期刊文献+

临床药师参与1例脑梗死后出血转化患者的药学监护 预览

Pharmaceutical care on a patient with hemorrhagic transformation after cerebral infarction
在线阅读 下载PDF
收藏 分享 导出
摘要 1例67岁男性患者,因1h前突发言语含糊、口角歪斜入院,入院后给予阿替普酶50mg溶栓治疗,发生症状性出血转化,在住院期间并发肺部感染。临床药师从血压控制、溶栓、抗血小板药物调整、活血类中药注射剂及抗菌药物使用等方面提供合理化建议。患者梗死急性期血压维持在125~130/70mmHg,临床药师建议降低甘露醇用量以增加脑部血液供应;中药注射剂与抗血小板联用出血风险增加,临床药师遂建议停用血栓通和丁苯酞;同时,建议将出血风险较大的头孢哌酮舒巴坦换用为头孢他啶(2g,q12h)行抗感染治疗。经过积极治疗干预,患者出血停止,感染得到有效控制,神志清楚,肌力较前明显恢复。 A 67-year-old male patient was hospitalized with sudden vague speech and skewed corners of mouth for an hour. After hospitalization, the patient was treated with alteplase 50 mg for thrombolytic therapy, and developed symptomatic hemorrhage transformation and subsequent pulmonary infection. Clinical pharmacists provided rationalization suggestions on blood pressure control, adjustment of antiplatelet drugs, use of traditional Chinese medicine injections and antimicrobials, etc. Considering that the blood pressure of the patients was maintained at 125–130/70 mm Hg in acute phase of cerebral infarction, pharmacist suggested reducing the dosage of mannitol injection in order to increase the brain blood supply. Xueshuantong injection and butylphthalide injection was suggested to stop because of the increased risk of bleeding in combination with antiplatelet drugs and traditional Chinese medicine. Because of the high bleeding risk of cefoperazone and sulbactam, it was replaced by ceftazidime according to the suggestion of clinical pharmacist. After active treatment, bleeding was stopped and infection was controlled. The patient had a clear mind and obviously recovered muscle strength.
作者 向道春 周庆 刘珏 王奕 邓艾平 XIANG Dao-chun;ZHOU Qing;LIU Jue;WANG Yi;DENG Ai-ping(Department of Pharmacy,the Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China)
出处 《中国药物应用与监测》 CAS 2019年第5期271-274,共4页 Chinese Journal of Drug Application and Monitoring
基金 国家自然科学基金青年项目(81502943).
关键词 脑梗死 出血转化 肺部感染 药学监护 Cerebral infarction Hemorrhagic transformation Pulmonary infection Pharmaceutical care
作者简介 向道春,女,主管药师,主要从事临床药学与药代动力学相关工。E-mailxiangdaochun@126.com;通信作者:邓艾平,女,主任药师,主要从事临床药学与医院药事管理工。E-mail1986818536@qq.com.
  • 相关文献

参考文献14

二级参考文献113

共引文献329

投稿分析

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈
新型冠状病毒肺炎防控与诊疗专栏