中国药物警戒 ›› 2025, Vol. 22 ›› Issue (10): 1159-1161.
DOI: 10.19803/j.1672-8629.20250125

• 安全与合理用药 • 上一篇    下一篇

1例两性霉素B胆固醇硫酸酯复合物致老年肺毛霉菌病患者低钾血症的药学监护

李冰1, 刘朔2,*   

  1. 1辽宁省金秋医院,辽宁省老年病医院药学部,辽宁 沈阳 110016;
    2辽宁省金秋医院,辽宁省老年病医院呼吸与危重症医学科,辽宁 沈阳 110016
  • 收稿日期:2025-02-28 出版日期:2025-10-15 发布日期:2025-10-20
  • 通讯作者: *刘朔,女,博士,主任医师,呼吸系统疾病研究。E-mail: cmu4hliushuo@126.com
  • 作者简介:李冰,女,硕士,副主任药师,临床药学。
  • 基金资助:
    中国药学会科技开发中心科普项目（CMEI2024KPYJ00177）

Pharmaceutical Care to a Hypokalemia Elderly Patient with Pulmonary Mucormycosis Induced by Amphotericin B Cholesteryl Sulfate Complex

LI Bing1, LIU Shuo2,*   

  1. 1Department of Pharmacy, Liaoning Jinqiu Hospital, Liaoning Provincial Geriatric Hospital, Shenyang Liaoning 110016, China;
    2Department of Respiratory and Critical Care Medicine, Liaoning Jinqiu Hospital, Liaoning Provincial Geriatric Hospital, Shenyang Liaoning 110016, China
  • Received:2025-02-28 Online:2025-10-15 Published:2025-10-20

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摘要： 目的 分析药师参与1例伴有基础低钾血症老年肺毛霉菌病患者予静脉泵入联合雾化两性霉素B胆固醇硫酸酯复合物（ABCD）治疗出现严重低钾血症的药学实践,为临床安全用药提供参考。方法 临床药师在1例基础低血钾状态因使用ABCD治疗肺毛霉菌病而导致血钾进一步下降的老年患者药学监护过程中,分析应用ABCD用法用量的合理性,探究再次发生低钾血症的原因,计算补钾所需的剂量,并对纠正血钾方案进行调整。结果 在临床药师的协助下,患者全身和局部应用ABCD治疗肺毛霉菌病并针对低钾血症状态通过口服和静脉途径补充血钾进行治疗。经过积极抗真菌药物治疗,患者病情稳定,复查真菌检测为阴性,同时血钾得到及时的纠正。结论 临床药师对老年患者个体化多途径应用ABCD治疗肺毛霉菌病的合理性进行分析,对ABCD所致低钾血症的不良反应有敏感的辨识能力,辅助医师提供科学的补钾方案,有效减少药品不良反应同时达到良好的治疗效果。

关键词: 两性霉素B胆固醇硫酸酯复合物, 老年患者, 肺毛霉菌病, 低钾血症, 药学监护

Abstract: Objective To analyze the pharmaceutical care given by a clinical pharmacist for an elderly patient with pulmonary mucormycosis who developed severe hypokalemia in order to provide references for safe clinical use. Methods A clinical pharmacist was involved in the pharmaceutical care for a patient who had underlying hypokalemia and experienced more decline in serum potassium levels during ABCD treatment for pulmonary mucormycosis. During the pharmaceutical care, the pharmacist assessed the rationality of the ABCD dosage and administration route, investigated the causes of recurrent hypokalemia, calculated the required potassium supplementation dose, and adjusted the potassium correction regimen. Results With the help of the clinical pharmacist, the patient received systemic and local ABCD treatment for pulmonary mucormycosis, along with oral and intravenous potassium supplementation to address hypokalemia. Following active antifungal therapy, the patient's condition stabilized, with negative results on follow-up fungal tests, and serum potassium levels were promptly corrected. Conclusion The clinical pharmacist has played a proactive role in the geriatric treatment team by analyzing the rationality of individualized, multi-route ABCD administration for pulmonary mucormycosis in elderly patients. The pharmacist has showed a keen ability to identify adverse reactions associated with ABCD-induced hypokalemia and assisted physicians in formulating scientific potassium supplementation regimens, effectively reducing adverse drug reactions while achieving favorable therapeutic outcomes.

Key words: Amphotericin B Cholesteryl Sulfate Complex, Elderly Patients, Pulmonary Mucormycosis, Hypokalemia, Pharmaceutical Care

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