达卡巴嗪致高热1例

1病例介绍患者,男,69岁,体质量51 kg,身高160 cm,体表面积1.55 m2,既往无药物过敏史。因"确诊霍奇金淋巴瘤3个月余"于2014年12月15日入院。体检:体温36.6℃,脉搏80次·min-1,呼吸20次·min-1,血压:110/70 mm Hg(1 mm Hg=0.133 k Pa),其他各指标无明显异常,于2014年12月29日开始第5次ABVD方案化疗[第1,15天,

Pharmaceutical Consultation Practice for One Case of Rapidly by Growing Mycobacteria Bloodstream Infections

目的：探讨快速生长分枝杆菌血流感染的诊治方法。方法：通过1例骨折术后快速生长分枝杆菌血流感染的两次会诊实践,对治疗过程中不同阶段需要考虑的药物治疗问题进行总结分析。结果：第一次会诊,根据患者的血药浓度和肌酐清除率,优化了万古霉素给药剂量。第二次会诊,在患者症状和检验结果明显好转情况下,建议医生积极针对快速生长分枝杆菌进行抗感染治疗。建议停用抗结核药,改为克拉霉素联用阿米卡星后,患者病情好转出院。结论：对手术部位疑似、确诊快速生长分枝杆菌感染的病例,积极的干预和正确的诊治是成功的关键。Objective： To investigate the diagnosis and treatment of rapidly growing mycobacteria bloodstream infections. Meth- ods： Based on the two pharmaceutical consultation practice for one case of rapidly growing mycobacteria bloodstream infections after fracture operation, the paper summarized and analyzed the problems in different stages of treatment. Results ： The first consultation op- timized the dosage of vancomycin according to the patient- serum concentration and creatinine clearance rate. The second consultation suggested doctors actively perform anti-infection treatment for rapidly growing mycobacteria after the patient＇ s clinical symptoms and ex- amination results were improved significantly. It is recommended to withdraw anti TB drugs, and the use of clarithromycin combined with amikacin was suitable. The patient was discharged with improved health conditions. Conclusion： Positive intervention and correct diagnosis are the keys for the successful treatment of suspected or definite mycobacteria infection in surgical sites.解放军第一七五医院2016年青年苗圃课题（编号：16Y023

多西环素联用阿托伐他汀钙致严重肝功能异常1例

1病例资料患者，男，73岁，因突发言语含糊、右侧肢体乏力4h，于2016年2月713就诊于我院神经内科。患者既往有冠心病史数年，未治疗。否认肝炎、结核、疟疾等传染病史，否认肾炎、高血压、糖尿病等病史，否认手术史、外伤史、输血史，否认药物、食物过敏史

Participation of Clinical Pharmacists in Identification of Infectious Bacteria and Colonization Bacteria and Treatment of One Patient with Pulmonary Infection after Craniocerebral Operation

目的:小结临床药师参与临床颅脑术后患者肺部感染的治疗。方法:临床药师协助医师鉴别1例颅脑术后肺部感染患者的感染菌与定植菌,并确立抗感染方案。结果:临床药师综合感染危险因素、临床与实验室表现、用药史等多方面因素进行分析,所选抗菌药物有效覆盖感染菌,及时控制感染。结论:临床药师利用自身专业知识,协助医师解读细菌培养及药敏报告,促进患者用药更安全、及时、有效。Objective: To summarize the participation of clinical pharmacists in the treatment of patients after craniocerebral operation with pulmonary infection.Methods: Clinical pharmacists assisted physicians in identifying infectious bacteria and colonization bacteria of one patient with pulmonary infection after craniocerebral operation and establishing the anti-infection treatment regimen.Results: Clinical pharmacists analyzed various factors such as infection risk factors,clinical and laboratory manifestation and medication history,and effectively selected antibacterial drugs covering the infectious bacteria to timely control the infection.Conclusion: With pharmaceutical knowledge,clinical pharmacists can assist physicians in the interpretation of bacterial culture and drug susceptibility reports to promote safer,more timely and effective medication for patients

