to discuss a patient with severe acute pancreatitis with ARC of pharmacy intervention work from the anti-infection plan formulation,blood drug concentration monitoring,the adjustment of drug doses,pharmaceutical care and so on.Results:Clinical pharmacist evaluated on the patients with ARC and put forward the optimized dosage regimen and appropriate drug dosage,which had obtained the good curative effect.Strengthened the monitoring risk and took relevant measures to improve the clinical medication safety.Conclusion:Clinical pharmacists played to their professional competence,finding out the breakthrough point,which could help clinicians effective drug treatment,optimization to dose,pharmaceutical care and improved medication safety.
Objective To discuss drugs pharmaceutical intervention and monitoring method of clinical pharmacists for severe acute pancreatitis of a patient with Augmented Renal Clearance(ARC).Methods:In a case of diagnosis and treatment of severe acute pancreatitis patients with abdominal cavity infection,to discuss a patient with severe acute pancreatitis with ARC of pharmacy intervention work from the anti-infection plan formulation,blood drug concentration monitoring,the adjustment of drug doses,pharmaceutical care and so on.Results:Clinical pharmacist evaluated on the patients with ARC and put forward the optimized dosage regimen and appropriate drug dosage,which had obtained the good curative effect.Strengthened the monitoring risk and took relevant measures to improve the clinical medication safety.Conclusion:Clinical pharmacists played to their professional competence,finding out the breakthrough point,which could help clinicians effective drug treatment,optimization to dose,pharmaceutical care and improved medication safety.
引文
[1]Mayumi T,Ura H,Arata S.et al.Evidence-based clinical practice guideline for acute pancreatitis:proposals[J]J Hepatobiliary Pancreat Surg.2002,9(4):413-422.
[2]黄洁,孙景勇,毛恩强,等.重症急性胰腺炎细菌感染的菌谱与耐药性分析[J].中国感染与化疗杂志.2009,9(5):372-376.
[3]Ahmed A.Negm,Hendrik Poos,Elmar Kruck,Ralf-Peter Vonberg,Dirk Domagk,Ahmed Madisch,Torsten Voigtlander,Michael P.Manns,Jochen Wedemeyer,Tim O.Lankisch.Microbiologic analysis of peri-pancreatic fluid collected during EUS in patients with pancreatitis:impact on antibiotic therapy[J].Gastrointestinal endoscopy.2013,78(2):303-311.
[4]Kevin S.Akers,Krista L.Niece,Kevin K.Chung,et al.Modified Augmented Renal Clearance score predictsrapid piperacillin and tazobactam clearance in criticallyill surgery and trauma patients[J].J Trauma Acute Care Surg.2014,77(3):s163-s170.
[5]TJ Howard.The Role of Antimicrobial Therapy in Severe Acute Pancreatitis[J].Surgical Clinics of North America.2013,93(3):58S-593.
[6]朱任媛,张小江,徐春英,等.2011年中国CHINET无菌体液细菌分布和耐药性监测[J].中国感染与化疗杂志.2013,13(5):349-356.
[7]汪复,朱德妹,胡付品,等.2012年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志.2013,13(5):321-330.
[8]R Kochhar,MT Noor,J Wig.Fungal infections in severe acute pancreatitis[J]Journal of Gastroenterology and Hepatology.2011,26(6):952-959.
[9]Jaruratanasirikul S,Sriwiriyajan S,Punyo J.Comparison of the pharmacodynamics of meropenem in patients with ventilator-associated pneumonia following administration by 3-hour infusion or bolus injection[J].Antimicrob Agents Chemother.2005,49(4):1337-1339.
[10]Feher C,Rovira M.Soriano A,etal.Effect of meropenem administration in extended infusion on the clinical outcome of febrile neutropenia:a retrospective observational study[J].J Antimicrob Chemother.2014,69(9):2556.
[11]桑福德.热病:桑福德抗微生物治疗指南(第44版)[M].范洪伟,吕玮,吴东,译.北京:中国协和医科大学出版社,2014:96.
[12]万古霉素临床应用中国专家共识(2011版),中国新药与临床杂志.2011,30(8):561-573.
[13]ManSS,CarrRR,Ensom.Comparison of Continuous and IntermittentⅣInfusion of Vancomycin:Systematic Review[J].Can J Hosp Pharm.2010,63(5):373-81.
[14]S.Tafelskia,I.Nachtigalla,UweTroegerb,et al.Observational clinical study on the effects of different dosing regimens on vancomycin target levels in critically ill patients:Continuous versus intermittent application[J]Journal oflnfectionandPublicHealth.2015,8,355-363.
[15]Maria Luz Campassi,Maria Cecilia Gonzalez,Fabio Daniel Masevicius,etal.Augmented renal clearance in critically ill patients:incidence,associated factors and effects on vancomycin treatment[J].Rev Bras Ter Intensiva.2014,26(1):13-20.
[16]Hobbs AL,Shea KM,Roberts KM,etal.Implications of Augmented Renal Clearance on Drug Dosing in Critically Ill Patients:A Focus on Antibiotics[J].Pharmacotherapy.2015,35(11):1063-1075.
[17]FB Sime,AAUdyJA Roberts.Fungal infections in severe acute pancreatitis[J].Current Opinion in Pharmacology.2015,24:1-6.
[18]Fekade Brack Sime,Andrew A UdyJason A Roberts.Augmented renal clearance in critically ill patients:etiology,definition and implications for beta-lactam dose optimization[J].Current Opinion in Pharmacology.2015,24:1-6.
