1例妊娠期氯氮平暴露对母婴影响的药学监护

One Case of Pharmaceutical Care of Effect in Clozapine Exposure on Maternal and Infant During Pregnancy

目的探讨妊娠期氯氮平暴露对母婴影响的药学监护策略,为妊娠合并精神疾病患者药学监护提供参考。方法临床药师参与1例妊娠期氯氮平暴露的精神分裂症患者分娩前、分娩后及新生儿治疗的全过程,对妊娠期氯氮平暴露产生的妊娠并发症、分娩时药物治疗、母源性不良反应对新生儿治疗影响及分娩后药物治疗等方面协助临床进行特殊人群个体化用药监护。结果临床药师通过辅助决策协助医师进行预估监护治疗,患者分娩顺利,未出现病情复发,新生儿病情好转,未发生氯氮平暴露不良事件。结论临床药师参与妊娠期氯氮平暴露诊疗过程,评估药物治疗获益风险,保障了患者用药安全及医疗安全。

OBJECTIVE To explore the pharmaceutical care strategy of the effects of clozapine exposure during pregnancy on maternal and infant and to provide references for the pharmaceutical care of pregnant patients with schizophrenia.METHODS Clinical pharmacist participated in the whole process of treatment of a schizophrenic patient who was exposed to clozapine during pregnancy before delivery,after delivery and neonatal treatment and treated the complications of pregnancy caused by clozapine exposure during pregnancy,drug treatment during delivery,and the impact of maternal adverse reactions on neonatal treatment and post-delivery medications would assist the clinic in individualized medication monitoring for special populations.RESULTS The clinical pharmacist assisted the physician in the estimated monitoring and treatment by assisting decision-making.The patient delivered smoothly with no disease recurrence occurred,and the infant was discharged after the condition improved,and no clozapine exposure adverse events occurred.CONCLUSION Clinical pharmacists participate in the diagnosis and treatment process of clozapine exposure during pregnancy,assess the risk of drug treatment benefits and ensure the safety of patients’medication and medical safety.