今日药学

2021, v.31(09) 713-715

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1例头孢哌酮钠舒巴坦钠致肝毒性的药学监护及不良反应分析
Pharmaceutical Care of Cefoperazone Sodium and Sulbactam Sodium-induced Hepatotoxicity and Analysis of Adverse Drug Reaction:A Case Report

杨金连;魏媛怡;邓后亮;梁倩莹;何艳玲;
YANG Jinlian;WEI Yuanyi;DENG Houliang;LIANG Qianying;HE Yanling;Department of Pharmacy,Guangzhou Women and Children's Medical Center;

摘要(Abstract):

目的探讨临床药师在头孢哌酮钠舒巴坦钠致儿童患者肝功能紊乱的药学监护作用,以及头孢哌酮钠舒巴坦钠致肝毒性的特点。方法临床药师参与1例头孢哌酮钠舒巴坦钠致儿童患者肝功能紊乱的保肝治疗,通过分析患者病情,查阅文献和临床指南,总结头孢哌酮钠舒巴坦钠致肝毒性的特点,协助医生判断头孢哌酮钠舒巴坦钠与患儿肝功能受损的相关性并制定保肝治疗方案。结果临床药师提出建议被临床采纳,通过及时停药,换用无肝毒性的抗菌药物以及合理的保肝治疗,患者病情痊愈,肝功能恢复,最后康复出院。另外,头孢哌酮钠舒巴坦钠致肝毒性可能存在以下特点:早期即可出现,肝功恢复周期短,肝功恢复周期可能与年龄相关。结论临床药师可以会诊的方式参与到临床治疗中,确保用药安全合理。头孢哌酮钠舒巴坦钠致患儿肝损伤的问题值得关注,早期发现、及时停药,对症处理,预后良好。
OBJECTIVE To explore the role of pharmacists in the pharmaceutical care of pediatric patients with liver dysfunction induced by cefoperazone sodium and sulbactam sodium, and the characteristics of hepatotoxicity caused by cefoperazone sodium and sulbactam sodium. METHODS Clinical pharmacists participated in the hepatoprotective treatment of a pediatric patient with hepatic dysfunction induced by cefoperazone sodium and sulbactam sodium. By analyzing the patient's condition and consulting literature, the characteristics of hepatotoxicity induced by cefoperazone sodium and sulbactam sodium were summarized. Moreover, pharmacists assisted the doctor to determine the relationship between cefoperazone sodium and sulbactam sodium and liver dysfunction, and to formulate the liver protection prescription. RESULTS The advices of clinical pharmacists were adopted by the doctor. The patient had a good prognosis and was discharged after liver function recovered by promptly stopping the drug, switching to non-hepatotoxic antibacterial drugs and reasonable liver protection treatment. According to the literatures, the hepatotoxicity caused by cefoperazone sodium and sulbactam sodium may have the following characteristics: early occurrence, short duration of liver function recovery, duration of liver function recovery maybe age-related. CONCLUSION Clinical pharmacists can participate in the clinical treatment through consultation to ensure safe and rational drug use. Liver dysfunction caused by cefoperazone sodium and sulbactam sodium is worthy of concentration. Early detection, timely discontinuation and symptomatic treatment will result in a good prognosis.

关键词(KeyWords): 头孢哌酮钠舒巴坦钠;肝毒性;药物不良反应;药学监护
cefoperazone sodium and sulbactam sodium;hepatotoxicity;adverse drug reaction;pharmaceutical care

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基金项目(Foundation): 广东省基础与应用基础研究基金项目(2020A1515110314)

作者(Author): 杨金连;魏媛怡;邓后亮;梁倩莹;何艳玲;
YANG Jinlian;WEI Yuanyi;DENG Houliang;LIANG Qianying;HE Yanling;Department of Pharmacy,Guangzhou Women and Children's Medical Center;

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