[19]臧宗美,王英,张睢扬,等.蒙特卡洛模拟优化哌拉西林-他唑巴坦的两步法给药方案[J].中国感染与化疗杂志,2012,12(5):372-376.
[20]张晋萍.药物热82例分析[J].医药导报.2008,27(6):726-727.
[2l]费燕,张云琛.临床药师参与1例颅脑术后肺部感染患者感染菌与定植菌鉴别及治疗的分析[J].中国药师.2015,18(10):1757-1759.
[22]王诗鸿,王秀中.注射用盐酸氨溴索的配伍禁忌[J].实用药物与临床.2013,16(2):141-144
[23]王诗鸿,王秀中.注射用奥美拉唑钠的配伍禁忌[J].实用药物与临床.2012,15(6):361-363
[24]何娟,杨婉花.临床药师在ICU开展药学服务的切入点[J].药学服务与研究.2014,14(1):66-68.
[2]黄洁,孙景勇,毛恩强,等.重症急性胰腺炎细菌感染的菌谱与耐药性分析[J].中国感染与化疗杂志.2009,9(5):372-376.
[3]Ahmed A.Negm,Hendrik Poos,Elmar Kruck,Ralf-Peter Vonberg,Dirk Domagk,Ahmed Madisch,Torsten Voigtlander,Michael P.Manns,Jochen Wedemeyer,Tim O.Lankisch.Microbiologic analysis of peri-pancreatic fluid collected during EUS in patients with pancreatitis:impact on antibiotic therapy[J].Gastrointestinal endoscopy.2013,78(2):303-311.
[4]Kevin S.Akers,Krista L.Niece,Kevin K.Chung,et al.Modified Augmented Renal Clearance score predictsrapid piperacillin and tazobactam clearance in criticallyill surgery and trauma patients[J].J Trauma Acute Care Surg.2014,77(3):s163-s170.
[5]TJ Howard.The Role of Antimicrobial Therapy in Severe Acute Pancreatitis[J].Surgical Clinics of North America.2013,93(3):58S-593.
[6]朱任媛,张小江,徐春英,等.2011年中国CHINET无菌体液细菌分布和耐药性监测[J].中国感染与化疗杂志.2013,13(5):349-356.
[7]汪复,朱德妹,胡付品,等.2012年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志.2013,13(5):321-330.
[8]R Kochhar,MT Noor,J Wig.Fungal infections in severe acute pancreatitis[J]Journal of Gastroenterology and Hepatology.2011,26(6):952-959.
[9]Jaruratanasirikul S,Sriwiriyajan S,Punyo J.Comparison of the pharmacodynamics of meropenem in patients with ventilator-associated pneumonia following administration by 3-hour infusion or bolus injection[J].Antimicrob Agents Chemother.2005,49(4):1337-1339.
[10]Feher C,Rovira M.Soriano A,etal.Effect of meropenem administration in extended infusion on the clinical outcome of febrile neutropenia:a retrospective observational study[J].J Antimicrob Chemother.2014,69(9):2556.
[11]桑福德.热病:桑福德抗微生物治疗指南(第44版)[M].范洪伟,吕玮,吴东,译.北京:中国协和医科大学出版社,2014:96.
[12]万古霉素临床应用中国专家共识(2011版),中国新药与临床杂志.2011,30(8):561-573.
[13]ManSS,CarrRR,Ensom.Comparison of Continuous and IntermittentⅣInfusion of Vancomycin:Systematic Review[J].Can J Hosp Pharm.2010,63(5):373-81.
[14]S.Tafelskia,I.Nachtigalla,UweTroegerb,et al.Observational clinical study on the effects of different dosing regimens on vancomycin target levels in critically ill patients:Continuous versus intermittent application[J]Journal oflnfectionandPublicHealth.2015,8,355-363.
[15]Maria Luz Campassi,Maria Cecilia Gonzalez,Fabio Daniel Masevicius,etal.Augmented renal clearance in critically ill patients:incidence,associated factors and effects on vancomycin treatment[J].Rev Bras Ter Intensiva.2014,26(1):13-20.
[16]Hobbs AL,Shea KM,Roberts KM,etal.Implications of Augmented Renal Clearance on Drug Dosing in Critically Ill Patients:A Focus on Antibiotics[J].Pharmacotherapy.2015,35(11):1063-1075.
[17]FB Sime,AAUdyJA Roberts.Fungal infections in severe acute pancreatitis[J].Current Opinion in Pharmacology.2015,24:1-6.
[18]Fekade Brack Sime,Andrew A UdyJason A Roberts.Augmented renal clearance in critically ill patients:etiology,definition and implications for beta-lactam dose optimization[J].Current Opinion in Pharmacology.2015,24:1-6.
[19]臧宗美,王英,张睢扬,等.蒙特卡洛模拟优化哌拉西林-他唑巴坦的两步法给药方案[J].中国感染与化疗杂志,2012,12(5):372-376.
[20]张晋萍.药物热82例分析[J].医药导报.2008,27(6):726-727.
[2l]费燕,张云琛.临床药师参与1例颅脑术后肺部感染患者感染菌与定植菌鉴别及治疗的分析[J].中国药师.2015,18(10):1757-1759.
[22]王诗鸿,王秀中.注射用盐酸氨溴索的配伍禁忌[J].实用药物与临床.2013,16(2):141-144
[23]王诗鸿,王秀中.注射用奥美拉唑钠的配伍禁忌[J].实用药物与临床.2012,15(6):361-363
[24]何娟,杨婉花.临床药师在ICU开展药学服务的切入点[J].药学服务与研究.2014,14(1):66-68.