氨茶碱致急性肌张力障碍1例

1病例介绍患儿,男,45 d,体质量5 kg,因咳嗽、流涕、低热3 d,口吐泡沫12 H于2012年12月20日入院治疗。临床给予静脉滴注头孢替安、氨溴索,超声雾化吸入布地奈德混悬液、复方异丙托溴铵溶液,口服小儿伪麻美芬滴剂、地氯雷他定干混悬剂、鸡胆口服液治疗。入院第3天,上午其他药物已输液完毕,于14∶00开始

大剂量右佐匹克隆致味觉异常1例

右佐匹克隆为快速短效非苯二氮 类镇静安眠药,该药为γ-氨基丁酸(GABA)受体激动剂,与苯二氮艹卓类结合于相同的受体和部位,作用区域不同,镇静、抗焦虑、肌肉松弛和抗惊厥的作用明显,且治疗失眠症的疗效与安全性均优于艾司唑仑~([1]),故在临床上较为常用。与此同时,其滥用和成瘾倾向

替普瑞酮联用雷贝拉唑致皮疹、眼部不适1例

1病例资料患者,女,49岁,因上腹部间歇性隐痛伴消瘦1月,于2016年4月18日入院。患者1个月前出现上腹部间歇性隐痛,疼痛与饮食、体位改变无明显相关联,无转移痛及放射痛,伴消瘦,1个月内体质量减轻约5 kg,伴纳差、乏力,无恶心、呕吐,无胸闷、气喘等不适,无口干、多饮、多尿,无食欲亢进等不适。曾就诊当地医院,

Practice and Experience of Clinical Pharmacists Participating in the Treatment of 2 Cases of Atypical Pathogens Infection

目的:探讨临床药师参与2例非典型病原体感染会诊的思维和方法。方法:对2例非典型病原体感染会诊案例进行分析,总结归纳会诊经验。结果:会诊后,2例患者治疗效果明显。结论:临床药师可协助医师提高药物治疗有效性和安全性。Objective: To investigate the thoughts and methods of clinical pharmacists involving in the treatment of 2 cases of atypical pathogen infection. Methods: The consultation cases of 2 patients with atypical pathogens infection were analyzed,and the consultation experience was summarized. Results: After the consultation,the treatment efficacy of the patients was obvious. Conclusion:Clinical pharmacists can assist doctors in improving the efficacy and safety of drug treatment

Risk factors of gastrointestinal bleeding with dabigatran etexilate for stroke prevention in atrial fibrillation patients and its preventive strategies

新型口服直接凝血酶抑制剂达比加群酯预防卒中疗效确切,但消化道出血风险不容小视。本文结合近5年达比加群酯用于预防心房颤动患者脑卒中时致消化道出血的临床随机试验和详细个案报道,对达比加群酯致消化道出血的可能危险因素、预防达比加群酯致消化道出血的措施等作一综述。临床医师应权衡应用达比加群酯的利弊,保证治疗的安全、有效。Dabigatran etexilate, a new direct thrombin inhibitor, has precise clinical curative effect on reducing the risk of stroke in patients with atrial fibrillation, but the risk for major gastrointestinal bleeding is significant. This paper reviewed risk factors and preventive strategies of gastrointestinal bleeding with dabigatran etexilate for stroke in atrial fibrillation patients according to randomized trials and case reports in recent five years. Clinician should balance the risk of bleeding with treatment outcome of dabigatran etexilate to ensure the effectiveness and safety of treatment

膦甲酸钠氯化钠注射液致四肢麻木1例

1病例资料患者女,59岁。于2016年7月19日因“反复关节肿痛10年余,发现外阴疱疹2天”入院。本次入院前2天发现右侧外阴、臀部、骶部疱疹,伴有刺痛。患者曾因“系统性红斑狼疮”多次在我院治疗,症状有缓解。院外多次复查白细胞偏低,长期口服升白细胞药物治疗。患者既往服用甲泼尼龙（40mg,qd）、羟氯喹（0.2 g,qd）和甲氨蝶呤（10 mg,qd）。否认食物、药物过敏史。无特殊家族史