1例磺胺脱敏方案治疗干燥综合征合并卡氏肺孢子菌肺炎的药学监护

doi:10.19803/j.1672-8629.2022.06.21

中国药物警戒 ›› 2022, Vol. 19 ›› Issue (6): 680-683.
DOI: 10.19803/j.1672-8629.2022.06.21

1例磺胺脱敏方案治疗干燥综合征合并卡氏肺孢子菌肺炎的药学监护

刘蕾¹, 张会娟², 钱效森², 孙瑞芳^1,*

¹民航总医院药剂科,北京 100123;
²民航总医院呼吸内科,北京 100123

收稿日期:2020-07-07 出版日期:2022-06-15 发布日期:2022-06-13
作者简介:刘蕾,女,硕士,副主任药师,药事管理与临床药学。E-mail：cpu_liulei@163.com
基金资助:
民航医学中心（民航总医院）科研基金资助项目（201927）

One case of pharmaceutical care during sulfanilamide desensitization treatment of sjogren's syndrome with pneumocystis carinii pneumonia

LIU Lei¹, ZHANG Huijuan², QIAN Xiaosen², SUN Ruifang^1,*

¹Department of Pharmacy, Civil Aviation General Hospital, Beijing 100123, China;
²Department of Respiratory Medicine, Civil Aviation General Hospital, Beijing 100123, China

Received:2020-07-07 Online:2022-06-15 Published:2022-06-13

摘要/Abstract

摘要： 目的探讨临床药师在干燥综合征合并卡氏肺孢子菌肺炎药物治疗中提供药学监护的方法和作用。方法临床药师参与1例干燥综合征合并卡氏肺孢子菌肺炎并有磺胺过敏史患者的药物治疗,面临替代药物不可获得或价格高昂时,建议临床采取磺胺脱敏方案治疗,并根据指南推荐用法设计了可行的磺胺脱敏试验实施步骤,与主治医师共同实施脱敏方案,同时对患者进行个体化的药学监护,从而保证疗效、避免药品不良反应发生。结果医师采纳临床药师建议,患者磺胺脱敏试验成功并顺利完成21 d治疗,患者肺内病灶基本吸收,感染得到控制。结论临床药师通过药学监护,优化患者的用药方案,及时帮助临床调整剂量,促进临床合理用药,提高了药物临床治疗的有效性和安全性,为患者节省了治疗费用。

关键词: 干燥综合征, 卡氏肺孢子菌肺炎, 磺胺, 脱敏试验, 药学监护

Abstract: Objective To explore the role of clinical pharmacists in pharmaceutical care of a patient with Sjogren's syndrome complicated with pneumocystis carinii pneumonia. Methods Clinical pharmacists participated in the treatment of a patient with Sjogren's syndrome complicated with Pneumocystis carinii pneumonia. Due to the patient's history of sulfanilamide allergy, the lack of alternative drugs and high cost, the pharmacists suggested trying the sulfanilamide desensitization test. According to the usage recommended by the guidelines, the feasible steps of the sulfanilamide desensitization test were designed, and the desensitization program was carried out with the attending physician. At the same time, individualized pharmaceutical care was provided to ensure the efficacy and to prevent adverse reactions. Results Physicians took the advice of clinical pharmacists and the sulfanilamide desensitization test was a success. After 21 days of treatment, the lung abnormal lesion was absorbed basically and infection was brought under control. Conclusion Clinical pharmacists can optimize the therapy plan of patients through pharmaceutical care to promote rational drug use in clinic, improve the effectiveness and safety of clinical treatment, and reduce the health care cost for patients.

Key words: Sjogren's syndrome, pneumocystis carinii pneumonia, sulfanilamide desensitization test, pharmaceutical care

中图分类号:

R994.11

刘蕾, 张会娟, 钱效森, 孙瑞芳. 1例磺胺脱敏方案治疗干燥综合征合并卡氏肺孢子菌肺炎的药学监护[J]. 中国药物警戒, 2022, 19(6): 680-683.

