中国药物警戒 ›› 2020, Vol. 17 ›› Issue (11): 838-840.
DOI: 10.19803/j.1672-8629.2020.11.20

• 安全与合理用药 • 上一篇    下一篇

注射用多粘菌素B致皮肤色素沉着1例分析

石云, 西娜*, 陈哲, 赵冠人   

  1. 解放军总医院第八医学中心药剂科,北京 100091
  • 收稿日期:2020-11-10 修回日期:2020-11-10 出版日期:2020-11-15 发布日期:2020-11-10
  • 通讯作者: *西娜,女,博士,主管药师,临床药学。E-mail:shiyun1985818@163.com
  • 作者简介:石云,女,本科,药师,临床药学。

Analysis of One Case of Skin Pigmentation Caused by Polymyxin B for Injection

SHI Yun, XI Na*, CHEN Zhe, ZHAO GuanRen   

  1. Department of Pharmacy, the 8th Medical Center Of Chinese PLA General Hospital, Beijing 100091, China
  • Received:2020-11-10 Revised:2020-11-10 Online:2020-11-15 Published:2020-11-10

摘要: 目的 探讨临床药师在参与多粘菌素B致皮肤色素沉着的诊断和药物治疗中的作用。方法 临床药师参与1例色素沉着患者的诊治过程,根据患者的病情变化,与临床医师共同协商讨论,分析患者出现不良反应的原因,提出药学建议,制定适宜的治疗方案。患者出院后临床药师进行随访,追踪病情转归。结果 医师在诊疗过程中采纳临床药师建议,皮肤色素沉着是由多粘菌素B所致,停用后症状未加重但皮肤颜色基线无变浅。结论 患者在使用多粘菌素B用药期间,一旦出现皮肤变黑,色素沉着,可以考虑为药品不良反应,临床医师和临床药师需权衡使用多粘菌素B的利弊来平衡疗效和不良事件。同时需谨慎考虑与其他可能导致皮肤样症状的药物合用。临床药师将药学专业技能优势和临床实践相结合,能够提高疾病确诊率、药物治疗水平及患者用药的安全性与有效性。

关键词: 皮肤色素沉着, 多粘菌素B, 不良反应, 肺炎克雷伯菌

Abstract: Objective To investigate the role of a clinical pharmacist in the diagnosis and treatment of skin pigmentation induced by polymyxin B. Methods A clinical pharmacist participated in the diagnosis and treatment of a patient with pigmentation. According to the changes of the patient's condition, the clinical pharmacist and the clinician consulted each other, analyzed the causes of the adverse reactions, raised pharmaceutical suggestions, and worked out an appropriate treatment plan. After discharge, the patient was followed up by the clinical pharmacist to track the prognosis. Results In the course of diagnosis and treatment, doctors adopted the advice of the clinical pharmacist that skin pigmentation was caused by polymyxin B. The symptoms did not aggravate after discontinuation, but the skin color base line remained unchanged. Conclusion When polymyxin B is used, the patient can take into account the adverse reactions caused by this drug, and the clinical physician and the clinical pharmacist need to weigh the advantages and disadvantages of using the polymyxin B to balance the efficacy and adverse events. At the same time, careful consideration should be given to the combination of other drugs that may lead to skin-like symptoms. Clinical pharmacists are expected to combine their expertise with clinical practice, improve the diagnosis of disease and the level of medication in order to ensure the safety of patients..

Key words: skin pigmentation, polymyxin B, adverse reactions, klebsiella pneumoniae

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