狼疮性肾炎患儿他克莫司联合伏立康唑的个体化药学监护

Individualized Pharmaceutical Care of Tacrolimus Combined with Voriconazole for Children with Lupus Nephritis

目的:探讨CYP3A5基因型和伏立康唑对他克莫司用药剂量的影响。方法:临床药师通过对1例狼疮性肾炎患儿进行药学监护,根据CYP3A5基因型对他克莫司初始用药剂量进行估算,联用伏立康唑后,对他克莫司用药剂量进行调整。结果:临床药师通过药学监护,给予个体化的用药建议,提高了患儿用药的安全性和有效性。结论:临床药师在临床个体化给药方案的制定中发挥着积极的作用。

Objective： To probe into the effects of CYP3 A5 genotype and voriconazole on the dosage of tacrolimus. Methods： Clinical pharmacists provided pharmaceutical care for a child with lupus nephritis,and estimated the initial dosage of tacrolimus according to CYP3 A5 genotype. After the drug combination of voriconazole, the dosage of tacrolimus was adjusted. Results： Through the pharmaceutical care,individualized medication recommendations were given to improve the safety and effectiveness of the medication.Conclusion： Clinical pharmacists play an active role in the formulation of individualized clinical dosage regimens.