LIU Lei, ZHANG Huijuan, QIAN Xiaosen, SUN Ruifang. One case of pharmaceutical care during sulfanilamide desensitization treatment of sjogren's syndrome with pneumocystis carinii pneumonia[J]. Chinese Journal of Pharmacovigilance, 2022, 19(6): 680-683.

参考文献

[1] TAO Q, LIANG PS.Evolution of diagnostic criteria for Sjögren's syndrome[J]. J Prev Treat Stom Dis(口腔疾病防治), 2019, 27(5): 273-278.
[2] HUANG MJ, WANG JC, SUN L, et al.Sjgren's syndrome compl-icated by pneumocystis pneumonia: a case report and literature review[J]. Journal of Tropical Medicine(热带医学杂志), 2010, 10(10): 1193-1195.
[3] SUN GL, LI LJ, ZHANG L, et al.Prognostic risk factors of pneumocystis pneumoniae with long-term glucocorticoid users[J]. Chin J Pract Intern Med(中国实用内科杂志), 2018, 38(10): 945-948.
[4] HE XQ, SHEN YZ.Research progress in the diagnosis and treatment of Pneumocystis pneumonia[J]. Chin J Mycol(中国真菌学杂志), 2018, 13(4): 247-251.
[5] KIM T, HONG HL, LEE YM, et al.Is caspofungin really an effective treatment for Pneumocystis jirovecii pneumonia in immunocompromised patients without human immunodeficiency virus infection? Experiences at a single center and a literature review[J]. Scandinavian Journal of Infectious Diseases, 2013, 45(6): 484-488.
[6] XU LT, LI HH, ZHANG JH, et al.Advances in research on medicine therapy in treating Pneumocystis carinii pneumonia[J]. Journal of Lanzhou University(Medical Sciences)[兰州大学学报(医学版)], 2017, 43(2): 66-70.
[7] CHEN XQ, JIN YY, TANG G.Newly edited pharmacology(新编药物学)[M]. 18th Ed.Beijing: People's Medical Publishing House,2018.
[8] DORN JM, ALPERN M, MCNULTY C, et al.Sulfonamide drug allergy[J]. Curr Allergy Asthma Rep, 2018, 18(2): 38.
[9] LI DK, SENG RY.Therapeutic Guidelines: Antibiotic[M]. 15th Ed.Beijing: Chemical Industry Publishers, 2018.
[10] JOSEPH B, PRYOR AJ, OLYAEI DK, et al.Sulfonamide desensit-ization in solid organ transplant recipients: a protocol-driven approach during the index transplant hospitalization[J]. Transpl Infect Dis, 2019(21): e13191.
[11] YUAN L, QIU XH, ZHAO TT, et al.Analysis of glucocorticoid applic-ation in a case of non- HIV complicated with severe pneumocystis pneumonia[J]. Chinese Journal of Clinical Rational Drug Use(临床合理用药杂志), 2019, 12(6A): 162-163.
[12] WANG J, MENG XM, DONG P.Analysis of adverse drug reactions during therapy in 186 AIDS patients in our hospital[J]. Chinese Journal of Pharmacovigilance(中国药物警戒), 2019, 16(6): 364-373.
[13] CHANG HM, TSAI HC, LEE SS, et al.High daily doses of trimet-hoprim/ sulfamethoxazole are an independent risk factor for adverse reactions in patients with Pneumocystis pneumonia and AIDS[J]. J Chin Med Assoc, 2016, 79(6): 314-323.
[14] MA XJ, XU YC, LIU ZY.Diagnosis and Treatment of Infectious Diseases(传染病的诊断和治疗)[M]. 2nd ed. Beijing: Scientific and Technical Docume-ntation Press, 2016.
[15] MASCHMEYER G, HELWEG LARSEN J, PAGANO L, et al.ECIL guidelines for treatment of Pneumocystis jirovecii pneumonia in non-HIV-infected haematology patients[J]. J Antimicrob Chemother, 2016, 71(9): 2405-2413.
[16] MILLER RF, HUANG L, WALZER PD.Pneumocystis pneumonia associated with human immuno deficiency virus[J]. Clin Chest Med, 2013, 34(2): 229-241.
[17] KAPLAN JE, BENSON C, HOLMES KK, et al. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health,the HIV Medicine Association of the Infectious Diseases Society of America[J]. MMWR Recomm Rep, 2009, 58(RR-4): 1-207, E1-E4.

1例磺胺脱敏方案治疗干燥综合征合并卡氏肺孢子菌肺炎的药学监护

One case of pharmaceutical care during sulfanilamide desensitization treatment of sjogren's syndrome with pneumocystis carinii pneumonia

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	张夏兰, 袁静, 吴斌, 秦媛媛. 甲磺酸阿帕替尼在恶性肿瘤患者的用药特征分析[J]. 中国药物警戒, 2023, 20(8): 927-932.
[2]	王然, 李轶凡, 刘小艳, 冯欣. 1例妊娠期药物暴露风险的药学监护[J]. 中国药物警戒, 2023, 20(8): 933-934.
[3]	刘婧, 夏亮, 张世杰. 1例多元药物过敏急性胰腺炎患者行药物激发试验的药学监护[J]. 中国药物警戒, 2023, 20(7): 822-824.
[4]	杨岩, 周德喜, 吴欣俐, 薛淑雅, 丁海华, 张泉, 张云玲. 84例新型抗肿瘤药品不良反应报告分析[J]. 中国药物警戒, 2023, 20(3): 334-338.
[5]	姚鑫, 葛秋格, 李亚敏, 王一帆, 李媛媛, 刘志强. 2018~2022年某院新型抗肿瘤药物消化系统不良反应分析[J]. 中国药物警戒, 2023, 20(11): 1273-1278.
[6]	郑金凤, 王景红. 1例多药联用致室性心律失常的药学监护[J]. 中国药物警戒, 2023, 20(11): 1279-1281.
[7]	苏甦, 伍诗琪, 张青霞, 闫素英. 1例吲达帕胺致粒细胞缺乏症患者的药学监护[J]. 中国药物警戒, 2023, 20(11): 1282-1285.
[8]	王燕婷, 张媛媛, 陈怡然, 孙捷, 朱宇, 杨荔艳, 吴知桂, 申丽君, 程敏, 李国辉. 1例恶性肿瘤患者抗感染与抗肿瘤治疗的平衡抉择及药学监护[J]. 中国药物警戒, 2023, 20(10): 1168-1172.
[9]	王祺茹, 左丽, 杜琼, 叶玲, 阮聪, 翟青, 徐蕊. 1例奥拉帕利致Ⅳ度骨髓抑制患者的药学监护[J]. 中国药物警戒, 2023, 20(10): 1176-1180.
[10]	孙雪林, 张攀, 胡欣. 1例维得利珠单抗治疗重症溃疡性结肠炎的药学监护[J]. 中国药物警戒, 2022, 19(7): 782-785.
[11]	唐静雅. 临床药师参与1例肠外营养相关性肝损伤治疗的药学监护[J]. 中国药物警戒, 2022, 19(7): 786-788.
[12]	李雁铭, 赵志刚. 基于循证的伊布替尼不良反应及药学监护[J]. 中国药物警戒, 2022, 19(7): 807-811.
[13]	周鹏, 杨晶晶. 3种清热解毒类中药注射剂的药学监护[J]. 中国药物警戒, 2022, 19(4): 441-445.
[14]	杜婧,李永辉,阎纳新,郭立杰,刘洋. 1例哌拉西林他唑巴坦治疗肺脓肿患者致药物热及横纹肌溶解症药学监护[J]. 中国药物警戒, 2022, 19(4): 450-452.
[15]	唐彦, 王嘉麟, 周婧雅, 赵维纲, 杜博冉, 胡丹丹, 杨丽萍, 杨莹莹, 赵喆, 袁涛. 1例胰岛素过敏合并胰岛素自身抗体阳性的暴发性1型糖尿病患者的药学监护[J]. 中国药物警戒, 2022, 19(12): 1376-1379.